@article{RectorIntziegianniMuelleretal.2017,
  author    = {Rector, Michael V. and Intziegianni, Konstantina and M{\"u}ller, Steffen and Mayer, Frank and Cassel, Michael},
  title     = {Reproducibility of an ankle joint rotation correction method for assessment of Achilles tendon elongation},
  series = {Isokinetics and exercise science : official journal of the European Isokinetic Society},
  volume    = {25},
  journal   = {Isokinetics and exercise science : official journal of the European Isokinetic Society},
  number    = {1},
  publisher = {IOS Press},
  address   = {Amsterdam},
  issn      = {0959-3020},
  doi       = {10.3233/IES-160644},
  pages     = {47 -- 52},
  year      = {2017},
  abstract  = {BACKGROUND: The Achilles tendon (AT) requires optimal material and mechanical properties to function properly. Calculation of these properties depends on accurate measurement of input parameters (i.e. tendon elongation). However, the measurement of AT elongation with ultrasound during maximum voluntary isometric contraction (MVIC) is overestimated by ankle joint rotation (AJR). Methods to correct the influence of this rotation on AT elongation exist, yet their reproducibility in clinical settings is unknown. OBJECTIVE: To evaluate the test-retest reproducibility of AT elongation during MVIC after AJR correction. METHODS: Ten participants attended test and retest measurements where they performed plantar-flexion MVIC on a dynamometer. Simultaneously, ultrasound recorded AT elongation as the displacement of the medial gastrocnemius-myotendinous junction, while an electrogoniometer measured AJR. The ankle was then passively rotated to the AJR achieved during MVIC and AT elongation again determined. Elongation was corrected by subtracting this passive AT elongation from the total AT elongation during MVIC. Reproducibility was evaluated using ICC (2.1), test-retest variability (TRV, \%), Bland-Altman analyses (Bias +/- LoA [1.96*SD]) and standard error of the measurement (SEM). RESULTS: Corrected AT elongation reproducibility exhibited an ICC = 0.79, SEM = 0.2 cm and TRV = 20 +/- 19\%. Bias +/- LoA were determined to be 0.0 +/- 0.8 cm. CONCLUSIONS: Using this ultrasound and electrogoniometer-based method, corrected AT elongation can be assessed reproducibly.},
  language  = {en}
}
@article{MuellerEngelKopinskietal.2017,
  author    = {M{\"u}ller, Juliane and Engel, Tilman and Kopinski, Stephan and Mayer, Frank and M{\"u}ller, Steffen},
  title     = {Neuromuscular trunk activation patterns in back pain patients during one-handed lifting},
  series = {World journal of orthopedics},
  volume    = {8},
  journal   = {World journal of orthopedics},
  number    = {2},
  publisher = {Baishideng Publishing Group},
  address   = {Pleasanton},
  issn      = {2218-5836},
  doi       = {10.5312/wjo.v8.i2.142},
  pages     = {142 -- 148},
  year      = {2017},
  abstract  = {AIM To analyze neuromuscular activity patterns of the trunk in healthy controls (H) and back pain patients (BPP) during one-handed lifting of light to heavy loads. METHODS RESULTS Seven subjects (3m/4f; 32 +/- 7 years; 171 +/- 7 cm; 65 +/- 11 kg) were assigned to BPP (pain grade >= 2) and 36 (13m/23f; 28 +/- 8 years; 174 +/- 10 cm; 71 +/- 12 kg) to H (pain grade <= 1). H and BPP did not differ significantly in anthropometrics (P > 0.05). All subjects were able to lift the light and middle loads, but 57\% of BPP and 22\% of H were not able to lift the heavy load (all women) chi(2) analysis revealed statistically significant differences in task failure between H vs BPP (P = 0.03). EMG-RMS ranged from 33\% +/- 10\%/30\% +/- 9\% (DL, 1 kg) to 356\% +/- 148\%/283\% +/- 80\% (VR, 20 kg) in H/BPP with no statistical difference between groups regardless of load (P > 0.05). However, the EMG-RMS of the VR was greatest in all lifting tasks for both groups and increased with heavier loads. CONCLUSION Heavier loading leads to an increase (2-to 3-fold) in trunk muscle activity with comparable patterns. Heavy loading (20 kg) leads to task failure, especially in women with back pain.},
  language  = {en}
}
@article{MartinezValdesNegroLaineetal.2017,
  author    = {Martinez-Valdes, Eduardo Andr{\´e}s and Negro, F. and Laine, C. M. and Falla, D. and Mayer, Frank and Farina, Dario},
  title     = {Tracking motor units longitudinally across experimental sessions with high-density surface electromyography},
  series = {The Journal of Physiology},
  volume    = {595},
  journal   = {The Journal of Physiology},
  publisher = {Wiley},
  address   = {Hoboken},
  issn      = {0022-3751},
  doi       = {10.1113/JP273662},
  pages     = {1479 -- 1496},
  year      = {2017},
