@article{IntziegianniCasselKoenigetal.2015, author = {Intziegianni, Konstantina and Cassel, Michael and K{\"o}nig, Niklas and M{\"u}ller, Steffen and Fr{\"o}hlich, Katja and Mayer, Frank}, title = {Ultrasonography for the assessment of the structural properties of the Achilles tendon in asymptomatic individuals: An intra-rater reproducibility study}, series = {Isokinetics and exercise science : official journal of the European Isokinetic Society}, volume = {23}, journal = {Isokinetics and exercise science : official journal of the European Isokinetic Society}, number = {4}, publisher = {IOS Press}, address = {Amsterdam}, issn = {0959-3020}, doi = {10.3233/IES-150586}, pages = {263 -- 270}, year = {2015}, abstract = {BACKGROUND: Reproducible measurements of tendon structural properties are a prerequisite for accurate diagnosis of tendon disorders and for determination of their mechanical properties. Despite the widely used application of Ultrasonography (US) in musculoskeletal assessment, its operator dependency and lack of standardization influences the consistency of the measurement. OBJECTIVE: To evaluate the intra-rater reproducibility of a standardized US method assessing the structural properties of the Achilles tendon (AT). METHODS: Sixteen asymptomatic participants were positioned prone on an isokinetic dynamometer with the knee extended and ankle at 90. flexion. US was used to assess AT-length, cross-sectional area (CSA), and AT-elongation during isometric plantarflexion contraction. The intra-rater reproducibility was assessed by ICC (2.1), Test-Retest Variability (TRV, \%), Bland-Altman analyses (Bias +/- LoA [1.96*SD]), and Standard-Error of Measurement (SEM). RESULTS: Measurements of AT-length demonstrated an ICC of 0.93, TRV of 4.5 +/- 3.9\%, Bias +/- LoA of -2.8 +/- 25.0 mm and SEM of 6.6 mm. AT-CSA showed an ICC of 0.79, TRV of 8.7 +/- 9.6\%, Bias +/- LoA of 1.7 +/- 19.4 mm(2) and SEM of 5.3 mm(2). AT-elongation revealed an ICC of 0.92, TRV of 12.9 +/- 8.9\%, Bias +/- LoA of 0.3 +/- 5.7 mm and SEM of 1.5 mm. CONCLUSIONS: The presented methodology allows a reproducible assessment of Achilles tendon structural properties when performed by a single rater.}, language = {en} } @article{KopinskiEngelCasseletal.2015, author = {Kopinski, Stephan and Engel, Tilman and Cassel, Michael and Fr{\"o}hlich, Katja and Mayer, Frank and Carlsohn, Anja}, title = {Ultrasound Applied to Subcutaneous Fat Tissue Measurements in International Elite Canoeists}, series = {International journal of sports medicine}, volume = {36}, journal = {International journal of sports medicine}, number = {14}, publisher = {Thieme}, address = {Stuttgart}, issn = {0172-4622}, doi = {10.1055/s-0035-1555857}, pages = {1134 -- 1141}, year = {2015}, abstract = {Subcutaneous adipose tissue (SAT) measurements with ultrasound have recently been introduced to assess body fat in elite athletes. However, appropriate protocols and data on various groups of athletes are missing. We investigated intra-rater reliability of SAT measurements using ultrasound in elite canoe athletes. 25 international level canoeists (18 male, 7 female; 23 +/- 4 years; 81 +/- 11 kg; 1.83 +/- 0.09 m; 20 +/- 3 training h/wk) were measured on 2 consecutive days. SAT was assessed with B-mode ultrasound at 8 sites (ISAK): triceps, subscapular, biceps, iliac crest, supraspinal, abdominal, front thigh, medial calf, and quantified using image analysis software. Data was analyzed descriptively (mean +/- SD, [range]). Coefficient of variation (CV \%), intraclass correlation coefficient (ICC, 2.1) and absolute (LoA) and ratio limits of agreement (RLoA) were calculated for day-to-day reliability. Mean sum of SAT thickness was 30.0 +/- 19.4 mm [8.0, 80.1 mm], with 3.9 +/- 1.8 mm [1.2 mm subscapular, 8.0 mm abdominal] for individual sites. CV for the sum of sites was 4.7 \%, ICC 0.99, LoA 1.7 +/- 3.6 mm, RLoA 0.940 (*/divided by 1.155). Measuring SAT with ultrasound has proved to have excellent day-to-day reliability in elite canoe athletes. Recommendations for standardization of the method will further increase accuracy and reproducibility.