@phdthesis{Lin2021,
  author    = {Lin, Chiao-I},
  title     = {The survey of the prevalence of chronic ankle instability in elite Taiwanese basketball athletes},
  doi       = {10.25932/publishup-53553},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-535534},
  school      = {Universit{\"a}t Potsdam},
  pages     = {xi, 128},
  year      = {2021},
  abstract  = {BACKGROUND: Ankle sprains are common in basketball. It could develop into Chronic Ankle Instability (CAI) causing decreased quality of life, functional performance, early osteoarthritis, and increased risk of other injuries. To develop a strategy of CAI prevention, localized epidemiology data and a valid/reliable tool are essential. However, the epidemiological data of CAI is not conclusive from previous studies and the prevalence of CAI in Taiwanese basketball athletes are not clear. In addition, a valid and reliable tool among the Taiwan-Chinese version to evaluate ankle instability is missing. PURPOSE: The aims were to have an overview of the prevalence of CAI in sports population using a systematic review, to develop a valid and reliable cross-cultural adapted Cumberland Ankle Instability Tool Questionnaire (CAIT) in Taiwan-Chinese (CAIT-TW), and to survey the prevalence of CAI in elite basketball athletes in Taiwan using CAIT-TW. METHODS: Firstly, a systematic search was conducted. Research articles applying CAI related questionnaires in order to survey the prevalence of CAI were included in the review. Second, the English version of CAIT was translated and cross-culturally adapted into the CAIT-TW. The construct validity, test-retest reliability, internal consistency, and cutoff score of CAIT-TW were evaluated in an athletic population (N=135). Finally, the cross-sectional data of CAI prevalence in 388 elite Taiwanese basketball athletes were presented. Demographics, presence of CAI, and difference of prevalence between gender, different competitive levels and play positions were evaluated. RESULTS: The prevalence of CAI was 25\%, ranging between 7\% and 53\%. The prevalence of CAI among participants with a history of ankle sprains was 46\%, ranging between 9\% and 76\%. In addition, the cross-cultural adapted CAIT-TW showed a moderate to strong construct validity, an excellent test-retest reliability, a good internal consistency, and a cutoff score of 21.5 for the Taiwanese athletic population. Finally, 26\% of Taiwanese basketball athletes had unilateral CAI while 50\% of them had bilateral CAI. In addition, women athletes in the investigated cohort had a higher prevalence of CAI than men. There was no difference in prevalence between competitive levels and among play positions. CONCLUSION: The systematic review shows that the prevalence of CAI has a wide range among included studies. This could be due to the different exclusion criteria, age, sports discipline, or other factors among the included studies. For future studies, standardized criteria to investigate the epidemiology of CAI are required. The CAI epidemiological study should be prospective. Factors affecting the prevalence of CAI ability should be investigated and described. The translated CAIT-TW is a valid and reliable tool to differentiate between stable and unstable ankles in athletes and may further apply for research or daily practice in Taiwan. In the Taiwanese basketball population, CAI is highly prevalent. This might relate to the research method, preexisting ankle instability, and training-related issues. Women showed a higher prevalence of CAI than men. When applying the preventive measure, gender should be taken into consideration.},
  language  = {en}
}
@phdthesis{Gebel2021,
  author    = {Gebel, Arnd},
  title     = {Postural control in youth: From performance to neural correlates},
  doi       = {10.25932/publishup-53303},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-533034},
  school      = {Universit{\"a}t Potsdam},
  pages     = {x, 121},
  year      = {2021},
