@phdthesis{Rector2019, author = {Rector, Michael V.}, title = {The acute effect of exercise on flow-mediated dilation in young people with cystic fibrosis}, doi = {10.25932/publishup-43893}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-438938}, school = {Universit{\"a}t Potsdam}, pages = {121}, year = {2019}, abstract = {Introduction: Cystic fibrosis (CF) is a genetic disease which disrupts the function of an epithelial surface anion channel, CFTR (cystic fibrosis transmembrane conductance regulator). Impairment to this channel leads to inflammation and infection in the lung causing the majority of morbidity and mortality. However, CF is a multiorgan disease affecting many tissues, including vascular smooth muscle. Studies have revealed young people with cystic fibrosis lacking inflammation and infection still demonstrate vascular endothelial dysfunction, measured per flow-mediated dilation (FMD). In other disease cohorts, i.e. diabetic and obese, endurance exercise interventions have been shown improve or taper this impairment. However, long-term exercise interventions are risky, as well as costly in terms of time and resources. Nevertheless, emerging research has correlated the acute effects of exercise with its long-term benefits and advocates the study of acute exercise effects on FMD prior to longitudinal studies. The acute effects of exercise on FMD have previously not been examined in young people with CF, but could yield insights on the potential benefits of long-term exercise interventions. The aims of these studies were to 1) develop and test the reliability of the FMD method and its applicability to study acute exercise effects; 2) compare baseline FMD and the acute exercise effect on FMD between young people with and without CF; and 3) explore associations between the acute effects of exercise on FMD and demographic characteristics, physical activity levels, lung function, maximal exercise capacity or inflammatory hsCRP levels. Methods: Thirty young volunteers (10 people with CF, 10 non-CF and 10 non-CF active matched controls) between the ages of 10 and 30 years old completed blood draws, pulmonary function tests, maximal exercise capacity tests and baseline FMD measurements, before returning approximately 1 week later and performing a 30-min constant load training at 75\% HRmax. FMD measurements were taken prior, immediately after, 30 minutes after and 1 hour after constant load training. ANOVAs and repeated measures ANOVAs were employed to explore differences between groups and timepoints, respectively. Linear regression was implemented and evaluated to assess correlations between FMD and demographic characteristics, physical activity levels, lung function, maximal exercise capacity or inflammatory hsCRP levels. For all comparisons, statistical significance was set at a p-value of α < 0.05. Results: Young people with CF presented with decreased lung function and maximal exercise capacity compared to matched controls. Baseline FMD was also significantly decreased in the CF group (CF: 5.23\% v non-CF: 8.27\% v non-CF active: 9.12\%). Immediately post-training, FMD was significantly attenuated (approximately 40\%) in all groups with CF still demonstrating the most minimal FMD. Follow-up measurements of FMD revealed a slow recovery towards baseline values 30 min post-training and improvements in the CF and non-CF active groups 60 min post-training. Linear regression exposed significant correlations between maximal exercise capacity (VO2 peak), BMI and FMD immediately post-training. Conclusion: These new findings confirm that CF vascular endothelial dysfunction can be acutely modified by exercise and will aid in underlining the importance of exercise in CF populations. The potential benefits of long-term exercise interventions on vascular endothelial dysfunction in young people with CF warrants further investigation.