}, language = {en} } @article{CasselStollMayer2015, author = {Cassel, Michael and Stoll, Josefine and Mayer, Frank}, title = {Tendinopathies of the Lower Extremities in Sport - Diagnostics and Therapy}, series = {Sportverletzung, Sportschaden : Grundlagen, Pr{\"a}vention, Rehabilitation}, volume = {29}, journal = {Sportverletzung, Sportschaden : Grundlagen, Pr{\"a}vention, Rehabilitation}, number = {2}, publisher = {Thieme}, address = {Stuttgart}, issn = {0932-0555}, doi = {10.1055/s-0034-1399668}, pages = {87 -- 98}, year = {2015}, abstract = {Tendinopathies are frequently the cause of chronic, load-dependent complaints of the lower extremity. Commonly, the large tendons of the ankle and knee joints are affected, especially the Achilles and patellar tendons. Repeated overuse in sports and/or daily activities is assumed as the aetiology. Besides the clinical examination including a comprehensive anamnesis of pain and training/loading, sonographic imaging has a high training/loading relevance for the diagnosis of tendon pathologies of the lower extremity. Training concepts are considered in first line as the treatment of choice. A combination with physical therapy interventions can be useful. In cases of a more severe pathology and long-standing complaints multimodal therapeutic options should be employed. The use of surgical treatment procedures should only be taken into account in case of failed response to conservative treatment.}, language = {de} } @inproceedings{RischBashfordKuligetal.2020, author = {Risch, Lucie and Bashford, Greg and Kulig, Kornelia and Kaplick, Hannes and Mayer, Frank and Cassel, Michael}, title = {Spatial frequency analysis identifies altered local Micromorphology in adolescent athletes with Achilles tendinopathy}, series = {Medicine and science in sports and exercise : MSSE ; official journal of the American College of Sports Medicine}, volume = {52}, booktitle = {Medicine and science in sports and exercise : MSSE ; official journal of the American College of Sports Medicine}, publisher = {Lippincott Williams \& Wilkins}, address = {Philadelphia}, issn = {0195-9131}, doi = {10.1249/01.mss.0000670932.99564.57}, pages = {82 -- 82}, year = {2020}, language = {en} } @article{CasselStollSchugardtetal.2019, author = {Cassel, Michael and Stoll, Josefine and Schugardt, Monique and Mayer, Frank}, title = {Overuse and injury prevention}, series = {Elite youth cycling}, journal = {Elite youth cycling}, publisher = {Routledge}, address = {London}, isbn = {978-1-315-11077-6}, pages = {141 -- 159}, year = {2019}, language = {en} } @article{RischStollSchomoelleretal.2020, author = {Risch, Lucie and Stoll, Josefine and Schom{\"o}ller, Anne and Engel, Tilman and Mayer, Frank and Cassel, Michael}, title = {Intraindividual Doppler Flow Response to Exercise Differs Between Symptomatic and Asymptomatic Achilles Tendons}, series = {Frontiers in physiology}, volume = {12}, journal = {Frontiers in physiology}, publisher = {Frontiers Research Foundation}, address = {Lausanne, Schweiz}, issn = {1664-042X}, doi = {10.3389/fphys.2021.617497}, pages = {1 -- 8}, year = {2020}, abstract = {Objective: This study investigated intraindividual differences of intratendinous blood flow (IBF) in response to running exercise in participants with Achilles tendinopathy. Design: This is a cross-sectional study. Setting: The study was conducted at the University Outpatient Clinic. Participants: Sonographic detectable intratendinous blood flow was examined in symptomatic and contralateral asymptomatic Achilles tendons of 19 participants (42 ± 13 years, 178 ± 10 cm, 76 ± 12 kg, VISA-A 75 ± 16) with clinically diagnosed unilateral Achilles tendinopathy and sonographic evident tendinosis. Intervention: IBF was assessed using Doppler ultrasound "Advanced Dynamic Flow" before (Upre) and 5, 30, 60, and 120 min (U5-U120) after a standardized