  abstract  = {A new method is proposed for tracking individual motor units (MUs) across multiple experimental sessions on different days. The technique is based on a novel decomposition approach for high-density surface electromyography and was tested with two experimental studies for reliability and sensitivity. Experiment I (reliability): ten participants performed isometric knee extensions at 10, 30, 50 and 70\% of their maximum voluntary contraction (MVC) force in three sessions, each separated by 1 week. Experiment II (sensitivity): seven participants performed 2 weeks of endurance training (cycling) and were tested pre-post intervention during isometric knee extensions at 10 and 30\% MVC. The reliability (Experiment I) and sensitivity (Experiment II) of the measured MU properties were compared for the MUs tracked across sessions, with respect to all MUs identified in each session. In Experiment I, on average 38.3\% and 40.1\% of the identified MUs could be tracked across two sessions (1 and 2 weeks apart), for the vastus medialis and vastus lateralis, respectively. Moreover, the properties of the tracked MUs were more reliable across sessions than those of the full set of identified MUs (intra-class correlation coefficients ranged between 0.63-0.99 and 0.39-0.95, respectively). In Experiment II, similar to 40\% of the MUs could be tracked before and after the training intervention and training-induced changes in MU conduction velocity had an effect size of 2.1 (tracked MUs) and 1.5 (group of all identified motor units). These results show the possibility of monitoring MU properties longitudinally to document the effect of interventions or the progression of neuromuscular disorders.},
  language  = {en}
}
@misc{PuschmannBeckSchiltenwolfetal.2017,
  author    = {Puschmann, Anne-Kathrin and Beck, Heidrun and Schiltenwolf, Marcus and Wippert, Pia-Maria and Mayer, Frank},
  title     = {Distress in a longitudinal study of a population with nonspecific low back pain},
  series = {Psychosomatic medicine},
  volume    = {79},
  journal   = {Psychosomatic medicine},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0033-3174},
  pages     = {A20 -- A21},
  year      = {2017},
  language  = {en}
}
@misc{DeWittHubertsNiedererWippertetal.2017,
  author    = {De Witt Huberts, Jessie and Niederer, Daniel and Wippert, Pia-Maria and Mayer, Frank},
  title     = {The effects of a new practical and synergetic multimodal treatment for chronic back pain on pain-related cognitions and wellbeing},
  series = {Psychosomatic medicine},
  volume    = {79},
  journal   = {Psychosomatic medicine},
  number    = {4},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0033-3174},
  pages     = {A22 -- A23},
  year      = {2017},
  language  = {en}
}
@article{RischCasselMayer2017,
  author    = {Risch, Lucie and Cassel, Michael and Mayer, Frank},
  title     = {Acute effect of running exercise on physiological Achilles tendon blood flow},
  series = {Scandinavian journal of medicine \& science in sports},
  volume    = {28},
  journal   = {Scandinavian journal of medicine \& science in sports},
  number    = {1},
  publisher = {Wiley},
  address   = {Hoboken},
  issn      = {0905-7188},
  doi       = {10.1111/sms.12874},
  pages     = {138 -- 143},
  year      = {2017},
  abstract  = {Sonographically detectable intratendinous blood flow (IBF) is found in 50\%-88\% of Achilles tendinopathy patients as well as in up to 35\% of asymptomatic Achilles tendons (AT). Although IBF is frequently associated with tendon pathology, it may also represent a physiological regulation, for example, due to increased blood flow in response to exercise. Therefore, this study aimed to investigate the acute effects of a standardized running exercise protocol on IBF assessed with Doppler ultrasound (DU) Advanced dynamic flow in healthy ATs. 10 recreationally active adults (5 f, 5m; 29 +/- 3years, 1.72 +/- 0.12m, 68 +/- 16kg, physical activity 206 +/- 145minute/wk) with no history of AT pain and inconspicious tendon structure performed 3 treadmill running tasks on separate days (M1-3) with DU examinations directly before and 5, 30, 60, and 120minutes after exercise. At M1, an incremental exercise test was used to determine the individual anaerobic threshold (IAT). At M2 and M3, participants performed 30-minute submaximal constant load tests (CL1/CL2) with an intensity 5\% below IAT. IBF in each tendon was quantified by counting the number of vessels. IBF increased in five ATs from no vessels at baseline to one to four vessels solely detectable 5minutes after CL1 or CL2. One AT had persisting IBF (three vessels) throughout all examinations. Fourteen ATs revealed no IBF at all. Prolonged running led to a physiological, temporary appearance of IBF in 25\% of asymptomatic ATs. To avoid exercise-induced IBF in clinical practice, DU examinations should be performed after 30minutes of rest.},
  language  = {en}
}
@article{RischWochatzMesserschmidtetal.2017,
  author    = {Risch, Lucie and Wochatz, Monique and Messerschmidt, Janin and Engel, Tilman and Mayer, Frank and Cassel, Michael},
  title     = {Reliability of evaluating achilles tendon vascularization assessed with doppler ultrasound advanced dynamic flow},
  series = {Journal of ultrasound in medicine},
  volume    = {37},
  journal   = {Journal of ultrasound in medicine},
  number    = {3},
  publisher = {Wiley},
  address   = {Hoboken},
  issn      = {0278-4297},
  doi       = {10.1002/jum.14414},
  pages     = {737 -- 744},
  year      = {2017},
