@article{GolleMuehlbauerWicketal.2015, author = {Golle, Kathleen and M{\"u}hlbauer, Thomas and Wick, Ditmar and Granacher, Urs}, title = {Physical Fitness Percentiles of German Children Aged 9-12 Years}, series = {PLoS ONE}, volume = {10}, journal = {PLoS ONE}, number = {11}, publisher = {Public Library of Science}, address = {Lawrence, Kan.}, issn = {1932-6203}, doi = {10.1371/journal.pone.0142393}, year = {2015}, abstract = {Background Generating percentile values is helpful for the identification of children with specific fitness characteristics (i.e., low or high fitness level) to set appropriate fitness goals (i.e., fitness/health promotion and/or long-term youth athlete development). Thus, the aim of this longitudinal study was to assess physical fitness development in healthy children aged 9-12 years and to compute sex- and age-specific percentile values. Methods Two-hundred and forty children (88 girls, 152 boys) participated in this study and were tested for their physical fitness. Physical fitness was assessed using the 50-m sprint test (i.e., speed), the 1-kg ball push test, the triple hop test (i.e., upper- and lower- extremity muscular power), the stand-and-reach test (i.e., flexibility), the star run test (i.e., agility), and the 9-min run test (i.e., endurance). Age- and sex-specific percentile values (i.e., P10 to P90) were generated using the Lambda, Mu, and Sigma method. Adjusted (for change in body weight, height, and baseline performance) age- and sex-differences as well as the interactions thereof were expressed by calculating effect sizes (Cohen's d). Results Significant main effects of Age were detected for all physical fitness tests (d = 0.40-1.34), whereas significant main effects of Sex were found for upper-extremity muscular power (d = 0.55), flexibility (d = 0.81), agility (d = 0.44), and endurance (d = 0.32) only. Further, significant Sex by Age interactions were observed for upper-extremity muscular power (d = 0.36), flexibility (d = 0.61), and agility (d = 0.27) in favor of girls. Both, linear and curvilinear shaped curves were found for percentile values across the fitness tests. Accelerated (curvilinear) improvements were observed for upper-extremity muscular power (boys: 10-11 yrs; girls: 9-11 yrs), agility (boys: 9-10 yrs; girls: 9-11 yrs), and endurance (boys: 9-10 yrs; girls: 9-10 yrs). Tabulated percentiles for the 9-min run test indicated that running distances between 1,407-1,507 m, 1,479-1,597 m, 1,423-1,654 m, and 1,433-1,666 m in 9- to 12-year-old boys and 1,262-1,362 m, 1,329-1,434 m, 1,392-1,501 m, and 1,415-1,526 m in 9- to 12-year-old girls correspond to a "medium" fitness level (i.e., P40 to P60) in this population. Conclusions The observed differences in physical fitness development between boys and girls illustrate that age- and sex-specific maturational processes might have an impact on the fitness status of healthy children. Our statistical analyses revealed linear (e.g., lower-extremity muscular power) and curvilinear (e.g., agility) models of fitness improvement with age which is indicative of timed and capacity-specific fitness development pattern during childhood. Lastly, the provided age- and sex-specific percentile values can be used by coaches for talent identification and by teachers for rating/grading of children's motor performance.}, language = {en} } @article{GolleMuehlbauerWicketal.2015, author = {Golle, Kathleen and M{\"u}hlbauer, Thomas and Wick, Ditmar and Granacher, Urs}, title = {Physical Fitness Percentiles of German Children Aged 9-12 Years: Findings from a Longitudinal Study}, series = {PLoS one}, volume = {10}, journal = {PLoS one}, number = {11}, publisher = {PLoS}, address = {San Fransisco}, issn = {1932-6203}, doi = {10.1371/journal.pone.0142393}, pages = {17}, year = {2015}, abstract = {Background Generating percentile values is helpful for the identification of children with specific fitness characteristics (i. e., low or high fitness level) to set appropriate fitness goals (i. e., fitness/ health promotion and/or long-term youth athlete development). Thus, the aim of this longitudinal study was to assess physical fitness development in healthy children aged 9-12 years and to compute sex-and age-specific percentile values. Methods Two-hundred and forty children (88 girls, 152 