@article{CasselBaurHirschmuelleretal.2015,
  author    = {Cassel, Michael and Baur, Heiner and Hirschmueller, Anja and Carlsohn, Anja and Fr{\"o}hlich, Katja and Mayer, Frank},
  title     = {Prevalence of Achilles and patellar tendinopathy and their association to intratendinous changes in adolescent athletes},
  series = {Scandinavian journal of medicine \& science in sports},
  volume    = {25},
  journal   = {Scandinavian journal of medicine \& science in sports},
  number    = {3},
  publisher = {Wiley-Blackwell},
  address   = {Hoboken},
  issn      = {0905-7188},
  doi       = {10.1111/sms.12318},
  pages     = {e310 -- e318},
  year      = {2015},
  abstract  = {Achilles (AT) and patellar tendons (PT) are commonly affected by tendinopathy in adult athletes but prevalence of symptoms and morphological changes in adolescents is unclear. The study aimed to determine prevalence of tendinopathy and intratendinous changes in ATs and PTs of adolescent athletes. A total of 760 adolescent athletes (13.0 +/- 1.9 years; 160 +/- 13cm; 50 +/- 14kg) were examined. History, local clinical examination, and longitudinal Doppler ultrasound analysis for both ATs and PTs were performed including identification of intratendinous echoic changes and vascularization. Diagnosis of tendinopathy was complied clinically in case of positive history of tendon pain and tendon pain on palpation. Achilles tendinopathy was diagnosed in 1.8\% and patellar tendinopathy in 5.8\%. Vascularizations were visible in 3.0\% of ATs and 11.4\% of PTs, hypoechogenicities in 0.7\% and 3.2\% as well as hyperechogenicities in 0\% and 0.3\%, respectively. Vascularizations and hypoechogenicities were statistically significantly more often in males than in females (P0.02). Subjects with patellar tendinopathy had higher prevalence of structural intratendinous changes than those without PT symptoms (P0.001). In adolescent athletes, patellar tendinopathy is three times more frequent compared with Achilles tendinopathy. Longitudinal studies are necessary to investigate physiological or pathological origin of vascularizations and its predictive value in development of tendinopathy.},
  language  = {en}
}
@article{CasselStollMayer2015,
  author    = {Cassel, Michael and Stoll, Josefine and Mayer, Frank},
  title     = {Tendinopathies of the Lower Extremities in Sport - Diagnostics and Therapy},
  series = {Sportverletzung, Sportschaden : Grundlagen, Pr{\"a}vention, Rehabilitation},
  volume    = {29},
  journal   = {Sportverletzung, Sportschaden : Grundlagen, Pr{\"a}vention, Rehabilitation},
  number    = {2},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0932-0555},
  doi       = {10.1055/s-0034-1399668},
  pages     = {87 -- 98},
  year      = {2015},
  abstract  = {Tendinopathies are frequently the cause of chronic, load-dependent complaints of the lower extremity. Commonly, the large tendons of the ankle and knee joints are affected, especially the Achilles and patellar tendons. Repeated overuse in sports and/or daily activities is assumed as the aetiology. Besides the clinical examination including a comprehensive anamnesis of pain and training/loading, sonographic imaging has a high training/loading relevance for the diagnosis of tendon pathologies of the lower extremity. Training concepts are considered in first line as the treatment of choice. A combination with physical therapy interventions can be useful. In cases of a more severe pathology and long-standing complaints multimodal therapeutic options should be employed. The use of surgical treatment procedures should only be taken into account in case of failed response to conservative treatment.},
  language  = {de}
}
@article{IntziegianniCasselKoenigetal.2015,
  author    = {Intziegianni, Konstantina and Cassel, Michael and K{\"o}nig, Niklas and M{\"u}ller, Steffen and Fr{\"o}hlich, Katja and Mayer, Frank},
  title     = {Ultrasonography for the assessment of the structural properties of the Achilles tendon in asymptomatic individuals: An intra-rater reproducibility study},