  abstract  = {The reliability of quantifying intratendinous vascularization by high-sensitivity Doppler ultrasound advanced dynamic flow has not been examined yet. Therefore, this study aimed to investigate the intraobserver and interobserver reliability of evaluating Achilles tendon vascularization by advanced dynamic flow using established scoring systems. Methods-Three investigators evaluated vascularization in 67 recordings in a test-retest design, applying the Ohberg score, a modified Ohberg score, and a counting score. Intraobserver and interobserver agreement for the Ohberg score and modified Ohberg score was analyzed by the Cohen kappa and Fleiss kappa coefficients (absolute), Kendall tau b coefficient, and Kendall coefficient of concordance (W; relative). The reliability of the counting score was analyzed by intraclass correlation coefficients (ICC) 2.1 and 3.1, the standard error of measurement (SEM), and Bland-Altman analysis (bias and limits of agreement [LoA]). Results-Intraobserver and interobserver agreement (absolute/relative) ranged from 0.61 to 0.87/0.87 to 0.95 and 0.11 to 0.66/0.76 to 0.89 for the Ohberg score and from 0.81 to 0.87/0.92 to 0.95 and 0.64 to 0.80/0.88 to 0.93 for the modified Ohberg score, respectively. The counting score revealed an intraobserver ICC of 0.94 to 0.97 (SEM, 1.0-1.5; bias, -1; and LoA, 3-4 vessels). The interobserver ICC for the counting score ranged from 0.91 to 0.98 (SEM, 1.0-1.9; bias, 0; and LoA, 3-5 vessels). Conclusions-The modified Ohberg score and counting score showed excellent reliability and seem convenient for research and clinical practice. The Ohberg score revealed decent intraobserver but unexpected low interobserver reliability and therefore cannot be recommended.},
  language  = {en}
}
@article{MuellerHadzicMugeleetal.2017,
  author    = {M{\"u}ller, Juliane and Hadzic, Miralem and Mugele, Hendrik and Stoll, Josefine and M{\"u}ller, Steffen and Mayer, Frank},
  title     = {Effect of high-intensity perturbations during core-specific sensorimotor exercises on trunk muscle activation},
  series = {Journal of biomechanics},
  volume    = {70},
  journal   = {Journal of biomechanics},
  publisher = {Elsevier},
  address   = {Oxford},
  issn      = {0021-9290},
  doi       = {10.1016/j.jbiomech.2017.12.013},
  pages     = {212 -- 218},
  year      = {2017},
  abstract  = {Core-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk. However, the influence of high-intensity perturbations on training efficiency is unclear within this context. Sixteen participants (29 +/- 2 yrs; 175 +/- 8 cm; 69 +/- 13 kg) were prepared with a 12-lead bilateral trunk EMG. Warm-up on a dynamometer was followed by maximum voluntary isometric trunk (flex/ext) contraction (MVC). Next, participants performed four conditions for a one-legged stance with hip abduction on a stable surface (HA) repeated randomly on an unstable surface (HAP), on a stable surface with perturbation (HA + P), and on an unstable surface with perturbation (HAP + P). Afterwards, bird dog (BD) was performed under the same conditions (BD, BDP, BD + P, BDP + P). A foam pad under the foot (HA) or the knee (BD) was used as an unstable surface. Exercises were conducted on a moveable platform. Perturbations (ACC 50 m/sec(2);100 ms duration;10rep.) were randomly applied in the anterior-posterior direction. The root mean square (RMS) normalized to MVC (\%) was calculated (whole movement cycle). Muscles were grouped into ventral right and left (VR;VL), and dorsal right and left (DR;DL). Ventral Dorsal and right-left ratios were calculated (two way repeated-measures ANOVA;alpha = 0,05). Amplitudes of all muscle groups in bird dog were higher compared to hip abduction (p <= 0.0001; Range: BD: 14 +/- 3\% (BD;VR) to 53 +/- 4\%; HA: 7 +/- 2\% (HA;DR) to 16 +/- 4\% (HA;DR)). EMG-RMS showed significant differences (p < 0.001) between conditions and muscle groups per exercise. Interaction effects were only significant for HA (p = 0.02). No significant differences were present in EMG ratios (p > 0.05). Additional high-intensity perturbations during core-specific sensorimotor exercises lead to increased neuromuscular activity and therefore higher exercise intensities. However, the beneficial effects on trunk function remain unclear. Nevertheless, BD is more suitable to address trunk muscles.},
  language  = {en}
}
@article{WochatzRabeWolteretal.2017,
  author    = {Wochatz, Monique and Rabe, Sophie and Wolter, Martin and Engel, Tilman and Mueller, Steffen and Mayer, Frank},
  title     = {Muscle activity of upper and lower trapezius and serratus anterior during unloaded and maximal loaded shoulder flexion and extension},
  series = {International Biomechanics},
  volume    = {4},
  journal   = {International Biomechanics},
  number    = {2},
  publisher = {Elsevier},
  address   = {Amsterdam},
  doi       = {https://doi.org/10.1080/23335432.2017.1364668},
  pages     = {68 -- 76},
  year      = {2017},