boys) participated in this study and were tested for their physical fitness. Physical fitness was assessed using the 50-m sprint test (i. e., speed), the 1-kg ball push test, the triple hop test (i. e., upper-and lower-extremity muscular power), the stand-and-reach test (i. e., flexibility), the star run test (i. e., agility), and the 9-min run test (i. e., endurance). Age-and sex-specific percentile values (i. e., P-10 to P-90) were generated using the Lambda, Mu, and Sigma method. Adjusted (for change in body weight, height, and baseline performance) age-and sex-differences as well as the interactions thereof were expressed by calculating effect sizes (Cohen's d). Results Significant main effects of Age were detected for all physical fitness tests (d = 0.40-1.34), whereas significant main effects of Sex were found for upper-extremity muscular power (d = 0.55), flexibility (d = 0.81), agility (d = 0.44), and endurance (d = 0.32) only. Further, significant Sex by Age interactions were observed for upper-extremity muscular power (d = 0.36), flexibility (d = 0.61), and agility (d = 0.27) in favor of girls. Both, linear and curvilinear shaped curves were found for percentile values across the fitness tests. Accelerated (curvilinear) improvements were observed for upper-extremity muscular power (boys: 10-11 yrs; girls: 9-11 yrs), agility (boys: 9-10 yrs; girls: 9-11 yrs), and endurance (boys: 9-10 yrs; girls: 9-10 yrs). Tabulated percentiles for the 9-min run test indicated that running distances between 1,407-1,507 m, 1,479-1,597 m, 1,423-1,654 m, and 1,433-1,666 m in 9-to 12-year-old boys and 1,262-1,362 m, 1,329-1,434 m, 1,392-1,501 m, and 1,415-1,526 m in 9-to 12-year-old girls correspond to a "medium" fitness level (i. e., P-40 to P-60) in this population. Conclusions The observed differences in physical fitness development between boys and girls illustrate that age- and sex-specific maturational processes might have an impact on the fitness status of healthy children. Our statistical analyses revealed linear (e. g., lower-extremity muscular power) and curvilinear (e. g., agility) models of fitness improvement with age which is indicative of timed and capacity-specific fitness development pattern during childhood. Lastly, the provided age-and sex-specific percentile values can be used by coaches for talent identification and by teachers for rating/ grading of children's motor performance.}, language = {en} } @article{DiehlMayerMayeretal.2015, author = {Diehl, Katharina and Mayer, Manfred and Mayer, Frank and G{\"o}rig, Tatiana and Bock, Christina and Herr, Raphael M. and Schneider, Sven}, title = {Physical Activity Counseling by Primary Care Physicians: Attitudes, Knowledge, Implementation, and Perceived Success}, series = {Journal of physical activity and health}, volume = {12}, journal = {Journal of physical activity and health}, number = {2}, publisher = {Human Kinetics Publ.}, address = {Champaign}, issn = {1543-3080}, doi = {10.1123/jpah.2013-0273}, pages = {216 -- 223}, year = {2015}, abstract = {Background: In physical activity (PA) counseling, primary care physicians (PCPs) play a key role because they are in regular contact with large sections of the population and are important contact people in all health-related issues. However, little is known about their attitudes, knowledge, and perceived success, as well as about factors associated with the implementation of PA counseling. Methods: We collected data from 4074 PCPs including information on physician and practice characteristics, attitudes toward cardiovascular disease (CVD) prevention, and measures used during routine practice to prevent CVD. Here, we followed widely the established 5 A's strategy (Assess, Advise, Agree, Assist, Arrange). Results: The majority (87.2\%) of PCPs rated their own level of competence in PA counseling as 'high,' while 52.3\% rated their own capability to motivate patients to increase PA as 'not good.' Nine of ten PCPs routinely provided at least 1 measure of the modified 5 A's strategy, while 9.5\% routinely used all 5 intervention strategies. Conclusions: The positive attitude toward PA counseling among PCPs should be supported by other stakeholders in the field of prevention and health promotion. An example would be the reimbursement of health counseling services by compulsory health insurance, which would enable PCPs to invest more time in individualized health promotion.