@misc{MartinezValdesNegroLaineetal.2016, author = {Martinez-Valdes, Eduardo and Negro, Francesco and Laine, Christopher M. and Falla, Deborah L. and Mayer, Frank and Farina, Dario}, title = {Identifying motor units in longitudinal studies with high-density surface electromyography}, series = {Converging clinical and engineering research on neurorehabilitation II}, volume = {15}, journal = {Converging clinical and engineering research on neurorehabilitation II}, publisher = {Springer}, address = {Cham}, isbn = {978-3-319-46669-9}, issn = {2195-3562}, doi = {10.1007/978-3-319-46669-9_27}, pages = {147 -- 151}, year = {2016}, abstract = {We investigated the possibility to identify motor units (MUs) with high-density surface electromyography (HDEMG) over experimental sessions in different days. 10 subjects performed submaximal knee extensions across three sessions in three days separated by one week, while EMG was recorded from the vastus medialis muscle with high-density electrode grids. The shapes of the MU action potentials (MUAPs) over multiple channels extracted from HDEMG decomposition were matched across sessions by cross-correlation. Forty and twenty percent of the MUs decomposed could be tracked across two and three sessions, respectively (average cross correlation 0.85 +/- 0.04). The estimated properties of the matched motor units were similar across the sessions. For example, mean discharge rate and recruitment thresholds were measured with an intra-class correlation coefficient (ICCs) > 0.80. These results strongly suggest that the same MUs were indeed identified across sessions. This possibility will allow monitoring changes in MU properties following interventions or during the progression of neuromuscular disorders.}, language = {en} } @article{SilveiraCarlsohnLangenetal.2016, author = {Silveira, Raul De Souza and Carlsohn, Anja and Langen, Georg and Mayer, Frank and Scharhag-Rosenberger, Friederike}, title = {Reliability and day-to-day variability of peak fat oxidation during treadmill ergometry}, series = {Journal of the International Society of Sports Nutrition}, volume = {13}, journal = {Journal of the International Society of Sports Nutrition}, publisher = {BioMed Central}, address = {London}, issn = {1550-2783}, doi = {10.1186/s12970-016-0115-1}, pages = {7}, year = {2016}, abstract = {Background: Exercising at intensities where fat oxidation rates are high has been shown to induce metabolic benefits in recreational and health-oriented sportsmen. The exercise intensity (Fat(peak)) eliciting peak fat oxidation rates is therefore of particular interest when aiming to prescribe exercise for the purpose of fat oxidation and related metabolic effects. Although running and walking are feasible and popular among the target population, no reliable protocols are available to assess Fat(peak) as well as its actual velocity (VPFO) during treadmill ergometry. Our purpose was therefore, to assess the reliability and day-to-day variability of VPFO and Fat(peak) during treadmill ergometry running. Conclusion: In summary, relative and absolute reliability indicators for V-PFO and Fat(peak) were found to be excellent. The observed LoA may now serve as a basis for future training prescriptions, although fat oxidation rates at prolonged exercise bouts at this intensity still need to be investigated.}, language = {en} } @article{CasselCarlsohnFroehlichetal.2016, author = {Cassel, Michael and Carlsohn, Anja and Fr{\"o}hlich, Katja and John, Mareike and Riegels, N. and Mayer, Frank}, title = {Tendon Adaptation to Sport-specific Loading in Adolescent Athletes}, series = {International journal of sports medicine}, volume = {37}, journal = {International journal of sports medicine}, publisher = {Thieme}, address = {Stuttgart}, issn = {0172-4622}, doi = {10.1055/s-0035-1559772}, pages = {159 -- 164}, year = {2016}, abstract = {Tendon adaptation due to mechanical loading is controversially discussed. However, data concerning the development of tendon thickness in adolescent athletes is sparse. The purpose of this study was to examine possible differences in Achilles (AT) and patellar tendon (PT) thickness in adolescent athletes while considering age, gender and sport-specific loading. In 500 adolescent competitive athletes of 16 different sports and 40 recreational controls both ATs and PTs were sonographically measured. Subjects were divided into 2 age groups (< 