  abstract  = {Altered scapular muscle activity is mostly described under unloaded and submaximal loaded conditions in impingement patients. However, there is no clear evidence on muscle activity with respect to movement phases under maximum load in healthy subjects. Therefore, this study aimed to investigate scapular muscle activity under unloaded and maximum loaded isokinetic shoulder flexion and extension in regard to the movement phase. Fourteen adults performed unloaded (continuous passive motion [CPM]) as well as maximum loaded (concentric [CON], eccentric [ECC]) isokinetic shoulder flexion (Flex) and extension (Ext). Simultaneously, scapular muscle activity was measured by EMG. Root mean square was calculated for the whole ROM and four movement phases. Data were analyzed descriptively and by two-way repeated measures ANOVA. CPMFlex resulted in a linear increase of muscle activity for all muscles. Muscle activity during CONFlex and ECCFlex resulted in either constant activity levels or in an initial increase followed by a plateau in the second half of movement. CPMExt decreased with the progression of movement, whereas CONExt and ECCExt initially decreased and either levelled off or increased in the second half of movement. Scapular muscle activity of unloaded shoulder flexion and extension changed under maximum load showing increased activity levels and an altered pattern over the course of movement.},
  language  = {en}
}
@article{MuellerMuellerStolletal.2017,
  author    = {M{\"u}ller, Juliane and M{\"u}ller, Steffen and Stoll, Josefine and Fr{\"o}hlich, K. and Otto, Christoph and Mayer, Frank},
  title     = {Back pain prevalence in adolescent athletes},
  series = {Scandinavian journal of medicine \& science in sports},
  volume    = {27},
  journal   = {Scandinavian journal of medicine \& science in sports},
  publisher = {Wiley},
  address   = {Hoboken},
  issn      = {0905-7188},
  doi       = {10.1111/sms.12664},
  pages     = {448 -- 454},
  year      = {2017},
  abstract  = {The research aimed to investigate back pain (BP) prevalence in a large cohort of young athletes with respect to age, gender, and sport discipline. BP (within the last 7days) was assessed with a face scale (face 1-2=no pain; face 3-5=pain) in 2116 athletes (m/f 61\%/39\%; 13.3 +/- 1.7years; 163.0 +/- 11.8cm; 52.6 +/- 13.9kg; 4.9 +/- 2.7 training years; 8.4 +/- 5.7 training h/week). Four different sports categories were devised (a: combat sports, b: game sports; c: explosive strength sport; d: endurance sport). Analysis was described descriptively, regarding age, gender, and sport. In addition, 95\% confidence intervals (CI) were calculated. About 168 (8\%) athletes were allocated into the BP group. About 9\% of females and 7\% of males reported BP. Athletes, 11-13years, showed a prevalence of 2-4\%; while prevalence increased to 12-20\% in 14- to 17-year olds. Considering sport discipline, prevalence ranged from 3\% (soccer) to 14\% (canoeing). Prevalences in weight lifting, judo, wrestling, rowing, and shooting were 10\%; in boxing, soccer, handball, cycling, and horse riding, 6\%. 95\% CI ranged between 0.08-0.11. BP exists in adolescent athletes, but is uncommon and shows no gender differences. A prevalence increase after age 14 is obvious. Differentiated prevention programs in daily training routines might address sport discipline-specific BP prevalence.},
  language  = {en}
}
@article{EngelMuellerKopinskietal.2017,
  author    = {Engel, Tilman and Mueller, Juliane and Kopinski, Stephan and Reschke, Antje and Mueller, Steffen and Mayer, Frank},
  title     = {Unexpected walking perturbations: Reliability and validity of a new treadmill protocol to provoke muscular reflex activities at lower extremities and the trunk},
  series = {Journal of biomechanics},
  volume    = {55},
  journal   = {Journal of biomechanics},
  publisher = {Elsevier},
  address   = {Oxford},
  issn      = {0021-9290},
  doi       = {10.1016/j.jbiomech.2017.02.026},
  pages     = {152 -- 155},
  year      = {2017},
  abstract  = {Instrumented treadmills offer the potential to generate standardized walking perturbations, which are particularly rapid and powerful. However, technical requirements to release adequate perturbations regarding timing, duration and amplitude are demanding. This study investigated the test-retest reliability and validity of a new treadmill perturbation protocol releasing rapid and unexpected belt perturbations to provoke muscular reflex responses at lower extremities and the trunk. Fourteen healthy participants underwent two identical treadmill walking protocols, consisting of 10 superimposed one-sided belt perturbations (100 ms duration; 2 m/s amplitude), triggered by a plantar pressure insole 200 ms after heel contact. Delay, duration and amplitude of applied perturbations were recorded by 3D-motion capture. Muscular reflex responses (within 200 ms) were measured at lower extremities and the trunk (10-lead EMG). Data was analyzed descriptively (mean +/- SD). Reliability was analyzed using test-retest variability (TRV\%) and limits of agreement (LoA, bias +/- 1.96*SD). Perturbation delay was 202 14 ms, duration was 102 +/- 4 ms and amplitude was 2.1 +/- 0.01 m/s. TRV for perturbation delay, duration and amplitude ranged from 5.0\% to 5.7\%. LoA reached 3 +/- 36 ms for delay, 2 +/- 13 ms for duration and 0.0 +/- 0.3 m/s for amplitude. EMG amplitudes following perturbations ranged between 106 +/- 97\% and 909 +/- 979\% of unperturbed gait and EMG latencies between 82 +/- 14 ms and 106 +/- 16 ms. Minor differences between preset and observed perturbation characteristics and results of test-retest analysis prove a high validity with excellent reliability of the setup. Therefore, the protocol tested can be recommended to provoke muscular reflex responses at lower extremities and the trunk in perturbed walking. (C) 2017 Elsevier Ltd. All rights reserved.},