}, language = {en} } @phdthesis{Rabe2019, author = {Rabe, Sophie}, title = {Wirksamkeit einer telemedizinisch assistierten Bewegungstherapie f{\"u}r die postrehabilitative Versorgung von Patienten mit Knie- oder H{\"u}ft-Totalendoprothese im berufsf{\"a}higen Alter}, doi = {10.25932/publishup-43055}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-430556}, school = {Universit{\"a}t Potsdam}, pages = {x, 78}, year = {2019}, abstract = {Einleitung Die Implantation einer Knie- oder H{\"u}ft-Totalendoprothese (TEP) ist eine der h{\"a}ufigsten operativen Eingriffe. Im Anschluss an die Operation und die postoperative Rehabilitation stellt die Bewegungstherapie einen wesentlichen Bestandteil der Behandlung zur Verbesserung der Gelenkfunktion und der Lebensqualit{\"a}t dar. In strukturschwachen Gebieten werden entsprechende Angebote nur in unzureichender Dichte vorgehalten. Zudem zeichnet sich ein fl{\"a}chendeckender Fachkr{\"a}ftemangel im Bereich der Physiotherapie ab. Die Tele-Nachsorge bietet daher einen innovativen Ansatz f{\"u}r die postrehabilitative Versorgung der Patienten. Das Ziel der vorliegenden Untersuchung war die {\"U}berpr{\"u}fung der Wirksamkeit einer interaktiven Tele-Nachsorgeintervention f{\"u}r Patienten mit Knie- oder H{\"u}ft-TEP im Vergleich zur herk{\"o}mmlichen Versorgung (usual care). Dazu wurden die Funktionalit{\"a}t und die berufliche Wiedereingliederung untersucht. Methode Zwischen August 2016 und August 2017 wurden 111 Patienten (54,9 ± 6,8 Jahre, 54,3 \% weiblich) zu Beginn ihrer station{\"a}ren Anschlussheilbehandlung nach Implantation einer Knie- oder H{\"u}ft-TEP in diese randomisiert, kontrolliert, multizentrische Studie eingeschlossen. Nach Entlassung aus der orthop{\"a}dischen Anschlussrehabilitation (Baseline) f{\"u}hrte die Interventionsgruppe (IG) ein dreimonatiges interaktives Training {\"u}ber ein Telerehabilitationssystem durch. Hierf{\"u}r erstellte ein betreuender Physiotherapeut einen individuellen Trainingsplan aus 38 {\"U}bungen zur Verbesserung der Kraft sowie der posturalen Kontrolle. Zur Anpassung des Trainingsplans {\"u}bermittelte das System dem Physiotherapeuten Daten zur Quantit{\"a}t sowie zur Qualit{\"a}t des Trainings. Die Kontrollgruppe (KG) konnte die herk{\"o}mmlichen Versorgungsangebote nutzen. Zur Beurteilung der Wirksamkeit der Intervention wurde die Differenz der Verbesserung im 6MWT zwischen der IG und der KG nach drei Monaten als prim{\"a}rer Endpunkt definiert. Als sekund{\"a}re Endpunkte wurden die Return-to-Work-Rate sowie die funktionelle Mobilit{\"a}t mittels des Stair Ascend Tests, des Five-Times-Sit-to-Stand Test und des Timed Up and Go Tests untersucht. Weiterhin wurden die gesundheitsbezogene Lebensqualit{\"a}t mit dem Short-Form 36 (SF-36) und die gelenkbezogenen Einschr{\"a}nkungen mit dem Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) evaluiert. Der prim{\"a}re und die sekund{\"a}ren Endpunkte wurden anhand von baseline-adjustierten Kovarianzanalysen im intention-to-treat-Ansatz ausgewertet. Zus{\"a}tzlich wurde die Teilnahme an Nachsorgeangeboten und die Adh{\"a}renz der Interventionsgruppe an der Tele-Nachsorge erfasst und evaluiert. Ergebnisse Zum Ende der Intervention wiesen beide Gruppen einen statistisch signifikanten Anstieg ihrer 6MWT Strecke auf (p < 0,001). Zu diesem Zeitpunkt legten die Teilnehmer der IG im Mittel 530,8 ± 79,7 m, die der KG 514,2 ± 71,2 m zur{\"u}ck. Dabei betrug die Differenz der Verbesserung der Gehstrecke in der IG 88,3 ± 57,7 m und in der KG 79,6 ± 48,7 m. Damit zeigt der prim{\"a}re Endpunkt keine signifikanten Gruppenunterschiede (p = 0,951). Bez{\"u}glich der beruflichen Wiedereingliederung konnte jedoch eine signifikant h{\"o}here Rate in der IG (64,6 \% versus 46,2 \%; p = 0,014) festgestellt werden. F{\"u}r die sekund{\"a}ren Endpunkte der funktionellen Mobilit{\"a}t, der Lebensqualit{\"a}t und der gelenkbezogenen Beschwerden belegen die Ergebnisse eine Gleichwertigkeit beider Gruppen zum Ende der Intervention. Schlussfolgerung Die telemedizinisch assistierte Bewegungstherapie f{\"u}r Knie- oder H{\"u}ft-TEP Patienten ist der herk{\"o}mmlichen Versorgung zur Nachsorge hinsichtlich der erzielten Verbesserungen der funktionellen Mobilit{\"a}t, der gesundheitsbezogenen Lebensqualit{\"a}t und