13; \&\#8805; 13 years) and 6 sport type categories (ball, combat, and water sports, combined disciplines, cycling, controls). In addition, 3 risk groups (low, moderate, high) were created according to the athlete's risk of developing tendinopathy. AT and PT thickness did not significantly differ between age groups (AT/PT:<13: 5.4±0.7 mm/3.6±0.5 mm;\&\#8805;13: 5.3±0.7 mm/3.6±0.5 mm). In both age groups males presented higher tendon thickness than females (p<0.001). AT thickness was highest in ball sports/cyclists and lowest in controls (p\&\#8804;0.002). PT thickness was greatest in water sports and lowest in controls (p=0.02). High risk athletes presented slightly higher AT thickness compared to the low risk group (p=0.03). Increased AT and PT thickness in certain sport types compared to controls supports the hypothesis of structural tendon adaptation due to sport-specific loading.}, language = {en} } @article{MuellerCarlsohnMuelleretal.2016, author = {Mueller, Steffen and Carlsohn, Anja and Mueller, Juliane and Baur, Heiner and Mayer, Frank}, title = {Influence of Obesity on Foot Loading Characteristics in Gait for Children Aged 1 to 12 Years}, series = {PLoS one}, volume = {11}, journal = {PLoS one}, publisher = {PLoS}, address = {San Fransisco}, issn = {1932-6203}, doi = {10.1371/journal.pone.0149924}, pages = {1710 -- 1717}, year = {2016}, abstract = {Background Overweight and obesity are increasing health problems that are not restricted to adults only. Childhood obesity is associated with metabolic, psychological and musculoskeletal comorbidities. However, knowledge about the effect of obesity on the foot function across maturation is lacking. Decreased foot function with disproportional loading characteristics is expected for obese children. The aim of this study was to examine foot loading characteristics during gait of normal-weight, overweight and obese children aged 1-12 years. Methods Results Mean walking velocity was 0.95 +/- 0.25 m/s with no differences between normal-weight, overweight or obese children (p = 0.0841). Results show higher foot contact area, arch index, peak pressure and force time integral in overweight and obese children (p< 0.001). Obese children showed the 1.48-fold (1 year-old) to 3.49-fold (10 year-old) midfoot loading (FTI) compared to normal-weight. Conclusion Additional body mass leads to higher overall load, with disproportional impact on the midfoot area and longitudinal foot arch showing characteristic foot loading patterns. Already the feet of one and two year old children are significantly affected. Childhood overweight and obesity is not compensated by the musculoskeletal system. To avoid excessive foot loading with potential risk of discomfort or pain in childhood, prevention strategies should be developed and validated for children with a high body mass index and functional changes in the midfoot area. The presented plantar pressure values could additionally serve as reference data to identify suspicious foot loading patterns in children.}, language = {en} } @misc{WippertPuschmannSchiltenwolfetal.2016, author = {Wippert, Pia-Maria and Puschmann, Anne-Katrin and Schiltenwolf, Marcus and Wiebking, Christine and Mayer, Frank}, title = {BACK PAIN: THE STUDY OF MECHANISMS AND THE TRANSLATION IN INTERVENTIONS WITHIN THE MISPEX NETWORK}, series = {Psychosomatic medicine}, volume = {78}, journal = {Psychosomatic medicine}, publisher = {Elsevier}, address = {Philadelphia}, issn = {0033-3174}, pages = {A91 -- A91}, year = {2016}, language = {en} } @article{MuellerMuellerEngeletal.2016, author = {M{\"u}ller, Juliane and M{\"u}ller, Steffen and Engel, Tilman and Reschke, Antje and Baur, Heiner and Mayer, Frank}, title = {Stumbling reactions during perturbed walking: Neuromuscular reflex activity and 3-D kinematics of the trunk - A pilot study}, series = {Journal of biomechanics}, volume = {49}, journal = {Journal of biomechanics}, publisher = {Elsevier}, address = {Oxford}, issn = {0021-9290}, doi = {10.1016/j.jbiomech.2015.09.041}, pages = {933 -- 938}, year = {2016}, abstract = {Stumbling led to an increase in ROM, compared to unperturbed gait, in all segments and planes. These increases ranged between 107 +/- 26\% (UTA/rotation) and 262 +/- 132\% (UTS/lateral flexion), significant only in lateral flexion. EMG activity of the trunk was increased during stumbling (abdominal: 665 +/- 283\%; back: 501 +/- 215\%), without significant differences between muscles. Provoked stumbling leads to a measurable effect on the trunk, quantifiable by an increase in ROM and EMG activity, compared to normal walking. Greater abdominal muscle activity and ROM of lateral flexion may indicate a specific compensation pattern occurring during stumbling. (C) 2015 Elsevier Ltd. All rights reserved.