  language  = {en}
}
@misc{ChaparroZechHeinzeletal.2017,
  author    = {Chaparro, Camilo G. A. Perez and Zech, Philipp A. and Heinzel, Stephan and Mayer, Frank and Wolfarth, Bernd and Rapp, Michael Armin and Heissel, Andreas},
  title     = {Effects Of Aerobic \& Resistance Training On Cardiorespiratory Fitness In People Living with HIV. A Meta-analysis},
  series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  volume    = {49},
  journal   = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0195-9131},
  doi       = {10.1249/01.mss.0000519265.28705.86},
  pages     = {842 -- 842},
  year      = {2017},
  language  = {en}
}
@article{MuellerStollMuelleretal.2017,
  author    = {M{\"u}ller, Steffen and Stoll, Josefine and Mueller, Juliane and Cassel, Michael and Mayer, Frank},
  title     = {Trunk Muscle Activity during Drop Jump Performance in Adolescent Athletes with Back Pain},
  series = {Frontiers in physiology},
  volume    = {8},
  journal   = {Frontiers in physiology},
  publisher = {Frontiers Research Foundation},
  address   = {Lausanne},
  issn      = {1664-042X},
  doi       = {10.3389/fphys.2017.00274},
  pages     = {124 -- 132},
  year      = {2017},
  abstract  = {In the context of back pain, great emphasis has been placed on the importance of trunk stability, especially in situations requiring compensation of repetitive, intense loading induced during high-performance activities, e.g., jumping or landing. This study aims to evaluate trunk muscle activity during drop jump in adolescent athletes with back pain (BP) compared to athletes without back pain (NBP). Eleven adolescent athletes suffering back pain (BP: m/f: n = 4/7; 15.9 +/- 1.3 y; 176 +/- 11 cm; 68 +/- 11 kg; 12.4 +/- 10.5 h/we training) and 11 matched athletes without back pain (NBP: m/f: n = 4/7; 15.5 +/- 1.3 y; 174 +/- 7 cm; 67 +/- 8 kg; 14.9 +/- 9.5 h/we training) were evaluated. Subjects conducted 3 drop jumps onto a force plate (ground reaction force). Bilateral 12-lead SEMG (surface Electromyography) was applied to assess trunk muscle activity. Ground contact time [ms], maximum vertical jump force [N], jump time [ms] and the jump performance index [m/s] were calculated for drop jumps. SEMG amplitudes (RMS: root mean square [\%]) for all 12 single muscles were normalized toMIVC (maximum isometric voluntary contraction) and analyzed in 4 time windows (100 ms pre- and 200 ms post-initial ground contact, 100 ms pre- and 200 ms post-landing) as outcome variables. In addition, muscles were grouped and analyzed in ventral and dorsal muscles, as well as straight and transverse trunk muscles. Drop jump ground reaction force variables did not differ between NBP and BP (p > 0.05). Mm obliquus externus and internus abdominis presented higher SEMG amplitudes (1.3-1.9-fold) for BP (p < 0.05). Mm rectus abdominis, erector spinae thoracic/lumbar and latissimus dorsi did not differ (p > 0.05). The muscle group analysis over the whole jumping cycle showed statistically significantly higher SEMG amplitudes for BP in the ventral (p = 0.031) and transverse muscles (p = 0.020) compared to NBP. Higher activity of transverse, but not straight, trunk muscles might indicate a specific compensation strategy to support trunk stability in athletes with back pain during drop jumps. Therefore, exercises favoring the transverse trunk muscles could be recommended for back pain treatment.},
  language  = {en}
}
@article{WochatzRabeWolteretal.2017,
  author    = {Wochatz, Monique and Rabe, Sophie and Wolter, Martin and Engel, Tilman and Mueller, Steffen and Mayer, Frank},
  title     = {Reproducibility of scapular muscle activity in isokinetic shoulder flexion and extension},
  series = {Journal of electromyography and kinesiology},
  volume    = {34},
  journal   = {Journal of electromyography and kinesiology},
  publisher = {Elsevier},
  address   = {Oxford},
  issn      = {1050-6411},
  doi       = {10.1016/j.jelekin.2017.04.006},
  pages     = {86 -- 92},
  year      = {2017},
  abstract  = {Repetitive overhead movements have been identified as a main risk factor to develop shoulder complaints with scapular muscle activity being altered. Reliable assessment of muscle activity is essential to differentiate between symptomatic and asymptomatic individuals. Therefore, the present study aimed to investigate the intra-and inter-session reliability of scapular muscle activity during maximal isokinetic shoulder flexion and extension. Eleven asymptomatic adults performed maximum effort isokinetic shoulder flexion and extension (concentric and eccentric at 60 degrees/s) in a test-retest design. Muscle activity of the upper and lower trapezius and serratus anterior was assessed by sEMG. Root Mean Square was calculated for whole ROM and single movement phases of absolute and normalized muscle activity. Absolute (Bland-Altman analysis (Bias, LoA), Minimal detectable change (MDC)) and relative reliability parameters (Intraclass correlation coefficient (ICC), coefficient of variation (CV)/test-retest variability (TRV)) were utilized for