submaximal constant load run. Main Outcome Measure: IBF was quantified by counting the number (n) of vessels in each tendon. Results: At Upre, IBF was higher in symptomatic compared with asymptomatic tendons [mean 6.3 (95\% CI: 2.8-9.9) and 1.7 (0.4-2.9), p < 0.01]. Overall, 63\% of symptomatic and 47\% of asymptomatic Achilles tendons responded to exercise, whereas 16 and 11\% showed persisting IBF and 21 and 42\% remained avascular throughout the investigation. At U5, IBF increased in both symptomatic and asymptomatic tendons [difference to baseline: 2.4 (0.3-4.5) and 0.9 (0.5-1.4), p = 0.05]. At U30 to U120, IBF was still increased in symptomatic but not in asymptomatic tendons [mean difference to baseline: 1.9 (0.8-2.9) and 0.1 (-0.9 to 1.2), p < 0.01]. Conclusion: Irrespective of pathology, 47-63\% of Achilles tendons responded to exercise with an immediate acute physiological IBF increase by an average of one to two vessels ("responders"). A higher amount of baseline IBF (approximately five vessels) and a prolonged exercise-induced IBF response found in symptomatic ATs indicate a pain-associated altered intratendinous "neovascularization."}, language = {en} } @article{CasselMuellerCarlsohnetal.2012, author = {Cassel, Michael and M{\"u}ller, Steffen and Carlsohn, Anja and Baur, Heiner and Jerusel, N. and Mayer, Frank}, title = {Intra- and interrater variability of sonographic investigations of patella and achilles tendons}, series = {Sportverletzung, Sportschaden : Grundlagen, Pr{\"a}vention, Rehabilitation}, volume = {26}, journal = {Sportverletzung, Sportschaden : Grundlagen, Pr{\"a}vention, Rehabilitation}, number = {1}, publisher = {Thieme}, address = {Stuttgart}, issn = {0932-0555}, doi = {10.1055/s-0031-1281839}, pages = {21 -- 26}, year = {2012}, abstract = {Background: Clinical examinations of tendon disorders routinely include ultrasound examinations, despite the fact that availability of data concerning validity criteria of these measurements are limited. The present study therefore aims to evaluate the reliability of measurements of Achilles- and Patella tendon diameter and in the detection of structural adaptations. Materials and Methods: In 14 healthy, recreationally active subjects both asymptomatic Achilles (AT) and patella tendons (PT) were measured twice by two examiners in a test-retest design. Besides the detection of anteroposterior (a.p.-) and mediolateral (m.l.-) diameters, areas of hypoechogenicity and neovascularisation were registered. Data were analysed descriptively with calculation of test-retest variability (TRV), intraclass-correlation coefficient (ICC) and Bland and Altman's plots with bias and 95\% limits of agreement (LOA). Results: Intra- and interrater differences of AT- and PT-a.p.-diameter varied from 0.2 - 1.2 mm, those of AT- and PT-m.l-diameter from 0.7-5.1 mm. Areas of hypoechogenicity were visible in 24\% of the tendons, while 15\% showed neovascularisations. Intrarater AT-a.p.-diameters showed sparse deviations (TRV 4.5-7.4\%; ICC 0.60-0.84; bias -0.05-0.07 mm; LOA-0.6-0.5 to -1.1 - 1.0 mm), while interrater AT- and PT-m.l.-diameters were highly variable (TRV 13.7-19.7\%; ICC 0.11-0.20; bias -1.4-4.3 mm; LOA-5.5-2.7 to -10.5 - 1.9 mm). Conclusion: Our results suggest that the measurement of AT- and PT-a.p.-diameters is a reliable parameter. In contrast, reproducibility of AT- and PT-m.l.-diameters is questionable. The study corroborates the presence of hypoechogenicity and neovascularisation in asymptomatic tendons.