}, language = {en} } @article{BohlkenSchulzRappetal.2015, author = {Bohlken, Jens and Schulz, Mandy and Rapp, Michael A. and Baetzing-Feigenbaum, Joerg}, title = {Pharmacotherapy of dementia in Germany: Results from a nationwide claims database}, series = {European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology}, volume = {25}, journal = {European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology}, number = {12}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0924-977X}, doi = {10.1016/j.euroneuro.2015.09.014}, pages = {2333 -- 2338}, year = {2015}, abstract = {In 2011, about 1.1-1.4 million patients with dementia were living in Germany, a number expected to rise to three million by 2050. Dementia poses a major challenge to the healthcare system and neuropharmacological service provision. The aim of this study was to determine prescription rates for anti-dementia drugs as well as for neuroleptics, sedative-hypnotics and antidepressants in dementia using the complete nationwide outpatient claims data pertaining to the services of statutory health insurance. We controlled for gender, age, dementia diagnosis, physician specialty (general practitioner GP versus neuropsychiatry specialist physician NPSP), and rural and urban living area. In about one million prevalent dementia patients (N=1,014,710) in 2011, the prescription prevalence rate of anti-dementia drugs was 24.6\%; it varied with gender, age, and diagnosis (highest in Alzheimer's disease; 42\%), and was higher in patients treated by NPSPs (48\% vs. 25\% in GPs). At the same time, we found an alarmingly high rate of treatment with neuroleptics in dementia patients (35\%), with an only slightly decreased risk in patients treated exclusively by NPSPs (OR=0.86). We found marginal differences between rural and urban areas. Our results show that the majority of anti-dementia drug prescriptions appear guideline-oriented, yet prescription rates are overall comparatively low. On the other hand, neuroleptic drugs, which are associated with excess morbidity and mortality in dementia, were prescribed very frequently, suggesting excess use given current guidelines. We therefore suggest that guideline implementation measures and increasing quality control procedures are needed with respect to the pharmacotherapy of this vulnerable population. (C) 2015 Elsevier B.V. and ECNR All rights reserved.}, language = {en} } @article{WiebkingNorthoff2015, author = {Wiebking, Christine and Northoff, Georg}, title = {Neural activity during interoceptive awareness and its associations with alexithymia-An fMRI study in major depressive disorder and non-psychiatric controls}, series = {Frontiers in psychology}, volume = {6}, journal = {Frontiers in psychology}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1664-1078}, doi = {10.3389/fpsyg.2015.00589}, pages = {16}, year = {2015}, abstract = {Objective: Alexithymia relates to difficulties recognizing and describing emotions. It has been linked to subjectively increased interoceptive awareness (IA) and to psychiatric illnesses such as major depressive disorder (MDD) and somatization. MDD in turn is characterized by aberrant emotion processing and IA on the subjective as well as on the neural level. However, a link between neural activity in response to IA and alexithymic traits in health and depression remains unclear. Methods: A well-established fMRI task was used to investigate neural activity during IA (heartbeat counting) and exteroceptive awareness (tone counting) in non-psychiatric controls (NC) and MDD. Firstly, comparing MDD and NC, a linear relationship between IA-related activity and scores of the Toronto Alexithymia Scale (TAS) was investigated through whole-brain regression. Secondly, NC were divided by median-split of TAS scores into groups showing low (NC-low) or high (NC-high) alexithymia. MDD and NC-high showed equally high TAS scores. Subsequently, IA-related neural activity was compared on a whole-brain level between the three independent samples (MDD, NC-low, NC-high). Results: Whole-brain regressions between MDD and NC revealed neural differences during IA as a function of TAS-DD (subscale difficulty describing feelings) in