the evaluation of reproducibility. Intra-session reliability revealed ICCs between 0.56 and 0.98, averaged CVs of 18\% and average MDCs of 81 mV. Inter-session reliability resulted in ICCs between 0.13 and 0.93, averaged TRVs of 21\%, average MDCs of 15\% and systematic and random error between -8 +/- 60\% and 12 +/- 36\%. Scapular muscle activity assessed in overhead movements can be measured reliably under maximum load conditions, though variability is dependent on the movement phase. Measurement variability does not exceed magnitudes of altered scapular muscle activities as reported in previous studies. Therefore, maximum load application is a promising approach for the evaluation of changes in scapular control related to pathologies. (C) 2017 Elsevier Ltd. All rights reserved.},
  language  = {en}
}
@article{MartinezValdesFallaNegroetal.2017,
  author    = {Martinez-Valdes, Eduardo Andr{\´e}s and Falla, Deborah and Negro, Francesco and Mayer, Frank and Farina, Dario},
  title     = {Differential Motor Unit Changes after Endurance or High-Intensity Interval Training},
  series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  volume    = {49},
  journal   = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0195-9131},
  doi       = {10.1249/MSS.0000000000001209},
  pages     = {1126 -- 1136},
  year      = {2017},
  abstract  = {Purpose Using a novel technique of high-density surface EMG decomposition and motor unit (MU) tracking, we compared changes in the properties of vastus medialis and vastus lateralis MU after endurance (END) and high-intensity interval training (HIIT). Methods Sixteen men were assigned to the END or the HIIT group (n = 8 each) and performed six training sessions for 14 d. Each session consisted of 8-12 x 60-s intervals at 100\% peak power output separated by 75 s of recovery (HIIT) or 90-120 min continuous cycling at similar to 65\% VO2peak (END). Pre- and postintervention, participants performed 1) incremental cycling to determine VO2peak and peak power output and 2) maximal, submaximal (10\%, 30\%, 50\%, and 70\% maximum voluntary contraction [MVC]), and sustained (until task failure at 30\% MVC) isometric knee extensions while high-density surface EMG signals were recorded from the vastus medialis and vastus lateralis. EMG signals were decomposed (submaximal contractions) into individual MU by convolutive blind source separation. Finally, MU were tracked across sessions by semiblind source separation. Results After training, END and HIIT improved VO2peak similarly (by 5.0\% and 6.7\%, respectively). The HIIT group showed enhanced maximal knee extension torque by similar to 7\% (P = 0.02) and was accompanied by an increase in discharge rate for high-threshold MU (50\% knee extension MVC) (P < 0.05). By contrast, the END group increased their time to task failure by similar to 17\% but showed no change in MU discharge rates (P > 0.05). Conclusions HIIT and END induce different adjustments in MU discharge rate despite similar improvements in cardiopulmonary fitness. Moreover, the changes induced by HIIT are specific for high-threshold MU. For the first time, we show that HIIT and END induce specific neuromuscular adaptations, possibly related to differences in exercise load intensity and training volume.},
  language  = {en}
}
@article{EichlerRabeSalzwedeletal.2017,
  author    = {Eichler, Sarah and Rabe, Sophie and Salzwedel, Annett and Mueller, Steffen and Stoll, Josefine and Tilgner, Nina and John, Michael and Wegscheider, Karl and Mayer, Frank and V{\"o}ller, Heinz},
  title     = {Effectiveness of an interactive telerehabilitation system with home-based exercise training in patients after total hip or knee replacement: study protocol for a multicenter, superiority, no-blinded randomized controlled trial},
  series = {Trials},
  volume    = {18},
  journal   = {Trials},
  publisher = {BioMed Central},
  address   = {London},
  issn      = {1745-6215},
  doi       = {10.1186/s13063-017-2173-3},
  pages     = {7},
  year      = {2017},
  abstract  = {Background: Total hip or knee replacement is one of the most frequently performed surgical procedures. Physical rehabilitation following total hip or knee replacement is an essential part of the therapy to improve functional outcomes and quality of life. After discharge from inpatient rehabilitation, a subsequent postoperative exercise therapy is needed to maintain functional mobility. Telerehabilitation may be a potential innovative treatment approach. We aim to investigate the superiority of an interactive telerehabilitation intervention for patients after total hip or knee replacement, in comparison to usual care, regarding physical performance, functional mobility, quality of life and pain. Methods/design: This is an open, randomized controlled, multicenter superiority study with two prospective arms. One hundred and ten eligible and consenting participants with total knee or hip replacement will be recruited at admission to subsequent inpatient rehabilitation. After comprehensive, 3-week, inpatient rehabilitation, the intervention group performs a 3-month, interactive, home-based exercise training with a telerehabilitation system. For this purpose, the physiotherapist