}, language = {de} } @article{RischMayerCassel2021, author = {Risch, Lucie and Mayer, Frank and Cassel, Michael}, title = {Doppler flow response following running exercise differs between healthy and tendinopathic Achilles tendons}, series = {Frontiers in Physiology}, volume = {12}, journal = {Frontiers in Physiology}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1664-042X}, doi = {10.3389/fphys.2021.650507}, pages = {10}, year = {2021}, abstract = {Background: The relationship between exercise-induced intratendinous blood flow (IBF) and tendon pathology or training exposure is unclear. Objective: This study investigates the acute effect of running exercise on sonographic detectable IBF in healthy and tendinopathic Achilles tendons (ATs) of runners and recreational participants. Methods: 48 participants (43 ± 13 years, 176 ± 9 cm, 75 ± 11 kg) performed a standardized submaximal 30-min constant load treadmill run with Doppler ultrasound "Advanced dynamic flow" examinations before (Upre) and 5, 30, 60, and 120 min (U5-U120) afterward. Included were runners (>30 km/week) and recreational participants (<10 km/week) with healthy (Hrun, n = 10; Hrec, n = 15) or tendinopathic (Trun, n = 13; Trec, n = 10) ATs. IBF was assessed by counting number [n] of intratendinous vessels. IBF data are presented descriptively (\%, median [minimum to maximum range] for baseline-IBF and IBF-difference post-exercise). Statistical differences for group and time point IBF and IBF changes were analyzed with Friedman and Kruskal-Wallis ANOVA (α = 0.05). Results: At baseline, IBF was detected in 40\% (3 [1-6]) of Hrun, in 53\% (4 [1-5]) of Hrec, in 85\% (3 [1-25]) of Trun, and 70\% (10 [2-30]) of Trec. At U5 IBF responded to exercise in 30\% (3 [-1-9]) of Hrun, in 53\% (4 [-2-6]) of Hrec, in 70\% (4 [-10-10]) of Trun, and in 80\% (5 [1-10]) of Trec. While IBF in 80\% of healthy responding ATs returned to baseline at U30, IBF remained elevated until U120 in 60\% of tendinopathic ATs. Within groups, IBF changes from Upre-U120 were significant for Hrec (p < 0.01), Trun (p = 0.05), and Trec (p < 0.01). Between groups, IBF changes in consecutive examinations were not significantly different (p > 0.05) but IBF-level was significantly higher at all measurement time points in tendinopathic versus healthy ATs (p < 0.05). Conclusion: Irrespective of training status and tendon pathology, running leads to an immediate increase of IBF in responding tendons. This increase occurs shortly in healthy and prolonged in tendinopathic ATs. Training exposure does not alter IBF occurrence, but IBF level is elevated in tendon pathology. While an immediate exercise-induced IBF increase is a physiological response, prolonged IBF is considered a pathological finding associated with Achilles tendinopathy.}, language = {en} } @misc{JoostBrechtMayeretal.2020, author = {Joost, Theresa Anna and Brecht, Pia and Mayer, Frank and Cassel, Michael}, title = {Feasibility of open low-field MRI measurements in adolescent athletes with spondylolisthesis}, series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine}, volume = {52}, journal = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine}, number = {17}, publisher = {Lippincott Williams \& Wilkins}, address = {Philadelphia}, issn = {0195-9131}, doi = {10.1249/01.mss.0000683832.74059.9d}, pages = {790 -- 790}, year = {2020}, abstract = {PURPOSE: To determine the feasibility of upright compared to supine MRI measurements to determine characteristics of the lumbar spine in AA with spondylolisthesis. METHODS: Ten AA (n=10; m/f: 4/6; 14.5±1.7y; 163±7cm; 52±8kg) from various sports, diagnosed with spondylolisthesis grade I-II Meyerding confirmed by x-ray in standing lateral view, were included. Open low-field MRI images (0.25 Tesla) in upright (82°) and supine (0°) position were evaluated by two observers. Medical imaging software was used to measure the anterior translation (AT, mm), lumbosacral joint angle (LSJA, °) and lordosis angle (LA, °). Reliability was analyzed by the intra-rater correlation coefficient (ICC) and standard error of measurements (SEM). RESULTS: Due to motion artifacts during upright position, measures of three participants had to be excluded. Between observers, AT ranged from 4.2±2.7mm to 5.5±1.9mm (ICC=0.94, SEM=0.6mm) in upright and from 4.9±2.4mm to 5.9±3.0mm (ICC=0.89, SEM=0.9mm) in supine position. LSJA varied from 5.1±2.2° to 7.3±1.5° (ICC=0.54, SEM=1.5°) in upright and from 9.8±2.5° to 10±2.4° (ICC=0.73, SEM=1.1°) in supine position. LA differed from 58.8±14.6° to 61.9±6° (ICC=0.94, SEM=1.19°) in upright and from 51.9±11.7° to 52.6±11.1° (ICC=0.98, SEM=1.59°) in supine position. CONCLUSIONS: Determination of AT and LA showed good to excellent reliability in both, upright and supine position. In contrast, reliability of LSJA had only moderate to good correlation between observers and should therefore be interpreted with caution. However, motion artifacts should be taken into consideration during upright imaging procedures.