  abstract  = {Background and objectives: The intricate interdependencies between the musculoskeletal and neural systems build the foundation for postural control in humans, which is a prerequisite for successful performance of daily and sports-specific activities. Balance training (BT) is a well-established training method to improve postural control and its components (i.e., static/dynamic steady-state, reactive, proactive balance). The effects of BT have been studied in adult and youth populations, but were systematically and comprehensively assessed only in young and old adults. Additionally, when taking a closer look at established recommendations for BT modalities (e.g., training period, frequency, volume), standardized means to assess and control the progressive increase in exercise intensity are missing. Considering that postural control is primarily neuronally driven, intensity is not easy to quantify. In this context, a measure of balance task difficulty (BTD) appears to be an auspicious alternative as a training modality to monitor BT and control training progression. However, it remains unclear how a systematic increase in BTD affects balance performance and neurophysiological outcomes. Therefore, the primary objectives of the present thesis were to systematically and comprehensively assess the effects of BT on balance performance in healthy youth and establish dose-response relationships for an adolescent population. Additionally, this thesis aimed to investigate the effects of a graded increase in BTD on balance performance (i.e., postural sway) and neurophysiological outcomes (i.e, leg muscle activity, leg muscle coactivation, cortical activity) in adolescents. Methods: Initially, a systematic review and meta-analysis on the effects of BT on balance performance in youth was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guidelines. Following this complementary analysis, thirteen healthy adolescents (3 female/ 10 male) aged 16-17 years were enrolled for two cross-sectional studies. The participants executed bipedal balance tasks on a multidirectional balance board that allowed six gradually increasing levels of BTD by narrowing the balance boards' base of support. During task performance, two pressure sensitive mats fixed on the balance board recorded postural sway. Leg muscle activity and leg muscle coactivation were assessed via electromyography while electroencephalography was used to monitor cortical activity. Results: Findings from the systematic review and meta-analysis indicated moderate-to-large effects of BT on static and dynamic balance performance in youth (static: weighted mean standardized mean differences [SMDwm] = 0.71; dynamic: SMDwm = 1.03). In adolescents, training-induced effects were moderate and large for static (SMDwm = 0.61) and dynamic (SMDwm = 0.86) balance performance, respectively. Independently (i.e. modality-specific) calculated dose-response relationships identified a training period of 12 weeks, a frequency of two training sessions per week, a total of 24-36 sessions, a duration of 4-15 minutes, and a total duration of 31-60 minutes as the training modalities with the largest effect on overall balance performance in adolescents. However, the implemented meta-regression indicated that none of these training modalities (R² = 0\%) could predict the observed performance-increasing effects of BT. Results from the first cross-sectional study revealed that a gradually increasing level of BTD caused increases in postural sway (p < 0.001; d = 6.36), higher leg muscle activity (p < 0.001; 2.19 < d < 4.88), and higher leg muscle coactivation (p < 0.001; 1.32 < d < 1.41). Increases in postural sway and leg muscle activity were mainly observed during low and high levels of task difficulty during continuous performance of the respective balance task. Results from the second cross-sectional study indicated frequency-specific increases/decreases in cortical activity of different brain areas (p < 0.005; 0.92 < d < 1.80) as a function of BTD. Higher cortical activity within the theta frequency band in the frontal and central right brain areas was observed with increasing postural demands. Concomitantly, activity in the alpha-2 frequency band was attenuated in parietal brain areas. Conclusion: BT is an effective method to increase static and dynamic balance performance and, thus, improve postural control in healthy youth populations. However, none of the reported training modalities (i.e., training period, frequency, volume) could explain the effects on balance performance. Furthermore, a gradually increasing level of task difficulty resulted in increases in postural sway, leg muscle activity, and coactivation. Frequency and brain area-specific increases/decreases in cortical activity emphasize the involvement of frontoparietal brain areas in regulatory processes of postural control dependent on BTD. Overall, it appears that increasing BTD can be easily accomplished by narrowing the base of support. Since valid methods to assess and quantify BT intensity do not exist, increasing BTD appears to be a very useful candidate to implement and monitor progression in BT programs in healthy adolescents.},