creates an individual training plan out of 38 different strength and balance exercises which were implemented in the system. Data about the quality and frequency of training are transmitted to the physiotherapist for further adjustment. Communication between patient and physiotherapist is possible with the system. The control group receives voluntary, usual aftercare programs. Baseline assessments are investigated after discharge from rehabilitation; final assessments 3 months later. The primary outcome is the difference in improvement between intervention and control group in 6-minute walk distance after 3 months. Secondary outcomes include differences in the Timed Up and Go Test, the Five-Times-Sit-to-Stand Test, the Stair Ascend Test, the Short-Form 36, the Western Ontario and McMaster Universities Osteoarthritis Index, the International Physical Activity Questionnaire, and postural control as well as gait and kinematic parameters of the lower limbs. Baseline-adjusted analysis of covariance models will be used to test for group differences in the primary and secondary endpoints. Discussion: We expect the intervention group to benefit from the interactive, home-based exercise training in many respects represented by the study endpoints. If successful, this approach could be used to enhance the access to aftercare programs, especially in structurally weak areas.},
  language  = {en}
}
@article{CasselIntziegianniRischetal.2017,
  author    = {Cassel, Michael and Intziegianni, Konstantina and Risch, Lucie and Mueller, Steffen and Engel, Tilman and Mayer, Frank},
  title     = {Physiological Tendon Thickness Adaptation in Adolescent Elite Athletes: A Longitudinal Study},
  series = {Frontiers in physiology},
  volume    = {8},
  journal   = {Frontiers in physiology},
  publisher = {Frontiers Research Foundation},
  address   = {Lausanne},
  issn      = {1664-042X},
  doi       = {10.3389/fphys.2017.00795},
  pages     = {599 -- 611},
  year      = {2017},
  abstract  = {Increased Achilles (AT) and Patellar tendon (PT) thickness in adolescent athletes compared to non-athletes could be shown. However, it is unclear, if changes are of pathological or physiological origin due to training. The aim of this study was to determine physiological AT and PT thickness adaptation in adolescent elite athletes compared to non-athletes, considering sex and sport. In a longitudinal study design with two measurement days (M1/M2) within an interval of 3.2 +/- 0.8 years, 131 healthy adolescent elite athletes (m/f: 90/41) out of 13 different sports and 24 recreationally active controls (m/f: 6/18) were included. Both ATs and PTs were measured at standardized reference points. Athletes were divided into 4 sport categories [ball (B), combat (C), endurance (E) and explosive strength sports (S)]. Descriptive analysis (mean SD) and statistical testing for group differences was performed (cy = 0.05). AT thickness did not differ significantly between measurement days, neither in athletes (5.6 +/- 0.7 mm/5.6 +/- 0.7 mm) nor in controls (4.8 +/- 0.4 mm/4.9 +/- 0.5 mm, p > 0.05). For PTs, athletes presented increased thickness at M2 (Ml: 3.5 +/- 0.5 mm, M2: 3.8 +/- 0.5 mm, p < 0.001). In general, males had thicker ATs and PTs than females (p < 0.05). Considering sex and sports, only male athletes from B, C, and S showed significant higher PT-thickness at M2 compared to controls (p <= 0.01). Sport-specific adaptation regarding tendon thickness in adolescent elite athletes can be detected in PTs among male athletes participating in certain sports with high repetitive jumping and strength components. Sonographic microstructural analysis might provide an enhanced insight into tendon material properties enabling the differentiation of sex and influence of different sports.},
  language  = {en}
}
@article{WippertPuschmannArampatzisetal.2017,
  author    = {Wippert, Pia-Maria and Puschmann, Anne-Katrin and Arampatzis, Adamantios and Schiltenwolf, Marcus and Mayer, Frank},
  title     = {Diagnosis of psychosocial risk factors in prevention of low back pain in athletes (MiSpEx)},
  series = {BMJ Open Sport \& Exercise Medicine},
  volume    = {3},
  journal   = {BMJ Open Sport \& Exercise Medicine},
  number    = {1},
  issn      = {2055-7647},
  doi       = {10.1136/bmjsem-2017-000295},
  year      = {2017},
  abstract  = {Background Low back pain (LBP) is a common pain syndrome in athletes, responsible for 28\% of missed training days/year. Psychosocial factors contribute to chronic pain development. This study aims to investigate the transferability of psychosocial screening tools developed in the general population to athletes and to define athlete-specific thresholds. Methods Data from a prospective multicentre study on LBP were collected at baseline and 1-year follow-up (n=52 athletes, n=289 recreational athletes and n=246 non-athletes). Pain was assessed using the Chronic Pain Grade questionnaire. The psychosocial Risk Stratification Index (RSI) was used to obtain prognostic information regarding the risk of chronic LBP (CLBP). Individual psychosocial risk profile was gained with the Risk Prevention Index - Social (RPI-S). Differences between groups were calculated using general linear