}, language = {en} } @article{MartinezValdesLaineFallaetal.2016, author = {Martinez-Valdes, Eduardo Andr{\´e}s and Laine, C. M. and Falla, D. and Mayer, Frank and Farina, D.}, title = {High-density surface electromyography provides reliable estimates of motor unit behavior}, series = {Clinical neurophysiology}, volume = {127}, journal = {Clinical neurophysiology}, publisher = {Elsevier}, address = {Clare}, issn = {1388-2457}, doi = {10.1016/j.clinph.2015.10.065}, pages = {2534 -- 2541}, year = {2016}, abstract = {Objective: To assess the intra-and inter-session reliability of estimates of motor unit behavior and muscle fiber properties derived from high-density surface electromyography (HDEMG). Methods: Ten healthy subjects performed submaximal isometric knee extensions during three recording sessions (separate days) at 10\%, 30\%, 50\% and 70\% of their maximum voluntary effort. The discharge timings of motor units of the vastus lateralis and medialis muscles were automatically identified from HDEMG by a decomposition algorithm. We characterized the number of detected motor units, their discharge rates, the coefficient of variation of their inter-spike intervals (CoVisi), the action potential conduction velocity and peak-to-peak amplitude. Reliability was assessed for each motor unit characteristics by intra-class correlation coefficient (ICC). Additionally, a pulse-to-noise ratio (PNR) was calculated, to verify the accuracy of the decomposition. Results: Good to excellent reliability within and between sessions was found for all motor unit characteristics at all force levels (ICCs > 0.8), with the exception of CoVisi that presented poor reliability (ICC < 0.6). PNR was high and similar for both muscles with values ranging between 45.1 and 47.6 dB (accuracy > 95\%). Conclusion: Motor unit features can be assessed non-invasively and reliably within and across sessions over a wide range of force levels. Significance: These results suggest that it is possible to characterize motor units in longitudinal intervention studies. (C) 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.}, language = {en} } @article{BisiBalogunCasselMayer2016, author = {Bisi-Balogun, Adebisi and Cassel, Michael and Mayer, Frank}, title = {Reliability of Various Measurement Stations for Determining Plantar Fascia Thickness and Echogenicity}, series = {Diagnostics : open access journal}, volume = {6}, journal = {Diagnostics : open access journal}, publisher = {MDPI}, address = {Basel}, issn = {2075-4418}, doi = {10.3390/diagnostics6020015}, pages = {506 -- 519}, year = {2016}, abstract = {This study aimed to determine the relative and absolute reliability of ultrasound (US) measurements of the thickness and echogenicity of the plantar fascia (PF) at different measurement stations along its length using a standardized protocol. Twelve healthy subjects (24 feet) were enrolled. The PF was imaged in the longitudinal plane. Subjects were assessed twice to evaluate the intra-rater reliability. A quantitative evaluation of the thickness and echogenicity of the plantar fascia was performed using Image J, a digital image analysis and viewer software. A sonography evaluation of the thickness and echogenicity of the PF showed a high relative reliability with an Intra class correlation coefficient of 0.88 at all measurement stations. However, the measurement stations for both the PF thickness and echogenicity which showed the highest intraclass correlation coefficient (ICCs) did not have the highest absolute reliability. Compared to other measurement stations, measuring the PF thickness at 3 cm distal and the echogenicity at a region of interest 1 cm to 2 cm distal from its insertion at the medial calcaneal tubercle showed the highest absolute reliability with the least systematic bias and random error. Also, the reliability was higher using a mean of three measurements compared to one measurement. To reduce discrepancies in the interpretation of the thickness and echogenicity measurements of the PF, the absolute reliability of the different measurement stations should be considered in clinical practice and research rather than the relative reliability with the ICC.