TY - JOUR A1 - Baur, Heiner A1 - Hirschmüller, Anja A1 - Cassel, Michael A1 - Müller, Steffen A1 - Mayer, Frank T1 - Gender-specific neuromuscular activity of the M. peroneus longus in healthy runners : a descriptive laboratory study N2 - Background: Gender-specific neuromuscular activity for the ankle (e.g., peroneal muscle) is currently not known. This knowledge may contribute to the understanding of overuse injury mechanisms. The purpose was therefore to analyse the neuromuscular activity of the peroneal muscle in healthy runners. Methods: Fifty-three male and 54 female competitive runners were tested on a treadmill at 3.33 m s(-1). Neuromuscular activity of the M. peroneus longus was measured by electromyography and analysed in the time domain (onset of activation, time of maximum of activation, total time of activation) in % of stride time in relation to touchdown (= 1.0). Additionally, mean amplitudes for the gait cycle phases preactivation, weight acceptance and push-off were calculated and normalised to the mean activity of the entire gait cycle. Findings: Onset of activation (mean; female: 0.86/male: 0.90, p<0.0001) and time of maximum of activation (female: 1.13/male: 1.16, p<0.0001) occurred earlier in female compared to male and the total time of activation was longer in women (female: 0.42/male: 0.39, p=0.0036). In preactivation, women showed higher amplitudes (+ 21%) compared to men (female: 1.16/male: 0.92, p<0.0001). Activity during weight acceptance (female: 2.26/male: 2.41, p = 0.0039) and push-off (female: 0.93/male: 1.07, p = 0.0027) were higher in men. Interpretation: Activation strategies of the peroneal muscle appear to be gender-specific. Higher preactivation amplitudes in females indicate a different neuromuscular control in anticipation of touchdown ("pre-programmed activity"). These data may help interpret epidemiologically reported differences between genders in overuse injury frequency and localisation. Y1 - 2010 UR - http://www.sciencedirect.com/science/journal/02680033 U6 - https://doi.org/10.1016/j.clinbiomech.2010.06.009 SN - 0268-0033 ER - TY - GEN A1 - Baur, Heiner A1 - Hirschmüller, Anja A1 - Jahn, Michael A1 - Müller, Steffen A1 - Mayer, Frank T1 - Therapeutic efficiency and biomechanical effects of sport insoles in female runners T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 624 KW - polyurethane foam KW - overuse injury KW - biomechanical effect KW - female runner KW - injury symptom Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-435525 SN - 1866-8364 IS - 624 ER - TY - JOUR A1 - Baur, Heiner A1 - Hirschmüller, Anja A1 - Müller, Steffen A1 - Cassel, Michael A1 - Mayer, Frank T1 - Is EMG of the lower leg dependent on weekly running mileage? JF - International journal of sports medicine N2 - 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. KW - locomotion KW - neuromuscular control KW - running gait KW - training volume Y1 - 2012 U6 - https://doi.org/10.1055/s-0031-1286250 SN - 0172-4622 VL - 33 IS - 1 SP - 53 EP - 57 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Baur, Heiner A1 - Hirschmüller, Anja A1 - Müller, Steffen A1 - Mayer, Frank T1 - Neuromuscular activity of the peroneal muscle after foot orthoses therapy in runners JF - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine N2 - BAUR, H., A. HIRSCHMULLER, S. MULLER, and F. MAYER. Neuromuscular Activity of the Peroneal Muscle after Foot Orthoses Therapy in Runners. Med. Sci. Sports Exerc., Vol. 43, No. 8, pp. 1500-1506, 2011. Purpose: Foot orthoses are a standard option to treat overuse injury. Biomechanical data providing mechanisms of foot orthoses' effectiveness are sparse. Stability of the ankle joint complex might be a key factor. The purpose was therefore to analyze neuromuscular activity of the musculus peroneus longus in runners with overuse injury symptoms treated with foot orthoses. Methods: