TY - JOUR A1 - Wippert, Pia-Maria A1 - Puschmann, Anne-Katrin A1 - Drießlein, David A1 - Arampatzis, Adamantios A1 - Banzer, Winfried A1 - Beck, Heidrun A1 - Schiltenwolf, Marcus A1 - Schmidt, Hendrik A1 - Schneider, Christian A1 - Mayer, Frank T1 - Development of a risk stratification and prevention index for stratified care in chronic low back pain. Focus: yellow flags (MiSpEx network) JF - Pain reports N2 - Introduction: Chronic low back pain (LBP) is a major cause of disability; early diagnosis and stratification of care remain challenges. Objectives: This article describes the development of a screening tool for the 1-year prognosis of patients with high chronic LBP risk (risk stratification index) and for treatment allocation according to treatment-modifiable yellow flag indicators (risk prevention indices, RPI-S). Methods: Screening tools were derived from a multicentre longitudinal study (n = 1071, age >18, intermittent LBP). The greatest prognostic predictors of 4 flag domains ("pain," "distress," "social-environment," "medical care-environment") were determined using least absolute shrinkage and selection operator regression analysis. Internal validity and prognosis error were evaluated after 1-year follow-up. Receiver operating characteristic curves for discrimination (area under the curve) and cutoff values were determined. Results: The risk stratification index identified persons with increased risk of chronic LBP and accurately estimated expected pain intensity and disability on the Pain Grade Questionnaire (0-100 points) up to 1 year later with an average prognosis error of 15 points. In addition, 3-risk classes were discerned with an accuracy of area under the curve = 0.74 (95% confidence interval 0.63-0.85). The RPI-S also distinguished persons with potentially modifiable prognostic indicators from 4 flag domains and stratified allocation to biopsychosocial treatments accordingly. Conclusion: The screening tools, developed in compliance with the PROGRESS and TRIPOD statements, revealed good validation and prognostic strength. These tools improve on existing screening tools because of their utility for secondary preventions, incorporation of exercise effect modifiers, exact pain estimations, and personalized allocation to multimodal treatments. KW - Back pain prognosis KW - Back pain diagnosis KW - Pain screening KW - PROGRESS/TRIPOD KW - Prediction of disability/intensity KW - Yellow flags KW - Exercise Y1 - 2017 U6 - https://doi.org/10.1097/PR9.0000000000000623 VL - 9 SP - 1 EP - 11 PB - Wolters Kluwer Health CY - Riverwoods, IL ER - TY - JOUR A1 - Hortobágyi, Tibor A1 - Vetrovsky, Tomas A1 - Balbim, Guilherme Moraes A1 - Sorte Silva, Narlon Cassio Boa A1 - Manca, Andrea A1 - Deriu, Franca A1 - Kolmos, Mia A1 - Kruuse, Christina A1 - Liu-Ambrose, Teresa A1 - Radak, Zsolt A1 - Vaczi, Mark A1 - Johansson, Hanna A1 - Rocha dos Santos, Paulo Cezar A1 - Franzen, Erika A1 - Granacher, Urs T1 - The impact of aerobic and resistance training intensity on markers of neuroplasticity in health and disease JF - Ageing research reviews : ARR N2 - Objective: To determine the effects of low- vs. high-intensity aerobic and resistance training on motor and cognitive function, brain activation, brain structure, and neurochemical markers of neuroplasticity and the association thereof in healthy young and older adults and in patients with multiple sclerosis, Parkinson's disease, and stroke. Design: Systematic review and robust variance estimation meta-analysis with meta-regression. Data sources: Systematic search of MEDLINE, Web of Science, and CINAHL databases. Results: Fifty studies with 60 intervention arms and 2283 in-analyses participants were included. Due to the low number of studies, the three patient groups were combined and analyzed as a single group. Overall, low- (g=0.19, p = 0.024) and high-intensity exercise (g=0.40, p = 0.001) improved neuroplasticity. Exercise intensity scaled with neuroplasticity only in healthy young adults but not in healthy older adults or patient groups. Exercise-induced improvements in neuroplasticity were associated with changes in motor but not cognitive outcomes. Conclusion: Exercise intensity is an important variable to dose and individualize the exercise stimulus for healthy young individuals but not necessarily for healthy older adults and neurological patients. This conclusion warrants caution because studies are needed that directly compare the effects of low- vs. high-intensity exercise on neuroplasticity to determine if such changes are mechanistically and incrementally linked to improved cognition and motor function. KW - Aging KW - Exercise KW - Intensity Dose -response relationship KW - Cognition motor KW - function Y1 - 2022 U6 - https://doi.org/10.1016/j.arr.2022.101698 SN - 1568-1637 SN - 1872-9649 VL - 80 PB - Elsevier CY - Clare ER - TY - JOUR A1 - Granacher, Urs A1 - Muehlbauer, Thomas A1 - Göstemeyer, Gerd A1 - Gruber, Stefanie A1 - Gruber, Markus T1 - The performance of balance exercises during daily tooth brushing is not sufficient to improve balance and muscle strength in healthy older adults JF - BMC Geriatrics N2 - Background High prevalence rates have been reported for physical inactivity, mobility limitations, and falls in older adults. Home-based exercise might be an adequate means to increase physical activity by improving health- (i.e., muscle strength) and skill-related components of physical fitness (i.e., balance), particularly in times of restricted physical activity due to pandemics. Objective The objective of this study was to examine the effects of home-based balance exercises conducted during daily tooth brushing on measures of balance and muscle strength in healthy older adults. Methods Fifty-one older adults were randomly assigned to a balance exercise group (n = 27; age: 65.1 ± 1.1 years) or a passive control group (n = 24; age: 66.2 ± 3.3 years). The intervention group conducted balance exercises over a period of eight weeks twice daily for three minutes each during their daily tooth brushing routine. Pre- and post-intervention, tests were included for the assessment of static steady-state balance (i.e., Romberg test), dynamic steady-state balance (i.e., 10-m single and dual-task walk test using a cognitive and motor interference task), proactive balance (i.e., Timed-Up-and-Go Test [TUG], Functional-Reach-Test [FRT]), and muscle strength (i.e., Chair-Rise-Test [CRT]). Results Irrespective of group, the statistical analysis revealed significant main effects for time (pre vs. post) for dual-task gait speed (p < .001, 1.12 ≤ d ≤ 2.65), TUG (p < .001, d = 1.17), FRT (p = .002, d = 0.92), and CRT (p = .002, d = 0.94) but not for single-task gait speed and for the Romberg-Test. No significant group × time interactions were found for any of the investigated variables. Conclusions The applied lifestyle balance training program conducted twice daily during tooth brushing routines appears not to be sufficient in terms of exercise dosage and difficulty level to enhance balance and muscle strength in healthy adults aged 60–72 years. Consequently, structured balance training programs using higher exercise dosages and/or more difficult balance tasks are recommended for older adults to improve balance and muscle strength. KW - Balance KW - Daily life KW - Exercise KW - Healthy aging KW - Mobility Y1 - 2021 U6 - https://doi.org/10.1186/s12877-021-02206-w SN - 1471-2318 VL - 21 PB - BioMed Central CY - London ER -