}, language = {en} } @article{MuellerMuellerStolletal.2016, author = {M{\"u}ller, Juliane and M{\"u}ller, Steffen and Stoll, Josefine and Rector, Michael V. and Baur, Heiner and Mayer, Frank}, title = {Influence of Load on Three-Dimensional Segmental Trunk Kinematics in One-Handed Lifting: A Pilot Study}, series = {Journal of applied biomechanics}, volume = {32}, journal = {Journal of applied biomechanics}, publisher = {Human Kinetics Publ.}, address = {Champaign}, issn = {1065-8483}, doi = {10.1123/jab.2015-0227}, pages = {520 -- 525}, year = {2016}, abstract = {Stability of the trunk is relevant in determining trunk response to different loading in everyday tasks initiated by the limbs. Descriptions of the trunk's mechanical movement patterns in response to different loads while lifting objects are still under debate. Hence, the aim of this study was to analyze the influence of weight on 3-dimensional segmental motion of the trunk during 1-handed lifting. Ten asymptomatic subjects were included (29 ± 3 y; 1.79 ± 0.09 m; 75 ± 14 kg). Subjects lifted 3× a light and heavy load from the ground up onto a table. Three-dimensional segmental trunk motion was measured (12 markers; 3 segments: upper thoracic area [UTA], lower thoracic area [LTA], lumbar area [LA]). Outcomes were total motion amplitudes (ROM;[°]) for anterior flexion, lateral flexion, and rotation of each segment. The highest ROM was observed in the LTA segment (anterior flexion), and the smallest ROM in the UTA segment (lateral flexion). ROM differed for all planes between the 3 segments for both tasks (P < .001). There were no differences in ROM between light and heavy loads (P > .05). No interaction effects (load × segment) were observed, as ROM did not reveal differences between loading tasks. Regardless of weight, the 3 segments did reflect differences, supporting the relevance of multisegmental analysis.}, language = {en} } @article{MuellerEngelMuelleretal.2016, author = {Mueller, Juliane and Engel, Tilman and Mueller, Steffen and Kopinski, Stephan and Baur, Heiner and Mayer, Frank}, title = {Neuromuscular response of the trunk to sudden gait disturbances: Forward vs. backward perturbation}, series = {Journal of electromyography and kinesiology}, volume = {30}, journal = {Journal of electromyography and kinesiology}, publisher = {Elsevier}, address = {Oxford}, issn = {1050-6411}, doi = {10.1016/j.jelekin.2016.07.005}, pages = {168 -- 176}, year = {2016}, abstract = {The study aimed to analyse neuromuscular activity of the trunk comparing four different perturbations during gait. Thirteen subjects (28 +/- 3 yrs) walked (1 m/s) on a split-belt treadmill, while 4 (belt) perturbations (F1, F2, B1, B2) were randomly applied. Perturbations differed, related to treadmill belt translation, in direction (forward (F)/backward (B)) and amplitude (20 m/s(2) (1)/40 m/s(2) (2)). Trunk muscle activity was assessed with a 12-lead-EMG. EMG-RMS [\%] (0-200 ms after perturbation; normalized to RMS of normal gait) was analyzed for muscles and four trunk areas (ventral left/right; dorsal left/right). Ratio of ventral: dorsal muscles were calculated. Muscle onset [ms] was determined. Data analysis was conducted descriptively, followed by ANOVA (post hoc Tukey-Kramer (alpha = 0.05)). All perturbations lead to an increase in EMG-RMS (428 +/- 289\%). F1 showed the lowest and F2 the highest increase for the flexors. B2 showed the highest increase for the extensors. Significant differences between perturbations could be observed for 6 muscles, as well as the 4 trunk areas. Ratio analysis revealed no significant differences (range 1.25 (B1) to 1.71 (F2) between stimuli. Muscle response time (ventral: 87.0 +/- 21.7 ms; dorsal: 88.4 +/- 17.0 ms) between stimuli was only significant (p = 0.005) for the dorsal muscles. Magnitude significantly influences neuromuscular trunk response patterns in healthy adults. Regardless of direction ventral muscles always revealed higher relative increase of activity while compensating the walking perturbations. (C) 2016 Elsevier Ltd. All rights reserved.