the supragenual anterior cingulate cortex (sACC; BA 24/32), which were due to negative associations between TAS-DD and IA-related activity in NC. Contrasting NC subgroups after median-split on a whole-brain level, high TAS scores were associated with decreased neural activity during IA in the sACC and increased insula activity. Though having equally high alexithymia scores, NC-high showed increased insula activity during IA compared to MDD, whilst both groups showed decreased activity in the sACC. Conclusions: Within the context of decreased sACC activity during IA in alexithymia (NC-high and MDD), increased insula activity might mirror a compensatory mechanism in NC-high, which is disrupted in MDD.}, language = {en} } @article{DuncanHayesWiebkingetal.2015, author = {Duncan, Niall W. and Hayes, Dave J. and Wiebking, Christine and Tiret, Brice and Pietruska, Karin and Chen, David Q. and Rainville, Pierre and Marjanska, Malgorzata and Ayad, Omar and Doyon, Julien and Hodaie, Mojgan and Northoff, Georg}, title = {Negative childhood experiences alter a prefrontal-insular-motor cortical network in healthy adults: A preliminary multimodal rsfMRI-fMRI-MRS-dMRI study}, series = {Human brain mapping : a journal devoted to functional neuroanatomy and neuroimaging}, volume = {36}, journal = {Human brain mapping : a journal devoted to functional neuroanatomy and neuroimaging}, number = {11}, publisher = {Wiley-Blackwell}, address = {Hoboken}, issn = {1065-9471}, doi = {10.1002/hbm.22941}, pages = {4622 -- 4637}, year = {2015}, abstract = {Research in humans and animals has shown that negative childhood experiences (NCE) can have long-term effects on the structure and function of the brain. Alterations have been noted in grey and white matter, in the brain's resting state, on the glutamatergic system, and on neural and behavioural responses to aversive stimuli. These effects can be linked to psychiatric disorder such as depression and anxiety disorders that are influenced by excessive exposure to early life stressors. The aim of the current study was to investigate the effect of NCEs on these systems. Resting state functional MRI (rsfMRI), aversion task fMRI, glutamate magnetic resonance spectroscopy (MRS), and diffusion magnetic resonance imaging (dMRI) were combined with the Childhood Trauma Questionnaire (CTQ) in healthy subjects to examine the impact of NCEs on the brain. Low CTQ scores, a measure of NCEs, were related to higher resting state glutamate levels and higher resting state entropy in the medial prefrontal cortex (mPFC). CTQ scores, mPFC glutamate and entropy, correlated with neural BOLD responses to the anticipation of aversive stimuli in regions throughout the aversion-related network, with strong correlations between all measures in the motor cortex and left insula. Structural connectivity strength, measured using mean fractional anisotropy, between the mPFC and left insula correlated to aversion-related signal changes in the motor cortex. These findings highlight the impact of NCEs on multiple inter-related brain systems. In particular, they highlight the role of a prefrontal-insular-motor cortical network in the processing and responsivity to aversive stimuli and its potential adaptability by NCEs. Hum Brain Mapp 36:4622-4637, 2015. (c) 2015 Wiley Periodicals, Inc.}, language = {en} } @article{LaineMartinezValdesFallaetal.2015, author = {Laine, Christopher M. and Martinez-Valdes, Eduardo Andr{\´e}s and Falla, Deborah and Mayer, Frank and Farina, Dario}, title = {Motor Neuron Pools of Synergistic Thigh Muscles Share Most of Their Synaptic Input}, series = {The journal of neuroscience}, volume = {35}, journal = {The journal of neuroscience}, number = {35}, publisher = {Society for Neuroscience}, address = {Washington}, issn = {0270-6474}, doi = {10.1523/JNEUROSCI.0240-15.2015}, pages = {12207 -- 12216}, year = {2015}, abstract = {Neural control of synergist muscles is not well understood. Presumably, each muscle in a synergistic group receives some unique neural drive and some drive that is also shared in common with other muscles in the group. In this investigation, we sought to characterize the strength, frequency spectrum, and force dependence of the neural drive to the human vastus lateralis and vastus medialis muscles during the production