}, language = {en} } @article{MuellerStollCasseletal.2017, author = {M{\"u}ller, Steffen and Stoll, Josefine 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}, 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 to MIVC (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{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}, series = {Frontiers in physiology}, volume = {8}, journal = {Frontiers in physiology}, publisher = {Frontiers}, address = {Lausanne}, issn = {1664-042X}, doi = {10.3389/fphys.2017.00795}, pages = {1 -- 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} } @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} } @inproceedings{MuellerCasselMuelleretal.2014, author = {M{\"u}ller, Steffen and Cassel, Michael and M{\"u}ller, Juliane and Stoll, Josefine and Baur, Heiner and Mayer, Frank}, title = {Trunk strength in adolescent athletes with Spondylolisthesis with/without back pain during training: Pilot study}, series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine}, volume = {46}, booktitle = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine}, number = {5}, publisher = {Lippincott Williams \& Wilkins}, address = {Philadelphia}, issn = {0195-9131}, pages = {642 -- 642}, year = {2014}, language = {en} } @misc{WahmkowCasselMayeretal.2017, author = {Wahmkow, Gunnar and Cassel, Michael and Mayer, Frank and Baur, Heiner}, title = {Effects of different medial arch support heights on rearfoot kinematics}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-402934}, pages = {11}, year = {2017}, abstract = {Background Foot orthoses are usually assumed to be effective by optimizing mechanically dynamic rearfoot configuration. However, the effect from a foot orthosis on kinematics that has been demonstrated scientifically has only been marginal. The aim of this study was to examine the effect of different heights in medial arch-supported foot orthoses on rear foot motion during gait. Methods Nineteen asymptomatic runners (36±11years, 180±5cm, 79±10kg; 41±22km/week) participated in the study. Trials were recorded at 3.1 mph (5 km/h) on a treadmill. Athletes walked barefoot and with 4 different not customized medial arch-supported foot orthoses of various arch heights (N:0 mm, M:30 mm, H:35 mm, E:40mm). Six infrared cameras and the `Oxford Foot Model´ were used to capture motion. The average stride in each condition was calculated from 50 gait cycles per condition. Eversion excursion and internal tibia rotation were analyzed. Descriptive statistics included calculating the mean ± SD and 95\% CIs. Group differences by condition were analyzed by one factor (foot orthoses) repeated measures ANOVA (α = 0.05). Results Eversion excursion revealed the lowest values for N and highest for H (B:4.6°±2.2°; 95\% CI [3.1;6.2]/N:4.0°±1.7°; [2.9;5.2]/M:5.2°±2.6°; [3.6;6.8]/H:6.2°±3.3°; [4.0;8.5]/E:5.1°±3.5°; [2.8;7.5]) (p>0.05). Range of internal tibia rotation was lowest with orthosis H and highest with E (B:13.3°±3.2°; 95\% CI [11.0;15.6]/N:14.5°±7.2°; [9.2;19.6]/M:13.8°±5.0°; [10.8;16.8]/H:12.3°±4.3°; [9.0;15.6]/E:14.9°±5.0°; [11.5;18.3]) (p>0.05). Differences between conditions were small and the intrasubject variation high. Conclusion Our results indicate that different arch support heights have no systematic effect on eversion excursion or the range of internal tibia rotation and therefore might not exert a crucial influence on rear foot alignment during gait.