models and planned contrasts. Discrimination thresholds for athletes were defined with receiver operating characteristics (ROC) curves. Results Athletes and recreational athletes showed significantly lower psychosocial risk profiles and prognostic risk for CLBP than non-athletes. ROC curves suggested discrimination thresholds for athletes were different compared with non-athletes. Both screenings demonstrated very good sensitivity (RSI=100\%; RPI-S: 75\%-100\%) and specificity (RSI: 76\%-93\%; RPI-S: 71\%-93\%). RSI revealed two risk classes for pain intensity (area under the curve (AUC) 0.92(95\% CI 0.85 to 1.0)) and pain disability (AUC 0.88(95\% CI 0.71 to 1.0)). Conclusions Both screening tools can be used for athletes. Athlete-specific thresholds will improve physicians' decision making and allow stratified treatment and prevention.},
  language  = {en}
}
@misc{KochCasselLinneetal.2017,
  author    = {Koch, Sarah and Cassel, Michael and Linne, Karsten and Mayer, Frank and Scharhag, J{\"u}rgen},
  title     = {ECG and echocardiographic findings in 10-15-year-old elite athletes},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-403186},
  pages     = {8},
  year      = {2017},
  abstract  = {Background: Data on electrocardiographic and echocardiographic pre-participation screening findings in paediatric athletes are limited. Methods and results: 10-15 year-old athletes (n = 343) were screened using electro- and echocardiography. The electrocardiogram (ECG) was normal in 220 (64\%), mildly abnormal in 108 (31\%), and distinctly abnormal in 15 (4\%) athletes. Echocardiographic upper reference limits (URL, 97.5 percentile) for the left ventricular (LV) wall thickness in 10-11-year-old boys and girls were 9-10 mm and 8-9 mm, respectively; in 12-13-year-old boys and girls 9-10 mm; and in 14-15-year-old boys and girls 10-11 mm and 9-10 mm, respectively. Three athletes were excluded from competitive sports: one for symptomatic Wolff-Parkinson-White syndrome with a normal echocardiogram; one for negative T-waves in V-1-V-4 and a dilated right ventricle by echocardiography suggestive of (arrhythmogenic) right ventricular disease; and one for normal ECG and biscupid aortic valve including an aneurysm of the ascending aorta detected by echocardiography. Related to echocardiographic findings, the sensitivity and specificity of the ECG to identify cardiovascular abnormalities was 38\% and 64\%, respectively. The ECG's positive-predictive and negative-predictive values were 13\% and 88\%, respectively. The numbers needed to screen and calculated costs were 172 for ECG ( 7049), 172 for echocardiography ( 11,530), and 114 combining ECG and echocardiography ( 9323). Conclusions: Compared to adults, paediatric athletes presented with fewer distinctly abnormal ECGs, and there was no gender difference in paediatric athletes' ECG-pattern distribution. A combination of ECG and echocardiography for pre-participation screening of paediatric athletes is superior to ECG alone but 30\% more costly.},
  language  = {en}
}
@misc{CasselIntziegianniRischetal.2017,
  author    = {Cassel, Michael and Intziegianni, Konstantina and Risch, Lucie and M{\"u}ller, Steffen and Engel, Tilman and Mayer, Frank},
  title     = {Physiological Tendon Thickness Adaptation in Adolescent Elite Athletes},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-403823},
  pages     = {8},
  year      = {2017},
  abstract  = {Increased Achilles (AT) and Patellar tendon (PT) thickness in adolescent athletes compared to non-athletes could be shown. However, it is unclear, if changes are of pathological or physiological origin due to training. The aim of this study was to determine physiological AT and PT thickness adaptation in adolescent elite athletes compared to non-athletes, considering sex and sport. In a longitudinal study design with two measurement days (M1/M2) within an interval of 3.2 ± 0.8 years, 131 healthy adolescent elite athletes (m/f: 90/41) out of 13 different sports and 24 recreationally active controls (m/f: 6/18) were included. Both ATs and PTs were measured at standardized reference points. Athletes were divided into 4 sport categories [ball (B), combat (C), endurance (E) and explosive strength sports (S)]. Descriptive analysis (mean ± SD) and statistical testing for group differences was performed (α = 0.05). AT thickness did not differ significantly between measurement days, neither in athletes (5.6 ± 0.7 mm/5.6 ± 0.7 mm) nor in controls (4.8 ± 0.4 mm/4.9 ± 0.5 mm, p > 0.05). For PTs, athletes presented increased thickness at M2 (M1: 3.5 ± 0.5 mm, M2: 3.8 ± 0.5 mm, p < 0.001). In general, males had thicker ATs and PTs than females (p < 0.05). Considering sex and sports, only male athletes from B, C, and S showed significant higher PT-thickness at M2 compared to controls (p ≤ 0.01). Sport-specific adaptation regarding tendon thickness in adolescent elite athletes can be detected in PTs among male athletes participating in certain sports with high repetitive jumping and strength components. Sonographic microstructural analysis might provide an enhanced insight into tendon material properties enabling the differentiation of sex and influence of different sports.},
  language  = {en}
}