}, language = {en} } @article{NiedererVogtWippertetal.2016, author = {Niederer, Daniel and Vogt, Lutz and Wippert, Pia-Maria and Puschmann, Anne-Katrin and Pfeifer, Ann-Christin and Schiltenwolf, Marcus and Banzer, Winfried and Mayer, Frank}, title = {Medicine in spine exercise (MiSpEx) for nonspecific low back pain patients: study protocol for a multicentre, single-blind randomized controlled trial}, series = {Trials}, volume = {17}, journal = {Trials}, publisher = {BioMed Central}, address = {London}, issn = {1745-6215}, doi = {10.1186/s13063-016-1645-1}, pages = {9}, year = {2016}, abstract = {Background: Arising from the relevance of sensorimotor training in the therapy of nonspecific low back pain patients and from the value of individualized therapy, the present trial aims to test the feasibility and efficacy of individualized sensorimotor training interventions in patients suffering from nonspecific low back pain. Methods and study design: A multicentre, single-blind two-armed randomized controlled trial to evaluate the effects of a 12-week (3 weeks supervised centre-based and 9 weeks home-based) individualized sensorimotor exercise program is performed. The control group stays inactive during this period. Outcomes are pain, and pain-associated function as well as motor function in adults with nonspecific low back pain. Each participant is scheduled to five measurement dates: baseline (M1), following centre-based training (M2), following home-based training (M3) and at two follow-up time points 6 months (M4) and 12 months (M5) after M1. All investigations and the assessment of the primary and secondary outcomes are performed in a standardized order: questionnaires - clinical examination biomechanics (motor function). Subsequent statistical procedures are executed after the examination of underlying assumptions for parametric or rather non-parametric testing. Discussion: The results and practical relevance of the study will be of clinical and practical relevance not only for researchers and policy makers but also for the general population suffering from nonspecific low back pain.}, language = {en} } @article{IntziegianniCasselRaufetal.2016, author = {Intziegianni, Konstantina and Cassel, Michael and Rauf, S. and White, S. and Rector, Michael V. and Kaplick, Hannes and Wahmkow, Gunnar and Kratzenstein, S. and Mayer, Frank}, title = {Influence of Age and Pathology on Achilles Tendon Properties During a Single-leg Jump}, series = {International journal of sports medicine}, volume = {37}, journal = {International journal of sports medicine}, publisher = {Thieme}, address = {Stuttgart}, issn = {0172-4622}, doi = {10.1055/s-0042-108198}, pages = {973 -- 978}, year = {2016}, abstract = {Prevalence of Achilles tendinopathy increases with age leading to a weaker tendon with predisposition to rupture. Conclusive evidence of the influence of age and pathology on Achilles tendon (AT) properties remains limited, as previous studies are based on standardized isometric conditions. The study investigates the influence of age and pathology on AT properties during single-leg vertical jump (SLVJ). 10 children (C), 10 asymptomatic adults (A), and 10 tendinopathic patients (T) were included. AT elongation [mm] from rest to maximal displacement during a SLVJ on a force-plate was sonographically assessed. AT compliance [mm/N]) and strain [\%] was calculated by dividing elongation by peak ground reaction force [N] and length, respectively. One-way ANOVA followed by Bonferroni post-hoc correction (=0.05) were used to compare C with A and A with T. AT elongation (p=0.004), compliance (p=0.001), and strain were found to be statistically significant higher in C (27 +/- 3mm, 0.026 +/- 0.006[mm/N], 13 +/- 2\%) compared to A (21 +/- 4mm, 0.017 +/- 0.005[mm/N], 10 +/- 2\%). No statistically significant differences (p0.05) was found between A and T (25 +/- 5mm, 0.019 +/- 0.004[mm/N], 12 +/- 3\%). During SLVJ, tendon responded differently in regards to age and pathology with children having the most compliant AT. Higher compliance found in healthy tendons might be considered as a protective factor against load-related injuries.