TY - GEN A1 - Timme, Sinika T1 - The face of affect and exertion BT - automated facial action analysis to decode the flow of experience during exercise T2 - Journal of sport & exercise psychology Y1 - 2020 SN - 0895-2779 SN - 1543-2904 VL - 42 SP - S3 EP - S3 PB - Human Kinetics Publishers CY - Champaign ER - TY - GEN A1 - Joost, Theresa Anna A1 - Brecht, Pia A1 - Mayer, Frank A1 - Cassel, Michael T1 - Feasibility of open low-field MRI measurements in adolescent athletes with spondylolisthesis T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine N2 - 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. Y1 - 2020 U6 - https://doi.org/10.1249/01.mss.0000683832.74059.9d SN - 0195-9131 SN - 1530-0315 VL - 52 IS - 17 SP - 790 EP - 790 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - GEN A1 - Nair, Alexandra A1 - Lin, Chiao-I A1 - Khajooei, Mina A1 - Heikkila, Mika A1 - Engel, Tilman A1 - Mayer, Frank T1 - Side comparison of knee muscle activities in response to perturbed walking of unilateral ankle instability T2 - Medicine and science in sports and exercise : MSSE N2 - Acute ankle sprain leads in 40% of all cases to chronic ankle instability (CAI). CAI is related to a variety of motor adaptations at the lower extremities. Previous investigations identified increased muscle activities while landing in CAI compared to healthy control participants. However, it remains unclear whether muscular alterations at the knee muscles are limited to the involved (unstable) ankle or are also present at the uninvolved leg. The latter might potentially indicate a risk of ankle sprain or future injury on the uninvolved leg. Purpose: To assess if there is a difference of knee muscle activities between the involved and uninvolved leg in participants with CAI during perturbed walking. Method: 10 participants (6 females; 4 males; 26±4 years; 169±9 cm; 65±7 kg) with unilateral CAI walked on a split-belt treadmill (1m/s) for 5 minutes of baseline walking and 6 minutes of perturbed walking (left and right side, each 10 perturbations). Electromyography (EMG) measurements were performed at biceps femoris (BF) and rectus femoris (RF). EMG amplitude (RMS; normalized to MVIC) were analyzed for 200ms pre-heel contact (Pre200), 100ms post heel contact (Post100) and 200ms after perturbation (Pert200). Data was analyzed by paired t-test/Wilcoxon test based on presence or absence of normal distribution (Bonferroni adjusted α level p≤ 0.0125). Results: No statistical difference was found between involved and uninvolved leg for RF (Pre200: 4±2% and 11± 22%, respectively, p= 0.878; Post100: 10± 5 and 18±31%, p=0.959; Pert200: 6±3% and 13±24%, p=0.721) as well as for BF (Pre200: 12±7% and 11±6, p=0.576; Post100: 10±7% and 9±7%, p=0.732; Pert200: 7±4 and 7±7%, p=0.386). Discussion: No side differences in muscle activity could be revealed for assessed feedforward and feedback responses (perturbed and unperturbed) in unilateral CAI. Reduced inter-individual variability of muscular activities at the involved leg might indicate a rather stereotypical response pattern. It remains to be investigated, whether muscular control at the knee is not affected by CAI, or whether both sides adapted in a similar style to the chronic condition at the ankle. Y1 - 2020 U6 - https://doi.org/10.1249/01.mss.0000671088.10003.6b SN - 0195-9131 SN - 1530-0315 VL - 52 IS - 17 SP - 97 EP - 97 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - GEN A1 - Lin, Chiao-I A1 - Khajooei, Mina A1 - Nair, Alexandra A1 - Heikkila, Mika A1 - Kaplick, Hannes A1 - Tilman, Engel A1 - Mayer, Frank T1 - Activities of hip muscles in response to perturbed walking in individual with chronic ankle instability T2 - Medicine and science in sports and exercise : MSSE N2 - Chronic ankle instability (CAI) is not only an ankle issue, but also affects sensorimotor system. People with CAI show altered muscle activation in proximal joints such as hip and knee. However, evidence is limited as controversial results have been presented regarding changes in activation of hip muscles in CAI population. PURPOSE: To investigate the effect of CAI on activity of hip muscles during normal