of isometric knee extension forces at 10 and 30\% of maximum voluntary effort. High-density surface electromyography recordings were decomposed into motor unit action potentials to examine the neural drive to each muscle. Motor unit coherence analysis was used to characterize the total neural drive to each muscle and the drive shared between muscles. Using a novel approach based on partial coherence analysis, we were also able to study specifically the neural drive unique to each muscle (not shared). The results showed that the majority of neural drive to the vasti muscles was a cross-muscle drive characterized by a force-dependent strength and bandwidth. Muscle-specific neural drive was at low frequencies (<5 Hz) and relatively weak. Frequencies of neural drive associated with afferent feedback (6 - 12 Hz) and with descending cortical input (similar to 20 Hz) were almost entirely shared by the two muscles, whereas low-frequency (<5 Hz) drive comprised shared (primary) and muscle-specific (secondary) components. This study is the first to directly investigate the extent of shared versus independent control of synergist muscles at the motor neuron level.}, language = {en} } @article{ReibisJannowitzHalleetal.2015, author = {Reibis, Rona Katharina and Jannowitz, Christina and Halle, Martin and Pittrow, David and Gitt, Anselm and V{\"o}ller, Heinz}, title = {Management and outcomes of patients with reduced ejection fraction after acute myocardial infarction in cardiac rehabilitation centers}, series = {Current medical research and opinion}, volume = {31}, journal = {Current medical research and opinion}, number = {2}, publisher = {Taylor \& Francis Group}, address = {London}, issn = {0300-7995}, doi = {10.1185/03007995.2014.977854}, pages = {211 -- 219}, year = {2015}, abstract = {Background: We aimed to describe the contemporary management of patients with systolic chronic heart failure (CHF) during a cardiac rehabilitation (CR) stay and present outcomes with focus on lipids, blood pressure, exercise capacity, and clinical events. Methods: Comparison of 3199 patients with moderately or severely impaired left ventricular ejection fraction (low EF, 13.3\%) and 20,913 patients with slightly reduced or normal LVEF (normal EF, 86.7\%) who underwent an inpatient CR period of about 3 weeks in 2009-2010. Results: Patients with low EF compared to those with normal EF were somewhat older (65.1 vs. 63.0 years, p<0.0001), and more often had risk factors such as diabetes mellitus (39.7\% vs. 32.0\%, p<0.0001) or other comorbidities. The overall rate of patients with regular physical activity of at least 90 minutes per week prior to CR was low overall (54.4\%), and reduced in patients with low EF compared to those with normal EF (47.7\% vs. 55.5\%, p<0.0001). The rate of patients that achieved lower LDL cholesterol (5100 mg/dl), total cholesterol (<200 mg/dl) and triglyceride (<150 mg/dl) values at discharge increased compared to baseline. Mean blood pressure was substantially lower in the low EF group compared to the normal EF group both at baseline (124/75 vs. 130/78 mmHg, p<0.0001) and at discharge (119/72 vs. 124/74 mmHg, p<0.0001). Maximum exercise improved substantially in both groups (at baseline 71 vs. 91 Watts, p<0.0001; at discharge 85 vs. 105 Watts, p<0.0001). Event rates during CR were low, and only 0.3\% in the low EF group died. As limitations to this study, information on brain natriuretic peptide (BNP), N-terminal pro-brain natriuretic peptide (NT-pro BNP) and/or cardiac troponin were not documented, and no long-term information was collected beyond the 3-week CR stay. Conclusions: Patients with CHF account for a considerable proportion of patients in CR. Also patients with moderate/severe EF benefited from participation in CR, as their lipid profile and physical fitness improved.