  series = {Isokinetics and exercise science : official journal of the European Isokinetic Society},
  volume    = {23},
  journal   = {Isokinetics and exercise science : official journal of the European Isokinetic Society},
  number    = {4},
  publisher = {IOS Press},
  address   = {Amsterdam},
  issn      = {0959-3020},
  doi       = {10.3233/IES-150586},
  pages     = {263 -- 270},
  year      = {2015},
  abstract  = {BACKGROUND: Reproducible measurements of tendon structural properties are a prerequisite for accurate diagnosis of tendon disorders and for determination of their mechanical properties. Despite the widely used application of Ultrasonography (US) in musculoskeletal assessment, its operator dependency and lack of standardization influences the consistency of the measurement. OBJECTIVE: To evaluate the intra-rater reproducibility of a standardized US method assessing the structural properties of the Achilles tendon (AT). METHODS: Sixteen asymptomatic participants were positioned prone on an isokinetic dynamometer with the knee extended and ankle at 90. flexion. US was used to assess AT-length, cross-sectional area (CSA), and AT-elongation during isometric plantarflexion contraction. The intra-rater reproducibility was assessed by ICC (2.1), Test-Retest Variability (TRV, \%), Bland-Altman analyses (Bias +/- LoA [1.96*SD]), and Standard-Error of Measurement (SEM). RESULTS: Measurements of AT-length demonstrated an ICC of 0.93, TRV of 4.5 +/- 3.9\%, Bias +/- LoA of -2.8 +/- 25.0 mm and SEM of 6.6 mm. AT-CSA showed an ICC of 0.79, TRV of 8.7 +/- 9.6\%, Bias +/- LoA of 1.7 +/- 19.4 mm(2) and SEM of 5.3 mm(2). AT-elongation revealed an ICC of 0.92, TRV of 12.9 +/- 8.9\%, Bias +/- LoA of 0.3 +/- 5.7 mm and SEM of 1.5 mm. CONCLUSIONS: The presented methodology allows a reproducible assessment of Achilles tendon structural properties when performed by a single rater.},
  language  = {en}
}
@article{KopinskiEngelCasseletal.2015,
  author    = {Kopinski, Stephan and Engel, Tilman and Cassel, Michael and Fr{\"o}hlich, Katja and Mayer, Frank and Carlsohn, Anja},
  title     = {Ultrasound Applied to Subcutaneous Fat Tissue Measurements in International Elite Canoeists},
  series = {International journal of sports medicine},
  volume    = {36},
  journal   = {International journal of sports medicine},
  number    = {14},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0172-4622},
  doi       = {10.1055/s-0035-1555857},
  pages     = {1134 -- 1141},
  year      = {2015},
  abstract  = {Subcutaneous adipose tissue (SAT) measurements with ultrasound have recently been introduced to assess body fat in elite athletes. However, appropriate protocols and data on various groups of athletes are missing. We investigated intra-rater reliability of SAT measurements using ultrasound in elite canoe athletes. 25 international level canoeists (18 male, 7 female; 23 +/- 4 years; 81 +/- 11 kg; 1.83 +/- 0.09 m; 20 +/- 3 training h/wk) were measured on 2 consecutive days. SAT was assessed with B-mode ultrasound at 8 sites (ISAK): triceps, subscapular, biceps, iliac crest, supraspinal, abdominal, front thigh, medial calf, and quantified using image analysis software. Data was analyzed descriptively (mean +/- SD, [range]). Coefficient of variation (CV \%), intraclass correlation coefficient (ICC, 2.1) and absolute (LoA) and ratio limits of agreement (RLoA) were calculated for day-to-day reliability. Mean sum of SAT thickness was 30.0 +/- 19.4 mm [8.0, 80.1 mm], with 3.9 +/- 1.8 mm [1.2 mm subscapular, 8.0 mm abdominal] for individual sites. CV for the sum of sites was 4.7 \%, ICC 0.99, LoA 1.7 +/- 3.6 mm, RLoA 0.940 (*/divided by 1.155). Measuring SAT with ultrasound has proved to have excellent day-to-day reliability in elite canoe athletes. Recommendations for standardization of the method will further increase accuracy and reproducibility.},
  language  = {en}
}