@phdthesis{Prieske2015,
  author    = {Prieske, Olaf},
  title     = {The role of surface condition in athletic performance},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-80503},
  school      = {Universit{\"a}t Potsdam},
  pages     = {viii, 118, ix},
  year      = {2015},
  abstract  = {During the last two decades, instability training devices have become a popular means in athletic training and rehabilitation of mimicking unstable surfaces during movements like vertical jumps. Of note, under unstable conditions, trunk muscles seem to have a stabilizing function during exercise to facilitate the transfer of torques and angular momentum between the lower and upper extremities. The present thesis addresses the acute effects of surface instability on performance during jump-landing tasks. Additionally, the long-term effects (i.e., training) of surface instability were examined with a focus on the role of the trunk in athletic performance/physical fitness. Healthy adolescent, and young adult subjects participated in three cross-sectional and one longitudinal study, respectively. Performance in jump-landing tasks on stable and unstable surfaces was assessed by means of a ground reaction force plate. Trunk muscle strength (TMS) was determined using an isokinetic device or the Bourban TMS test. Physical fitness was quantified by standing long jump, sprint, stand-and-reach, jumping sideways, Emery balance, and Y balance test on stable surfaces. In addition, activity of selected trunk and leg muscles and lower limb kinematics were recorded during jump-landing tasks. When performing jump-landing tasks on unstable compared to stable surfaces, jump performance and leg muscle activity were significantly lower. Moreover, significantly smaller knee flexion angles and higher knee valgus angles were observed when jumping and landing on unstable compared to stable conditions and in women compared to men. Significant but small associations were found between behavioral and neuromuscular data, irrespective of surface condition. Core strength training on stable as well as on unstable surfaces significantly improved TMS, balance and coordination. The findings of the present thesis imply that stable rather than unstable surfaces provide sufficient training stimuli during jump exercises (i.e., plyometrics). Additionally, knee motion strategy during plyometrics appears to be modified by surface instability and sex. Of note, irrespective of surface condition, trunk muscles only play a minor role for leg muscle performance/activity during jump exercises. Moreover, when implemented in strength training programs (i.e., core strength training), there is no advantage in using instability training devices compared to stable surfaces in terms of enhancement of athletic performance.},
  language  = {en}
}
@phdthesis{Kopinski2016,
  author    = {Kopinski, Stephan},
  title     = {The neuromuscular efficiency of lower back muscles in low back pain},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-101241},
  school      = {Universit{\"a}t Potsdam},
  pages     = {117},
  year      = {2016},
  abstract  = {BACKGROUND: The etiology of low back pain (LBP), one of the most prevalent and costly diseases of our time, is accepted to be multi-causal, placing functional factors in the focus of research. Thereby, pain models suggest a centrally controlled strategy of trunk stiffening in LBP. However, supporting biomechanical evidence is mostly limited to static measurements during maximum voluntary contractions (MVC), probably influenced by psychological factors in LBP. Alternatively, repeated findings indicate that the neuromuscular efficiency (NME), characterized by the strength-to-activation relationship (SAR), of lower back muscles is impaired in LBP. Therefore, a dynamic SAR protocol, consisting of normalized trunk muscle activation recordings during submaximal loads (SMVC) seems to be relevant. This thesis aimed to investigate the influence of LBP on the NME and activation pattern of trunk muscles during dynamic trunk extensions. METHODS: The SAR protocol consisted of an initial MVC reference trial (MVC1), followed by SMVCs at 20, 40, 60 and 80\% of MVC1 load. An isokinetic trunk dynamometer (Con-Trex TP, ROM: 45° flexion to 10° extension, velocity: 45°/s) and a trunk surface EMG setup (myon, up to 12 leads) was used. Extension torque output [Nm] and muscular activation [V] were assessed in all trials. Finally, another MVC trial was performed (MVC2) for reliability analysis. For SAR evaluation the SMVC trial values were normalized [\%MVC1] and compared inter- and intra-individually. The methodical validity of the approach was tested in an isometric SAR single-case pilot study (S1a: N = 2, female LBP patient vs. healthy male). In addition, the validity of the MVC reference method was verified by comparing different contraction modes (S1b: N = 17, healthy individuals). Next, the isokinetic protocol was validated in terms of content for its applicability to display known physiological differences between sexes in a cross-sectional study (S2: each n = 25 healthy males/females). Finally, the influence of acute pain on NME was investigated longitudinally by comparing N = 8 acute LBP patients with the retest after remission of pain (S3). The SAR analysis focused on normalized agonistic extensor activation and abdominal and synergistic extensor co-activation (t-tests, ANOVA, α = .05) as well as on reliability of MVC1/2 outcomes. RESULTS: During the methodological validation of the protocol (S1a), the isometric SAR was found to be descriptively different between individuals. Whereas torque output was highest during eccentric MVC, no relevant difference in peak EMG activation was found between contraction modes (S1b). The isokinetic SAR sex comparison (S2), though showing no significant overall effects, revealed higher normalized extensor activation at moderate submaximal loads in females (13 ± 4\%), primarily caused by pronounced thoracic activation. Similarly, co-activation analysis resulted in significantly higher antagonistic activation at moderate loads compared to males (33 ± 9\%). During intra-individual analysis of SAR in LBP patients (S3), a significant effect of pain status on the SAR has been identified, manifesting as increased normalized EMG activation of extensors during acute LBP (11 ± 8\%) particularly at high load. Abdominal co-activation tended to be elevated (27 ± 11\%) just as the thoracic extensor parts seemed to take over proportions of lumbar activation. All together, the M. erector spinae behaviour during the SAR protocol was rather linear with the tendency to rise exponentially during high loads. For the level of normalized EMG activation during SMVCs, a clear increasing trend from healthy males to females over to non-acute and acute LBP patients was discovered. This was associated by elevated antagonistic activation and a shift of synergistic towards lumbar extensor activation. The MVC data revealed overall good reliability, with clearly higher variability during acute LBP. DISCUSSION: The present thesis demonstrates that the NME of lower back muscles is impaired in LBP patients, especially during an acute pain episode. A new dynamic protocol has been developed that makes it possible to display the underlying SAR using normalized trunk muscle EMG during submaximal isokinetic loads. The protocol shows promise as a biomechanical tool for diagnostic analysis of NME in LBP patients and monitoring of rehabilitation progress. Furthermore, reliability not of maximum strength but rather of peak EMG of MVC measurements seems to be decreased in LBP patients. Meanwhile, the findings of this thesis largely substantiate the assumptions made by the recently presented 'motor adaptation to pain' model, suggesting a pain-related intra- and intermuscular activation redistribution affecting movement and stiffness of the trunk. Further research is needed to distinguish the grade of NME impairment between LBP subgroups.},
  language  = {en}
}