}, language = {en} } @misc{NiedererVogtWippertetal.2016, author = {Niederer, Daniel and Vogt, Lutz and Wippert, Pia-Maria and Puschmann, Anne-Katrin and Pfeifer, Ann-Christin and Schiltenwolf, Marcus and Banzer, Winfried and Mayer, Frank}, title = {Medicine in spine exercise (MiSpEx) for nonspecific low back pain patients}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {444}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-407308}, pages = {9}, year = {2016}, abstract = {Background: Arising from the relevance of sensorimotor training in the therapy of nonspecific low back pain patients and from the value of individualized therapy, the present trial aims to test the feasibility and efficacy of individualized sensorimotor training interventions in patients suffering from nonspecific low back pain. Methods and study design: A multicentre, single-blind two-armed randomized controlled trial to evaluate the effects of a 12-week (3 weeks supervised centre-based and 9 weeks home-based) individualized sensorimotor exercise program is performed. The control group stays inactive during this period. Outcomes are pain, and pain-associated function as well as motor function in adults with nonspecific low back pain. Each participant is scheduled to five measurement dates: baseline (M1), following centre-based training (M2), following home-based training (M3) and at two follow-up time points 6 months (M4) and 12 months (M5) after M1. All investigations and the assessment of the primary and secondary outcomes are performed in a standardized order: questionnaires - clinical examination - biomechanics (motor function). Subsequent statistical procedures are executed after the examination of underlying assumptions for parametric or rather non-parametric testing. Discussion: The results and practical relevance of the study will be of clinical and practical relevance not only for researchers and policy makers but also for the general population suffering from nonspecific low back pain. Trial registration: Identification number DRKS00010129. German Clinical Trial registered on 3 March 2016.}, language = {en} } @misc{DeSouzaSilveiraCarlsohnLangenetal.2016, author = {De Souza Silveira, Raul and Carlsohn, Anja and Langen, Georg and Mayer, Frank and Scharhag-Rosenberger, Friederike}, title = {Reliability and day-to-day variability of peak fat oxidation during treadmill ergometry}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {423}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-407334}, pages = {7}, year = {2016}, abstract = {Background: Exercising at intensities where fat oxidation rates are high has been shown to induce metabolic benefits in recreational and health-oriented sportsmen. The exercise intensity (Fat peak ) eliciting peak fat oxidation rates is therefore of particular interest when aiming to prescribe exercise for the purpose of fat oxidation and related metabolic effects. Although running and walking are feasible and popular among the target population, no reliable protocols are available to assess Fat peak as well as its actual velocity (V PFO ) during treadmill ergometry. Our purpose was therefore, to assess the reliability and day-to-day variability of V PFO and Fat peak during treadmill ergometry running. Methods: Sixteen recreational athletes (f = 7, m = 9; 25 ± 3 y; 1.76 ± 0.09 m; 68.3 ± 13.7 kg; 23.1 ± 2.9 kg/m 2 ) performed 2 different running protocols on 3 different days with standardized nutrition the day before testing. At day 1, peak oxygen uptake (VO 2peak ) and the velocities at the aerobic threshold (V LT ) and respiratory exchange ratio (RER) of 1.00 (V RER ) were assessed. At days 2 and 3, subjects ran an identical submaximal incremental test (Fat-peak test) composed of a 10 min warm-up (70 \% V LT ) followed by 5 stages of 6 min with equal increments (stage 1 = V LT , stage 5 = V RER ). Breath-by-breath gas exchange data was measured continuously and used to determine fat oxidation rates. A third order polynomial function was used to identify V PFO and subsequently Fat peak . The reproducibility and variability of variables was verified with an int raclass correlation coef ficient (ICC), Pearson ' s correlation coefficient, coefficient of variation (CV) an d the mean differences (bias) ± 95 \% limits of agreement (LoA). Results: ICC, Pearson ' s correlation and CV for V PFO and Fat peak were 0.98, 0.97, 5.0 \%; and 0.90, 0.81, 7.0 \%, respectively. Bias ± 95 \% LoA was - 0.3 ± 0.9 km/h for V PFO and - 2±8\%ofVO 2peak for Fat peak. Conclusion: In summary, relative and absolute reliability indicators for V PFO and Fat peak were found to be excellent. The observed LoA may now serve as a basis for future training prescriptions, although fat oxidation rates at prolonged exercise bouts at this intensity still need to be investigated.