  language  = {en}
}
@phdthesis{Risch2021,
  author    = {Risch, Lucie},
  title     = {Acute effect of exercise on sonographic detectable achilles tendon blood flow},
  school      = {Universit{\"a}t Potsdam},
  year      = {2021},
  language  = {en}
}
@phdthesis{Wochatz2021,
  author    = {Wochatz, Monique},
  title     = {Influence of different loading conditions on scapular movement and scapular muscle activation patterns},
  school      = {Universit{\"a}t Potsdam},
  pages     = {iv, 129, xiv},
  year      = {2021},
  abstract  = {The scapula plays a significant role in efficient shoulder movement. Thus, alterations from typical scapular motion during upper limb movements are thought to be associated with shoulder pathologies. However, a clear understanding of the relationship is not yet obtained.. Scapular alterations may only represent physiological variability as their occurrence can appear equally as frequent in individuals with and without shoulder disorders. Evaluation of scapular motion during increased load might be a beneficial approach to detect clinically relevant alterations. However, functional motion adaptations in response to maximum effort upper extremity loading has not been established yet. Therefore, the overall purpose of this research project was to give further insight in physiological adaptations of scapular kinematics and their underlying scapular muscle activity in response to high demanding shoulder movements in healthy asymptomatic individuals. Prior to the investigation of the effect of various load situation, the reproducibility of scapular kinematics and scapular muscle activity were evaluated under maximum effort arm movements. Healthy asymptomatic adults performed unloaded and maximal loaded concentric and eccentric isokinetic shoulder flexion and extension movements in the scapular plane while scapular kinematics and scapular muscle activity were simultaneously assessed. A 3D motion capture system (infra-red cameras \& reflective markers) was utilized to track scapular and humerus motion in relation to the thorax. 3D scapular position angles were given for arm raising and lowering between humerus positions of 20° and 120° flexion. To further characterize the scapular pattern, the scapular motion extent and scapulohumeral rhythm (ratio of scapular and humerus motion extent) were determined. Muscle activity of the upper and lower trapezius and the serratus anterior were assessed with surface electromyography. Amplitudes were calculated for the whole ROM and four equidistant movement phases. Reliability was characterized by overall moderate to good reproducibility across the load conditions. Irrespective of applied load, scapular kinematics followed a motion pattern of continuous upward rotation, posterior tilt and external rotation during arm elevation and a continuous downward rotation, anterior tilt and internal rotation during arm lowering. However, kinematics were altered between maximal loaded and unloaded conditions showing increased upward rotation, reduced posterior tilt and external rotation. Further, the scapulohumeral rhythm was decreased and scapular motion extent increased under maximal loaded movements. Muscle activity during maximum effort were of greater magnitude and differed in their pattern in comparison to the continuous increase and decrease of activity during unloaded shoulder flexion and extension. Relationships between scapular kinematics and their underlying scapular muscle activity could only be identified for a few isolated combinations, whereas the majority showed no associations. Scapular kinematics and scapular muscle activity pattern alter