}, language = {en} } @article{MayerBonaventuraCasseletal.2012, author = {Mayer, Frank and Bonaventura, Klaus and Cassel, Michael and M{\"u}ller, Steffen and Weber, Josefine and Scharhag-Rosenberger, Friederike and Carlsohn, Anja and Baur, Heiner and Scharhag, J{\"u}rgen}, title = {Medical results of preparticipation examination in adolescent athletes}, series = {British journal of sports medicine : the journal of sport and exercise medicine}, volume = {46}, journal = {British journal of sports medicine : the journal of sport and exercise medicine}, number = {7}, publisher = {BMJ Publ. Group}, address = {London}, issn = {0306-3674}, doi = {10.1136/bjsports-2011-090966}, pages = {524 -- 530}, year = {2012}, abstract = {Background Preparticipation examinations (PPE) are frequently used to evaluate eligibility for competitive sports in adolescent athletes. Nevertheless, the effectiveness of these examinations is under debate since costs are high and its validity is discussed controversial. Purpose To analyse medical findings and consequences in adolescent athletes prior to admission to a sports school. Methods In 733 adolescent athletes (318 girls, 415 boys, age 12.3+/-0.4, 16 sports disciplines), history and clinical examination (musculoskeletal, cardiovascular, general medicine) was performed to evaluate eligibility. PPE was completed by determination of blood parameters, ECG at rest and during ergometry, echocardiography and x-rays and ultrasonography if indicated. Eligibility was either approved or rated with restriction. Recommendations for therapy and/or prevention were given to the athletes and their parents. Results Historical (h) and clinical (c) findings (eg, pain, verified pathologies) were more frequent regarding the musculoskeletal system (h: 120, 16.4\%; c: 247, 33.7\%) compared to cardiovascular (h: 9, 1.2\%; c: 23, 3.1\%) or general medicine findings (h: 116, 15.8\%; c: 71, 9.7\%). ECG at rest was moderately abnormal in 46 (6.3\%) and severely abnormal in 25 athletes (3.4\%). Exercise ECG was suspicious in 25 athletes (3.4\%). Relevant echocardiographic abnormalities were found in 17 athletes (2.3\%). In 52 of 358 cases (14.5\%), x-rays led to diagnosis (eg, Spondylolisthesis). Eligibility was temporarily restricted in 41 athletes (5.6\%). Three athletes (0.4\%) had to be excluded from competitive sports. Therapy (eg, physiotherapy, medication) and/or prevention (sensorimotor training, vaccination) recommendations were deduced due to musculoskeletal (t:n = 76,10.3\%; p:n = 71,9.8\%) and general medicine findings (t:n = 80, 10.9\%; p:n = 104, 14.1\%). Conclusion Eligibility for competitive sports is restricted in only 5.5\% of adolescent athletes at age 12. Eligibility refusals are rare. However, recommendations for therapy and prevention are frequent, mainly regarding the musculoskeletal system. In spite of time and cost consumption, adolescent preparticipation before entering a career in high-performance sports is supported.}, language = {en} } @article{BaurHirschmuellerMuelleretal.2012, author = {Baur, Heiner and Hirschm{\"u}ller, Anja and M{\"u}ller, Steffen and Cassel, Michael and Mayer, Frank}, title = {Is EMG of the lower leg dependent on weekly running mileage?}, series = {International journal of sports medicine}, volume = {33}, journal = {International journal of sports medicine}, number = {1}, publisher = {Thieme}, address = {Stuttgart}, issn = {0172-4622}, doi = {10.1055/s-0031-1286250}, pages = {53 -- 57}, year = {2012}, abstract = {Neuromuscular activity of the lower leg is dependent on the task performed, speed of movement and gender. Whether training volume influences neuromuscular activity is not known. The EMG of physically active persons differing in running mileage was analysed to investigate this. 55 volunteers were allocated to a low (LM: < 30 km), intermediate (IM: > 30 km \& < 45 km) or high mileage (HM: > 45 km) group according to their weekly running volume. Neuromuscular activity of the lower leg was measured during running (3.33 