walking and walking with perturbations. METHODS: 8 subjects with CAI (23 ± 2 years, 171 ± 7 cm and 65 ± 4 kg) and 8 controls (CON) matched by age, height, weight and dominant leg (25 ± 3 years, 172 ± 7 cm and 65 ± 6 kg) walked shoed on a split-belt treadmill (1 m/s). Subjects performed 5 minutes of baseline walking and 6 minutes walking with 10 perturbations (at 200 ms after heel contact with 42 m/s2 deceleration impulse) on each side. Electromyography signals from gluteus medius (Gmed) and gluteus maximus (Gmax) were recorded while walking. Muscle amplitudes (Root Mean Square normalized to maximum voluntary isometric contraction) were calculated at 200 ms before heel contact (Pre200), 100 ms after heel contact (Post100) during normal walking and 200 ms after perturbations (Pert200). Differences between groups were examined using Mann Whitney U test and Bonferroni correction to account for multiple testing (adjust α level p≤ 0.0125). RESULT: In Gmed, CAI group showed lower muscle amplitude than CON group after heel contact (Post100: 18±7 % and 47±21 %, p< .01) and after walking perturbations ( 31±13 % and 62±26 %, p< .01), but not before heel contact (Pre200: 5±2 % and 11±10 %, p= 0.195). In Gmax, no difference was found between CAI and CON groups in all three time points (Pre200: 12±5 % and 17±12 %, p= 0.574; Post100: 41±21 % and 41±13 %, p= 1.00; Pert200: 79±46 % and 62±35 %, p= 0.505). CONCLUSION: People with CAI activated Gmed less than healthy control in feedback mechanism (after heel contact and walking with perturbations), but not in feedforward mechanism (before heel contact). Less activation on Gmed may affect the balance in frontal plane and increase the risk of recurrent ankle sprain, giving way or feeling ankle instability in patients with CAI during walking. Future studies should investigate the effect of Gmed strengthening or neuromuscular training on CAI rehabilitation. Y1 - 2020 U6 - https://doi.org/10.1249/01.mss.0000671060.98581.0b SN - 0195-9131 SN - 1530-0315 VL - 52 IS - 17 SP - 94 EP - 94 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - GEN A1 - Schomöller, Anne A1 - Risch, Lucie A1 - Kaplick, Hannes A1 - Schraplau, Anne A1 - Wochatz, Monique A1 - Engel, Tilman A1 - Sonnenburg, Dominik A1 - Mayer, Frank T1 - Changes in paraspinal muscle T2 times and creatine kinase after a bout of eccentric exercise T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine N2 - Eccentric (ECC) exercises might cause muscle damage, characterized by delayed-onset muscle soreness, elevated creatine kinase (CK) levels and local muscle oedema, shown by elevated T2 times in magnet resonance imaging (MRI) scans. Previous research suggests a high inter-individual difference regarding these systemic and local responses to eccentric workload. PURPOSE: To analyze ECC exercise-induced muscle damage in lumbar paraspinal muscles assessed via MRI. METHODS: Ten participants (3f/7m; 33±6y; 174±8cm; 71±12kg) were included in the study. Quantitative paraspinal muscle constitution of M. erector spinae and M. multifidius were assessed in supine position before and 72h after an intense eccentric trunk exercise bout in a mobile 1.5 tesla MRI device. MRI scans were recorded on spinal level L3 (T2-weighted TSE echo sequences, 11 slices, 2mm slice thickness, 3mm gap, echo times: 20, 40, 60, 80, 100ms, TR time: 2500ms). Muscle T2 times were calculated for manually traced regions of interest of the respective muscles with an imaging software. The exercise protocol was performed in an isokinetic device and consisted of 120sec alternating ECC trunk flexion-extension with maximal effort. Venous blood samples were taken before and 72h after the ECC exercise. Descriptive statistics (mean±SD) and t-testing for pre-post ECC exercises were performed. RESULTS: T2 times increased from pre- to post-ECC MRI measurements from 55±3ms to 79±28ms in M. erector spinae and from 62±5ms to 78±24ms in M. multifidius (p<0.001). CK increased from 126±97 U/L to 1447±20579 U/L. High SDs of T2 time and CK in post-ECC measures could be due to inter-individual reactions to ECC exercises. 