der gelenkbezogenen Beschwerden gleichwertig. In dieser Patientenpopulation ließen sich klinisch relevante Verbesserungen unabh{\"a}ngig von der Form der Bewegungstherapie erzielen. Im Hinblick auf die berufliche Wiedereingliederung zeigte sich eine signifikant h{\"o}here Rate in der Interventionsgruppe. Die telemedizinisch assistierte Bewegungstherapie scheint eine geeignete Versorgungsform der Nachsorge zu sein, die orts- und zeitunabh{\"a}ngig durchgef{\"u}hrt werden kann und somit den Bed{\"u}rfnissen berufst{\"a}tiger Patienten entgegenkommt und in den Alltag der Patienten integriert werden kann. Die Tele-Nachsorge sollte daher als optionale und komplement{\"a}re Form der postrehabilitativen Nachsorge angeboten werden. Auch im Hinblick auf den zunehmenden Fachkr{\"a}ftemangel im Bereich der Physiotherapie und bestehende Versorgungsl{\"u}cken in strukturschwachen Gebieten kann der Einsatz der Tele-Nachsorge innovative und bedarfsgerechte L{\"o}sungsans{\"a}tze bieten.}, language = {de} } @phdthesis{Lesinski2019, author = {Lesinski, Melanie}, title = {Modulating factors for drop jump performance}, school = {Universit{\"a}t Potsdam}, pages = {viii, 57, xiii}, year = {2019}, abstract = {Background and objectives: Drop jumps (DJs) are well-established exercise drills during plyometric training. Several sports are performed under unstable surface conditions (e.g., soccer, beach volleyball, gymnastics). To closely mimic sport-specific demands, plyometric training includes DJs on both stable and unstable surfaces. According to the mechanical properties of the unstable surface (e.g., thickness, stiffness), altered temporal, mechanical, and physiological demands have been reported from previous cross-sectional studies compared with stable conditions. However, given that the human body simultaneously interacts with various factors (e.g., drop height, footwear, gender) during DJs on unstable surfaces, the investigation of isolated effects of unstable surface conditions might not be sufficient for designing an effective and safe DJ stimulus. Instead, the combined investigation of different factors and their interaction with surface instability have to be taken into consideration. Therefore, the present doctoral thesis seeks to complement our knowledge by examining the main and interaction effects of surface instability, drop height, footwear, and gender on DJ performance, knee joint kinematics, and neuromuscular activation. Methods: Healthy male and female physically active sports science students aged 19-26 years participated in the cross-sectional studies. Jump performance, sagittal and frontal plane knee joint kinematics, and leg muscle activity were measured during DJs on stable (i.e., firm force plate) and (highly) unstable surfaces (i.e., one or two AIREX® balance pads) from different drop heights (i.e., 20 cm, 40 cm, 60 cm) or under multiple footwear conditions (i.e., barefoot, minimal shoes, cushioned shoes). Results: Findings revealed that surface instability caused a DJ performance decline, reduced sagittal plane knee joint kinematics, and lower leg muscle activity during DJs. Sagittal plane knee joint kinematics as well as leg muscle activity decreased even more with increasing surface instability (i.e., two vs. one AIREX® balance pads). Higher (60 cm) compared to lower drop heights (≤ 40 cm) resulted in a DJ performance decline. In addition, increased sagittal plane knee joint kinematics as well as higher shank muscle activity were found during DJs from higher (60 cm) compared to lower drop heights (≤ 40 cm). Footwear properties almost exclusively affected frontal plane knee joint kinematics, indicating larger maximum knee valgus angles when performing DJs barefoot compared to shod. Between the different shoe properties (i.e., minimal vs. cushioned shoes), no significant differences during DJs were found at all. Only a few significant surface-drop height as well as surface-footwear interactions were found during DJs. They mainly indicated that drop height- and footwear-related effects are more pronounced during DJs on