m.s(-1)). Mean amplitude values for preactivation, weight acceptance and push-off were calculated and normalised to the mean activity of the entire gait cycle. Higher activity in the gastrocnemius group was observed in weight acceptance in LM compared to IM (+30\%) and HM (+25\%) but lower activity was present in the push-off for LM compared to IM and HM. For the peroneal muscle, differences were present in the push-off where HM showed increased activity compared to IM (+24\%) and LM (+60\%). The tibial muscle revealed slightly lower activity during preactivation for the high mileage runners. Neuromuscular activity differs during stance between the high and intermediate group compared to low mileage runners. Slight adaptations in neuromuscular activation indicate a more target-oriented activation strategy possibly due to repetitive training in runners with higher weekly mileage.}, language = {en} } @article{QuarmbyZhangGeisleretal.2023, author = {Quarmby, Andrew and Zhang, Martin and Geisler, Moritz and Javorsky, Tomas and Mugele, Hendrik and Cassel, Michael and Lawley, Justin}, title = {Risk factors and injury prevention strategies for overuse injuries in adult climbers}, series = {Frontiers in sports and active living}, volume = {5}, journal = {Frontiers in sports and active living}, publisher = {Frontiers Media}, address = {Lausanne}, issn = {2624-9367}, doi = {10.3389/fspor.2023.1269870}, pages = {13}, year = {2023}, abstract = {Introduction Climbing is an increasingly popular activity and imposes specific physiological demands on the human body, which results in unique injury presentations. Of particular concern are overuse injuries (non-traumatic injuries). These injuries tend to present in the upper body and might be preventable with adequate knowledge of risk factors which could inform about injury prevention strategies. Research in this area has recently emerged but has yet to be synthesized comprehensively. Therefore, the aim of this study was to conduct a systematic review of the potential risk factors and injury prevention strategies for overuse injuries in adult climbers. Methods This systematic review was conducted in accordance with the PRISMA guidelines. Databases were searched systematically, and articles were deemed eligible based upon specific criteria. Research included was original and peer-reviewed, involving climbers, and published in English, German or Czech. Outcomes included overuse injury, and at least one or more variable indicating potential risk factors or injury prevention strategies. The methodological quality of the included studies was assessed with the Downs and Black Quality Index. Data were extracted from included studies and reported descriptively for population, climbing sport type, study design, injury definition and incidence/prevalence, risk factors, and injury prevention strategies. Results Out of 1,183 records, a total of 34 studies were included in the final analysis. Higher climbing intensity, bouldering, reduced grip/finger strength, use of a "crimp" grip, and previous injury were associated with an increased risk of overuse injury. Additionally, a strength training intervention prevented shoulder and elbow injuries. BMI/body weight, warm up/cool downs, stretching, taping and hydration were not associated with risk of overuse injury. The evidence for the risk factors of training volume, age/years of climbing experience, and sex was conflicting. Discussion This review presents several risk factors which appear to increase the risk of overuse injury in climbers. Strength and conditioning, load management, and climbing technique could be targeted in injury prevention programs, to enhance the health and wellbeing of climbing athletes. Further research is required to investigate the conflicting findings reported across included studies, and to investigate the effectiveness of injury prevention programs. Systematic Review Registrationhttps://www.crd.york.ac.uk/, PROSPERO (CRD42023404031).}, language = {en} }