3 participants showed high local and systemic reactions (HR) with T2 time increases of 120±24% (M. erector spinae) and 73±50% (M. multifidius). In comparison, the remaining 7 participants showed increases of 11±12% (M. erector spinae) and 7±9% (M. multifidius) in T2 time. Mean CK increased 9.5-fold in the 3 HR subjects compared with the remaining 7 subjects. CONCLUSIONS: The 120sec maximal ECC trunk flexion-extension protocol induced high amounts of muscle damage in 3 participants. Moderate to low responses were found in the remaining 7 subjects, assuming that inter-individual predictors play a role regarding physiological responses to ECC workload. Y1 - 2020 U6 - https://doi.org/10.1249/01.mss.0000685648.68626.f1 SN - 0195-9131 SN - 1530-0315 SN - 0025-7990 VL - 52 IS - 17 SP - 929 EP - 929 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - GEN A1 - Hocher, Berthold A1 - Yin, Lianghong T1 - Why Current PTH Assays Mislead Clinical Decision Making in Patients with Secondary Hyperparathyroidism T2 - Nephron N2 - Preclinical studies in cell culture systems as well as in whole animal chronic kidney disease (CKD) models showed that parathyroid hormone (PTH), oxidized at the 2 methionine residues (positions 8 and 18), caused a loss of function. This was so far not considered in the development of PTH assays used in current clinical practice. Patients with advanced CKD are subject to oxidative stress, and plasma proteins (including PTH) are targets for oxidants. In patients with CKD, a considerable but variable fraction (about 70 to 90%) of measured PTH appears to be oxidized. Oxidized PTH (oxPTH) does not interact with the PTH receptor resulting in loss of biological activity. Currently used intact PTH (iPTH) assays detect both oxidized and non-oxPTH (n-oxPTH). Clinical studies demonstrated that bioactive, n-oxPTH, but not iPTH nor oxPTH, is associated with mortality in CKD patients. KW - Serum intact-parathyroid hormone level KW - Dialysis patients KW - Mortality Y1 - 2017 U6 - https://doi.org/10.1159/000455289 SN - 1660-8151 SN - 2235-3186 SN - 0028-2766 VL - 136 IS - 2 SP - 137 EP - 142 PB - Karger CY - Basel ER - TY - GEN A1 - Schraplau, Anne A1 - Sonnenburg, Dominik A1 - Wochatz, Monique A1 - Engel, Tilman A1 - Schomöller, Anne A1 - Risch, Lucie A1 - Kaplick, Hannes A1 - Mayer, Frank T1 - Characterization of muscle damage and inflammation following repeated maximal eccentric loading of the trunk T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine N2 - Eccentric exercises (ECC) induce reversible muscle damage, delayed-onset muscle soreness and an inflammatory reaction that is often followed by a systemic anti-inflammatory response. Thus, ECC might be beneficial for treatment of metabolic disorders which are frequently accompanied by a low-grade systemic inflammation. However, extent and time course of a systemic immune response after repeated ECC bouts are poorly characterized. PURPOSE: To analyze the (anti-)inflammatory response after repeated ECC loading of the trunk. METHODS: Ten healthy participants (33 ± 6 y; 173 ± 14 cm; 74 ± 16 kg) performed three isokinetic strength measurements of the trunk (concentric (CON), ECC1, ECC2, each 2 wks apart; flexion/extension, velocity 60°/s, 120s MVC). Pre- and 4, 24, 48, 72, 168h post-exercise, muscle soreness (numeric rating scale, NRS) was assessed and blood samples were taken and analyzed [Creatine kinase (CK), C-reactive protein (CRP), Interleukin-6 (IL-6), IL-10, Tumor necrosis factor-α (TNF-α)]. Statistics were done by Friedman‘s test with Dunn‘s post hoc test (α=.05). RESULTS: Mean peak torque was higher during ECC1 (319 ± 142 Nm) than during CON (268 ± 108 Nm; p<.05) and not different between ECC1 and ECC2 (297 ± 126 Nm; p>.05). Markers of muscle damage (peaks post-ECC1: NRS 48h, 4.4±2.9; CK 72h, 14407 ± 19991 U/l) were higher after ECC1 than after CON and ECC2 (p<.05). The responses over 72h (stated as Area under the Curve, AUC) were abolished after ECC2 compared to ECC1 (p<.05) indicating the presence of the repeated bout effect. CRP levels were not changed. IL-6 levels increased 2-fold post-ECC1 (pre: 0.5 ± 0.4 vs. 72h: 1.0 ± 0.8 pg/ml). The IL-6 response was enhanced after ECC1 (AUC 61 ± 37 