}, language = {en} } @article{HuangIvYueetal.2015, author = {Huang, Zirui and Iv, Henry (Hap) Davis and Yue, Qiang and Wiebking, Christine and Duncan, Niall W. and Zhang, Jianfeng and Wagner, Nils-Frederic and Wolff, Annemarie and Northoff, Georg}, title = {Increase in glutamate/glutamine concentration in the medial prefrontal cortex during mental imagery: A combined functional mrs and fMRI study}, series = {Human brain mapping : a journal devoted to functional neuroanatomy and neuroimaging}, volume = {36}, journal = {Human brain mapping : a journal devoted to functional neuroanatomy and neuroimaging}, number = {8}, publisher = {Wiley-Blackwell}, address = {Hoboken}, issn = {1065-9471}, doi = {10.1002/hbm.22841}, pages = {3204 -- 3212}, year = {2015}, abstract = {Recent functional magnetic resonance spectroscopy (fMRS) studies have shown changes in glutamate/glutamine (Glx) concentrations between resting-state and active-task conditions. However, the types of task used have been limited to sensory paradigms, and the regions from which Glx concentrations have been measured limited to sensory ones. This leaves open the question as to whether the same effect can be seen in higher-order brain regions during cognitive tasks. Cortical midline structures, especially the medial prefrontal cortex (MPFC), have been suggested to be involved in various such cognitive tasks. We, therefore set out to use fMRS to investigate the dynamics of Glx concentrations in the MPFC between resting-state and mental imagery task conditions. The auditory cortex was used as a control region. In addition, functional magnetic resonance imaging was used to explore task-related neural activity changes. The mental imagery task consisted of imagining swimming and was applied to a large sample of healthy participants (n=46). The participants were all competitive swimmers, ensuring proficiency in mental-swimming. Glx concentrations in the MPFC increased during the imagery task, as compared to resting-state periods preceding and following the task. These increases mirror BOLD activity changes in the same region during the task. No changes in either Glx concentrations or BOLD activity were seen in the auditory cortex. These findings contribute to our understanding of the biochemical basis of generating or manipulating mental representations and the MPFC's role in this. Hum Brain Mapp 36:3204-3212, 2015. (c) 2015 Wiley Periodicals, Inc.}, language = {en} } @article{SalzwedelWegscheiderHerichetal.2015, author = {Salzwedel, Annett and Wegscheider, Karl and Herich, Lena and Rieck, Angelika and Strandt, Gert and V{\"o}ller, Heinz}, title = {Impact of clinical and sociodemographic patient characteristics on the outcome of cardiac rehabilitation in older patients}, series = {Aging clinical and experimental research}, volume = {27}, journal = {Aging clinical and experimental research}, number = {3}, publisher = {Springer}, address = {New York}, issn = {1594-0667}, doi = {10.1007/s40520-014-0283-2}, pages = {315 -- 321}, year = {2015}, abstract = {Background Cardiac rehabilitation (CR) seeks to simultaneously improve several outcome parameters related to patient risk factors, exercise capacity and subjective health. A single score, the multiple outcome criterion (MOC), comprised of alterations in 13 outcome variables was used to measure the overall success of CR in an older population. As this success depends on the older patient's characteristics at the time of admission to CR, we attempted to determine the most important influences. Methods The impact of baseline characteristics on the success of CR, measured by MOC, was analysed using a mixed model for 1,220 older patients (70.9 +/- A 7.0 years, 78.3 \% men) who enrolled in 12 CR clinics. A multitude of potentially influential baseline patient characteristics was considered including sociodemographic variables, comorbidity, duration of hospital stay, exercise capacity, cardiovascular risk factors, emotional status, and laboratory and echocardiographic data. Results Overall, CR was successful, as indicated by the mean value of the MOC (0.6 +/- A 0.45; min -1.0, max 2.0; positive values denoting improvement, negative ones deterioration). Examples of association with negative MOC values included smoking (MOC -0.15, p < 0.001), female gender (MOC -0.07, p = 0.049), and a longer hospital stay (MOC -0.03, p = 0.03). An example of association with positive MOC value was depression score (MOC 0.06, p = 0.003). Further associations included maximal exercise capacity, blood pressure, heart rate and the rehabilitation centre attended. Conclusion Our results emphasize the necessity to take into consideration baseline characteristics when evaluating the success of CR and setting treatment targets for older patients.}, language = {en} }