unstable compared to stable surfaces. In this regard, the maximum knee valgus angle was significantly greater when performing DJs from high drop heights (60 cm), but only on highly unstable surface. Further, braking and push-off times were significantly longer when performing DJs barefoot compared to shod, but only on unstable surface. Finally, analyses indicated no significant interactions with the gender factor. Conclusions: The findings of the present cumulative thesis indicate that stable rather than unstable surfaces as well as moderate (≤ 40 cm) rather than high (60 cm) drop heights provide sufficient stimuli to perform DJs. Furthermore, findings suggest that DJs on highly unstable surfaces (i.e., two AIREX® balance pads) from high drop heights (60 cm) as well as barefoot compared to shod seem to increase maximal knee valgus angle/stress by providing a more harmful DJ stimulus. Neuromuscular activation strategies appear to be modified by surface instability and drop height. However, leg muscle activity is only marginally effected by footwear and by the interactions of various external factors i.e., surface instability, drop height, footwear). Finally, gender did not significantly modulate the main or interaction effects of the observed external factors during DJs.}, language = {en} } @phdthesis{AppiahDwomoh2019, author = {Appiah-Dwomoh, Edem Korkor}, title = {Postural control and back pain in adolescent athletes}, doi = {10.25932/publishup-44269}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-442692}, school = {Universit{\"a}t Potsdam}, pages = {VI, 77, X}, year = {2019}, abstract = {Back pain is a problem in adolescent athletes affecting postural control which is an important requirement for physical and daily activities whether under static or dynamic conditions. One leg stance and star excursion balance postural control tests are effective in measuring static and dynamic postural control respectively. These tests have been used in individuals with back pain, athletes and non-athletes without first establishing their reliabilities. In addition to this, there is no published literature investigating dynamic posture in adolescent athletes with back pain using the star excursion balance test. Therefore, the aim of the thesis was to assess deficit in postural control in adolescent athletes with and without back pain using static (one leg stance test) and dynamic postural (SEBT) control tests. Adolescent athletes with and without back pain participated in the study. Static and dynamic postural control tests were performed using one leg stance and SEBT respectively. The reproducibility of both tests was established. Afterwards, it was determined whether there was an association between static and dynamic posture using the measure of displacement of the centre pressure and reach distance respectively. Finally, it was investigated whether there was a difference in postural control in adolescent athletes with and without back pain using the one leg stance test and the SEBT. Fair to excellent reliabilities was recorded for the static (one leg stance) and dynamic (star excursion balance) postural control tests in the subjects of interest. No association was found between variables of the static and dynamic tests for the adolescent athletes with and without back pain. Also, no statistically significant difference was obtained between adolescent athletics with and without back pain using the static and dynamic postural control test. One leg stance test and SEBT can be used as measures of postural control in adolescent athletes with and without back pain. Although static and dynamic postural control might be related, adolescent athletes with and without back pain might be using different mechanisms in controlling their static and dynamic posture. Consequently, static and dynamic postural control in adolescent athletes with back pain was not different from those without back pain. These outcome measures might not be challenging enough to detect deficit in postural control in our study group of interest.}, language = {en} }