}, language = {en} } @article{MuellerMuellerStolletal.2016, author = {M{\"u}ller, Steffen and M{\"u}ller, Juliane and Stoll, Josefine and Prieske, Olaf and Cassel, Michael and Mayer, Frank}, title = {Incidence of back pain in adolescent athletes}, series = {BMC sports science, medicine \& rehabilitation}, volume = {8}, journal = {BMC sports science, medicine \& rehabilitation}, publisher = {BioMed Central}, address = {London}, issn = {2052-1847}, doi = {10.1186/s13102-016-0064-7}, pages = {5}, year = {2016}, abstract = {Background Recently, the incidence rate of back pain (BP) in adolescents has been reported at 21\%. However, the development of BP in adolescent athletes is unclear. Hence, the purpose of this study was to examine the incidence of BP in young elite athletes in relation to gender and type of sport practiced. Methods Subjective BP was assessed in 321 elite adolescent athletes (m/f 57\%/43\%; 13.2 ± 1.4 years; 163.4 ± 11.4 cm; 52.6 ± 12.6 kg; 5.0 ± 2.6 training yrs; 7.6 ± 5.3 training h/week). Initially, all athletes were free of pain. The main outcome criterion was the incidence of back pain [\%] analyzed in terms of pain development from the first measurement day (M1) to the second measurement day (M2) after 2.0 ± 1.0 year. Participants were classified into athletes who developed back pain (BPD) and athletes who did not develop back pain (nBPD). BP (acute or within the last 7 days) was assessed with a 5-step face scale (face 1-2 = no pain; face 3-5 = pain). BPD included all athletes who reported faces 1 and 2 at M1 and faces 3 to 5 at M2. nBPD were all athletes who reported face 1 or 2 at both M1 and M2. Data was analyzed descriptively. Additionally, a Chi2 test was used to analyze gender- and sport-specific differences (p = 0.05). Results Thirty-two athletes were categorized as BPD (10\%). The gender difference was 5\% (m/f: 12\%/7\%) but did not show statistical significance (p = 0.15). The incidence of BP ranged between 6 and 15\% for the different sport categories. Game sports (15\%) showed the highest, and explosive strength sports (6\%) the lowest incidence. Anthropometrics or training characteristics did not significantly influence BPD (p = 0.14 gender to p = 0.90 sports; r2 = 0.0825). Conclusions BP incidence was lower in adolescent athletes compared to young non-athletes and even to the general adult population. Consequently, it can be concluded that high-performance sports do not lead to an additional increase in back pain incidence during early adolescence. Nevertheless, back pain prevention programs should be implemented into daily training routines for sport categories identified as showing high incidence rates.}, language = {en} } @misc{MuellerCarlsohnMuelleretal.2016, author = {M{\"u}ller, Steffen and Carlsohn, Anja and M{\"u}ller, Juliane and Baur, Heiner and Mayer, Frank}, title = {Influence of Obesity on Foot Loading Characteristics in Gait for Children Aged 1 to 12 Years}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-90108}, year = {2016}, abstract = {Background Overweight and obesity are increasing health problems that are not restricted to adults only. Childhood obesity is associated with metabolic, psychological and musculoskeletal comorbidities. However, knowledge about the effect of obesity on the foot function across maturation is lacking. Decreased foot function with disproportional loading characteristics is expected for obese children. The aim of this study was to examine foot loading characteristics during gait of normal-weight, overweight and obese children aged 1-12 years. Methods A total of 10382 children aged one to twelve years were enrolled in the study. Finally, 7575 children (m/f: n = 3630/3945; 7.0 +/- 2.9yr; 1.23 +/- 0.19m; 26.6 +/- 10.6kg; BMI: 17.1 +/- 2.4kg/m(2)) were included for (complete case) data analysis. Children were categorized to normalweight (>= 3rd and <90th percentile; n = 6458), overweight (>= 90rd and <97th percentile; n = 746) or obese (>97th percentile; n = 371) according to the German reference system that is based on age and gender-specific body mass indices (BMI). Plantar pressure measurements were assessed during gait on an instrumented walkway. Contact area, arch index (AI), peak pressure (PP) and force time integral (FTI) were calculated for the total, fore-, mid-and hindfoot. Data was analyzed descriptively (mean +/- SD) followed by ANOVA/Welch-test (according to homogeneity of variances: yes/no) for group differences according to BMI categorization (normal-weight, overweight, obesity) and for each age group 1 to 12yrs (post-hoc Tukey Kramer/Dunnett's C; alpha = 0.05). Results Mean walking velocity was 0.95 +/- 0.25 m/s with no differences between normal-weight, overweight or obese children (p = 0.0841). Results show higher foot contact area, arch index, peak pressure and force time integral in overweight and obese children (p< 0.001). Obese children showed the 1.48-fold (1 year-old) to 3.49-fold (10 year-old) midfoot loading (FTI) compared to normal-weight. Conclusion Additional body mass leads to higher overall load, with disproportional impact on the midfoot area and longitudinal foot arch showing characteristic foot loading patterns. Already the feet of one and two year old children are significantly affected. Childhood overweight and obesity is not compensated by the musculoskeletal system. To avoid excessive foot loading with potential risk of discomfort or pain in childhood, prevention strategies should be developed and validated for children with a high body mass index and functional changes in the midfoot area. The presented plantar pressure values could additionally serve as reference data to identify suspicious foot loading patterns in children.}, language = {en} } @article{MuellerCarlsohnMuelleretal.2016, author = {M{\"u}ller, Steffen and Carlsohn, Anja and M{\"u}ller, Juliane and Baur, Heiner and Mayer, Frank}, title = {Influence of Obesity on Foot Loading Characteristics in Gait for Children Aged 1 to 12 Years}, series = {PLoS one}, volume = {11}, journal = {PLoS one}, number = {2}, publisher = {Public Library of Science}, address = {Lawrence, Kan.}, issn = {1932-6203}, doi = {10.1371/journal.pone.0149924}, year = {2016}, abstract = {Background Overweight and obesity are increasing health problems that are not restricted to adults only. Childhood obesity is associated with metabolic, psychological and musculoskeletal comorbidities. However, knowledge about the effect of obesity on the foot function across maturation is lacking. Decreased foot function with disproportional loading characteristics is expected for obese children. The aim of this study was to examine foot loading characteristics during gait of normal-weight, overweight and obese children aged 1-12 years. Methods A total of 10382 children aged one to twelve years were enrolled in the study. Finally, 7575 children (m/f: n = 3630/3945; 7.0 +/- 2.9yr; 1.23 +/- 0.19m; 26.6 +/- 10.6kg; BMI: 17.1 +/- 2.4kg/m(2)) were included for (complete case) data analysis. Children were categorized to normalweight (>= 3rd and <90th percentile; n = 6458), overweight (>= 90rd and <97th percentile; n = 746) or obese (>97th percentile; n = 371) according to the German reference system that is based on age and gender-specific body mass indices (BMI). Plantar pressure measurements were assessed during gait on an instrumented walkway. Contact area, arch index (AI), peak pressure (PP) and force time integral (FTI) were calculated for the total, fore-, mid-and hindfoot. Data was analyzed descriptively (mean +/- SD) followed by ANOVA/Welch-test (according to homogeneity of variances: yes/no) for group differences according to BMI categorization (normal-weight, overweight, obesity) and for each age group 1 to 12yrs (post-hoc Tukey Kramer/Dunnett's C; alpha = 0.05). Results Mean walking velocity was 0.95 +/- 0.25 m/s with no differences between normal-weight, overweight or obese children (p = 0.0841). Results show higher foot contact area, arch index, peak pressure and force time integral in overweight and obese children (p< 0.001). Obese children showed the 1.48-fold (1 year-old) to 3.49-fold (10 year-old) midfoot loading (FTI) compared to normal-weight. Conclusion Additional body mass leads to higher overall load, with disproportional impact on the midfoot area and longitudinal foot arch showing characteristic foot loading patterns. Already the feet of one and two year old children are significantly affected. Childhood overweight and obesity is not compensated by the musculoskeletal system. To avoid excessive foot loading with potential risk of discomfort or pain in childhood, prevention strategies should be developed and validated for children with a high body mass index and functional changes in the midfoot area. The presented plantar pressure values could additionally serve as reference data to identify suspicious foot loading patterns in children.}, language = {en} }