pg/ml*72h) compared to CON (AUC 33 ± 31 pg/ml*72h; p<.05). After ECC2, the IL-6 response (AUC 43 ± 25 pg/ml*72h) remained lower than post-ECC1, but the difference was not statistically significant. Serum levels of TNF-α and of the anti-inflammatory cytokine IL-10 were below detection limits. Overall, markers of muscle damage and immune response showed high inter-individual variability. CONCLUSION: Despite maximal ECC loading of a large muscle group, no anti-inflammatory and just weak inflammatory responses were detected in healthy adults. Whether ECC elicits a different reaction in inflammatory clinical conditions is unclear. Y1 - 2020 U6 - https://doi.org/10.1249/01.mss.0000679532.65880.af SN - 0195-9131 SN - 1530-0315 VL - 52 IS - 7S SP - 497 EP - 497 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - GEN A1 - Martinez-Valdes, Eduardo A1 - Negro, Francesco A1 - Laine, Christopher M. A1 - Falla, Deborah L. A1 - Mayer, Frank A1 - Farina, Dario T1 - Identifying motor units in longitudinal studies with high-density surface electromyography T2 - Converging clinical and engineering research on neurorehabilitation II N2 - 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. Y1 - 2016 SN - 978-3-319-46669-9 SN - 978-3-319-46668-2 U6 - https://doi.org/10.1007/978-3-319-46669-9_27 SN - 2195-3562 VL - 15 SP - 147 EP - 151 PB - Springer CY - Cham ER - TY - GEN A1 - Völler, Heinz A1 - Bindl, Dominik A1 - Nagels, Klaus A1 - Hofmann, Reiner A1 - Vettorazzi, Eik A1 - Wegscheider, Karl A1 - Fleck, Eckart A1 - Nagel, Eckhard T1 - Remote telemonitoring in chronic heart failure does not reduce healthcare cost but improves quality of life BT - endpoints of the cardiobbeat trail T2 - Journal of the American College of Cardiology N2 - Background: Evidence that home telemonitoring (HTM) for patients with chronic heart failure (CHF) offers clinical benefit over usual care is controversial as is evidence of a health economic advantage. Therefore the CardioBBEAT trial was designed to prospectively assess the health economic impact of a dedicated home monitoring system for patients with CHF based on actual costs directly obtained from patients’ health care providers. Methods: Between January 2010 and June 2013, 621 patients (mean age 63,0 ± 11,5 years, 88 % male) with a confirmed diagnosis of CHF (LVEF ≤ 40 %) were enrolled and randomly assigned to two study groups comprising usual care with and without an interactive bi-directional HTM (Motiva®). The primary endpoint was the Incremental Cost-Effectiveness Ratio (ICER) established by the groups’ difference in total cost and in the combined clinical endpoint “days alive and not in hospital nor inpatient care per potential days in study” within the follow up of 12 months. Secondary outcome measures were total mortality and health related quality of life (SF-36, WHO-5 and KCCQ). Results: In the intention-to-treat analysis, total mortality (HR 0.81; 95% CI 0.45 – 1.45) and days alive and not in hospital (343.3 ± 55.4 vs. 347.2 ± 43.9; p = 0.909) were not significantly different between HTM and usual care. While the resulting primary endpoint ICER was not positive (-181.9; 95% CI −1626.2 ± 1628.9), quality of life assessed by SF-36, WHO-5 and KCCQ as a secondary endpoint was significantly higher in the HTW group at 6 and 12 months of follow-up. Conclusions: The first simultaneous assessment of clinical and economic outcome of HTM in patients with CHF did not demonstrate superior incremental cost effectiveness compared to usual care. On the other hand, quality of life was improved. It remains open whether the tested HTM solution represents a useful innovative approach in the recent health care setting. Y1 - 2017 SN - 0735-1097 SN - 1558-3597 VL - 69 IS - 11 Supplement SP - 672 EP - 672 PB - Elsevier CY - New York ER - TY - GEN A1 - Puschmann, Anne-Kathrin A1 - Beck, Heidrun A1 - Schiltenwolf, Marcus A1 - Wippert, Pia-Maria A1 - Mayer, Frank T1 - Distress in a longitudinal study of a population with nonspecific low back pain T2 - Psychosomatic medicine Y1 - 2017 SN - 0033-3174 SN - 1534-7796 VL - 79 SP - A20 EP - A21 PB - Lippincott Williams & Wilkins CY - Philadelphia ER -