according to the applied load. Alterations between the load conditions comply in magnitude and partially in direction with differences seen between symptomatic and asymptomatic individuals. Even though long-term effects of identified adaptations in response to maximum load are so far unclear, deviations from typical scapular motion or muscle activation should not per se be seen as indicators of shoulder impairment. However, evaluation of alterations in scapular motion and activation in response to maximum effort may have the potential to identify individuals that are unable to cope with increased upper limb demands. Findings further challenge the understanding of scapular motion and stabilization by the trapezius and serratus anterior muscles, as clear relationships between the underlying scapular muscle activity and scapular kinematics were neither observed during unloaded nor maximal loaded shoulder movements.},
  language  = {en}
}
@phdthesis{Hadzic2021,
  author    = {Hadzic, Miralem},
  title     = {Erfassung des funktionellen und nutritiven Status hochbetagter Patienten in der kardiologischen Rehabilitation},
  doi       = {10.25932/publishup-50680},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-506806},
  school      = {Universit{\"a}t Potsdam},
  pages     = {XIII, 48, XXXI},
  year      = {2021},
  abstract  = {Einleitung {\"A}ltere Patienten mit Herzklappenerkrankungen werden zunehmend h{\"a}ufig mit der kathetergest{\"u}tzten Aortenklappenimplantation (Transcatheter Aortic Valve Implantation, TAVI) oder dem MitraClip®-Verfahren behandelt. In der kardiologischen Rehabilitation nimmt infolgedessen die Patientenpopulation der Hochbetagten stetig zu. Die funktionale Gesundheit dieser Patienten wird durch h{\"a}ufig auftretende, sogenannte geriatrische Syndrome wie Multimorbidit{\"a}t, Mangelern{\"a}hrung, Gebrechlichkeit oder Sturzereignisse beeinflusst. Insbesondere die eingeschr{\"a}nkte Mobilit{\"a}t und Mangelern{\"a}hrung sind wichtige Pr{\"a}diktoren f{\"u}r die Prognose der Patienten nach TAVI. Etablierte Verfahren, um die k{\"o}rperliche Leistungsf{\"a}higkeit von kardiologischen Rehabilitanden zu beurteilen, sind die Belastungsergometrie und der 6-Minuten-Gehtest. Allerdings ist nahezu die H{\"a}lfte der hochbetagten Patienten nicht in der Lage, eine Belastungsergometrie durchzuf{\"u}hren. Bislang erfolgt in der kardiologischen Rehabilitation keine differenzierte Erfassung des funktionellen Status hinsichtlich Mobilit{\"a}t, Kraft und Gleichgewicht, um die geriatrischen Syndrome individuell zu beurteilen. Dar{\"u}ber hinaus werden keine Assessments zur Erfassung des Ern{\"a}hrungsstatus eingesetzt. Daher war es das Ziel der vorliegenden Arbeit, die Auspr{\"a}gung des funktionellen und nutritiven Status {\"a}lterer Patienten anhand geeigneter Assessments in der kardiologischen Rehabilitation zu ermitteln. Methode Zwischen Oktober 2018 und Juni 2019 nahmen Patienten im Alter von 75 Jahren oder {\"a}lter nach TAVI, atrioventrikul{\"a}rer Intervention mittels MitraClip®-Verfahren (AVI) oder perkutaner Koronarintervention (PCI) an der Studie teil. Zu Beginn der kardiologischen Rehabilitation wurden soziodemografische Daten, echokardiografische Parameter (z. B. links und rechtsventrikul{\"a}re Ejektionsfraktion, Herzrhythmus) und Komorbidit{\"a}ten (z. B. Diabetes mellitus, Niereninsuffizienz, orthop{\"a}dische Erkrankungen) erhoben, um die Patientenpopulation zu beschreiben. Zus{\"a}tzlich wurde die Gebrechlichkeit der Rehabilitanden mit dem Index von Stortecky et al., bestehend aus den Komponenten Kognition, Mobilit{\"a}t, Ern{\"a}hrung und Aktivit{\"a}ten des t{\"a}glichen Lebens, beurteilt. Der 6-Minuten-Gehtest diente zur Ermittlung der k{\"o}rperlichen Leistungsf{\"a}higkeit der Patienten. Die Mobilit{\"a}t wurde mit Hilfe des Timed-Up-and-Go-Tests, die Ganggeschwindigkeit mit dem Gait Speed Test und die Handkraft mit dem Hand Grip Test erfasst. F{\"u}r die Objektivierung des Gleichgewichts wurde eine Kraftmessplatte (uni- und bipedaler Stand mit ge{\"o}ffneten und geschlossenen Augen) erprobt, die bislang bei {\"a}lteren Rehabilitanden noch nicht eingesetzt wurde. Der Ern{\"a}hrungsstatus wurde mit dem Mini Nutritional Assessment-Short Form und den ern{\"a}hrungsbezogenen Laborparametern (H{\"a}moglobin, Serumalbumin, Eiweißkonzentration) erfasst. Die Eignung der Assessments bewerteten wir anhand folgender Kriterien: Durchf{\"u}hrbarkeit (bei ≥ 95 \% der Patienten durchf{\"u}hrbar), Sicherheit (< 95 \% St{\"u}rze oder andere unerw{\"u}nschte Ereignisse) und der Pearson-Korrelationen zwischen den funktionellen Tests und dem Goldstandard 6-Minuten-Gehtest sowie den Laborparametern und dem Mini Nutritional Assessment-Short Form. Ergebnisse Es wurden 124 Patienten (82 ± 4 Jahre, 48 \% Frauen, 5 ± 2 Komorbidit{\"a}ten, 9 ± 3 Medikamente) nach TAVI (n = 59), AVI (n = 21) und PCI (n = 44) konsekutiv in die Studie eingeschlossen. Etwa zwei Drittel aller Patienten der Gesamtpopulation waren als gebrechlich zu klassifizieren, bei einer mittleren Punktzahl von 2,9 ± 1,4. Ann{\"a}hernd die H{\"a}lfte der Patienten zeigte eine eingeschr{\"a}nkte k{\"o}rperliche Leistungsf{\"a}higkeit aufgrund einer reduzierten 6-Minuten-Gehstrecke (48 \% < 350 m) sowie eine eingeschr{\"a}nkte Mobilit{\"a}t im Timed-Up-and-Go-Test (55 \% > 10 s). Es wurden eine mittlere Gehstrecke von 339 ± 131 m und eine durchschnittliche Zeit im Timed-Up-and-Go-Test von 11,4 ± 6,3 s erzielt. Dar{\"u}ber hinaus wies ein Viertel der Patienten eine eingeschr{\"a}nkte Ganggeschwindigkeit (< 0,8 m/s) auf und etwa 35 \% von Ihnen zeigten eine reduzierte Handkraft (Frauen/M{\"a}nner < 16/27 kg). Im Mittel wurde eine Geschwindigkeit von 1,0 ± 0,2 m/s im Gait Speed Test sowie eine Handkraft von 24 ± 9 kg im Hand Grip Test erreicht. Ein Risiko einer Mangelern{\"a}hrung konnte bei 38 \% (< 12 Punkte) der Patienten nachgewiesen werden bei einer mittleren Punktzahl von 11,8 ± 2,2 im Mini Nutritional Assessment-Short Form. Im Vergleich zwischen den einzelnen Subpopulationen bestanden keine statistisch signifikanten Unterschiede in den Ergebnissen der funktionellen Assessments. Bez{\"u}glich des Ern{\"a}hrungsstatus wiesen allerdings die Patienten nach AVI einen statistisch signifikant niedrigeren Punktewert im Mini Nutritional Assessment-Short Form (10,3 ± 3,0 Punkte) auf als die Patienten nach TAVI (12,0 ± 1,8 Punkte) und PCI (12,1 ± 2,1 Punkte), wobei etwa 57 \% der Patienten nach AVI, 38 \% nach TAVI und 50 \% nach PCI ein Risiko einer Mangelern{\"a}hrung zeigten. Mit Ausnahme der Tests auf der Kraftmessplatte waren alle Assessments durchf{\"u}hrbar und sicher. W{\"a}hrend 86 \% der Patienten den bipedalen Stand mit geschlossenen Augen auf der Kraftmessplatte durchf{\"u}hren konnten und damit nahezu den Grenzwert von 95 \% erreichten, war der unipedale Stand mit 12 \% an durchf{\"u}hrbaren Messungen weit von diesem entfernt. Der Gait Speed Test (r = 0,79), Timed-Up-and-Go-Test (r = 0,68) und Hand Grip Test (r = 0,33) korrelierten signifikant mit dem 6-Minuten-Gehtest, H{\"a}moglobin (r = 0,20) und Albumin (r = 0,24) korrelierten mit dem Mini Nutritional Assessment-Short Form. Schlussfolgerung {\"U}ber die bestehende Multimorbidit{\"a}t und Multimedikation hinaus wiesen die untersuchten Patienten vor allem eine eingeschr{\"a}nkte Mobilit{\"a}t und ein Risiko einer Mangelern{\"a}hrung auf, wobei die Subpopulation nach AVI besonders betroffen war. Um den Bed{\"u}rfnissen hochbetagter Rehabilitanden nach kathetergest{\"u}tzer Intervention gerecht zu werden, ist eine individuelle Behandlung der einzelnen Defizite erforderlich, mit besonderer Ber{\"u}cksichtigung der Komorbidit{\"a}ten sowie der geriatrischen Kofaktoren. Aufgrund des multidisziplin{\"a}ren Ansatzes erf{\"u}llt die kardiologische Rehabilitation bereits die Voraussetzung, hochbetagte Patienten bedarfsgerecht zu behandeln, jedoch mangelt es an Assessments, um die individuellen Defizite der Patienten zu identifizieren Der Gait Speed Test, der Timed-Up-and-Go-Test und der Hand Grip Test sollten daher in den klinischen Alltag der kardiologischen Rehabilitation implementiert werden, um die k{\"o}rperliche Funktion und Leistungsf{\"a}higkeit {\"a}lterer Patienten detailliert zu beurteilen. In Kombination dieser Assessments mit dem Mini Nutritional Assessment-Short Form k{\"o}nnen die individuellen funktionellen und nutritiven Bed{\"u}rfnisse der Patienten w{\"a}hrend der Rehabilitation erkannt und mit geeigneten Maßnahmen die weitere Ausbildung geriatrischer Syndrome gemindert werden.},
  language  = {de}
}