A total of 99 male and female runners with overuse injury symptoms randomized in a control group (CO) and an orthoses group (OR) were analyzed on a treadmill at 3.3 m.s(-1) before and after an 8-wk foot orthoses intervention. Muscular activity of the musculus peroneus longus was measured and quantified in the time domain (initial onset of activation (T-ini), time of maximal activity (T-max), total time of activation (T-tot)) and amplitude domain (amplitude in preactivation (A(pre)), weight acceptance (A(wa)), push-off (A(po))). Results: Peroneal activity in the time domain did not differ initially between CO and OR, and no effect was observed after therapy (T-ini: CO = -0.88 +/- 0.09, OR = -0.88 +/- 0.08 / T-max: CO = 0.14 +/- 0.06, OR = 0.15 +/- 0.06 / T-tot: CO = 0.40 +/- 0.09, OR = 0.41 +/- 0.09; P > 0.05). In preactivation (Apre), muscle activity was higher in OR after intervention (CO = 0.97 +/- 0.32, 95% confidence interval = 0.90-1.05; OR = 1.18 +/- 0.43, 95% confidence interval = 1.08-1.28; P = 0.003). There was no group or intervention effect during stance (A(wa): CO = 2.33 +/- 0.66, OR = 2.33 +/- 0.74 / A(po): CO = 0.80 +/- 0.41, OR = 0.88 +/- 0.40; P > 0.05). Conclusions: Enhanced muscle activation of the musculus peroneus longus in preactivation suggests an altered preprogrammed activity, which might lead to better ankle stability providing a possible mode of action for foot orthoses therapy. KW - ANKLE JOINT KW - EMG KW - INSERT KW - INSOLE KW - JOINT STABILITY KW - OVERUSE INJURY Y1 - 2011 U6 - https://doi.org/10.1249/MSS.0b013e31820c64ae SN - 0195-9131 VL - 43 IS - 8 SP - 1500 EP - 1506 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Baur, Heiner A1 - Müller, Steffen A1 - Hirschmüller, Anja A1 - Cassel, Michael A1 - Weber, Josefine A1 - Mayer, Frank T1 - Comparison in lower leg neuromuscular activity between runners with unilateral mid-portion Achilles tendinopathy and healthy individuals JF - Journal of electromyography and kinesiology N2 - Neuromuscular control in functional situations and possible impairments due to Achilles tendinopathy are not well understood. Thirty controls (CO) and 30 runners with Achilles tendinopathy (AT) were tested on a treadmill at 3.33 m s(-1) (12 km h(-1)). Neuromuscular activity of the lower leg (tibialis anterior, peroneal, and gastrocnemius muscle) was measured by surface electromyography. Mean amplitude values (MAV) for the gait cycle phases preactivation, weight acceptance and push-off were calculated and normalised to the mean activity of the entire gait cycle. MAVs of the tibialis anterior did not differ between CO and AT in any gait cycle phase. The activation of the peroneal muscle was lower in AT in weight acceptance (p = 0.006), whereas no difference between CO and AT was found in preactivation (p = 0.71) and push-off (p = 0.83). Also, MAVs of the gastrocnemius muscle did not differ between AT and CO in preactivity (p = 0.71) but were reduced in AT during weight acceptance (p = 0.001) and push-off (p = 0.04). Achilles tendinopathy does not seem to alter pre-programmed neural control but might induce mechanical deficits of the lower extremity during weight bearing (joint stability). This should be addressed in the therapy process of AT. KW - Ankle joint KW - Electromyography KW - Overuse injury KW - Running gait Y1 - 2011 U6 - https://doi.org/10.1016/j.jelekin.2010.11.010 SN - 1050-6411 VL - 21 IS - 3 SP - 499 EP - 505 PB - Elsevier CY - Oxford ER - TY - JOUR A1 - Baur, Heiner A1 - Müller, Steffen A1 - Hirschmüller, Anja A1 - Huber, Georg A1 - Mayer, Frank T1 - Reactivity, stability, and strength performance capacity in motor sports JF - British journal of sports medicine : the journal of sport and exercise medicine N2 - Background: Racing drivers require multifaceted cognitive and physical abilities in a multitasking situation. A knowledge of their physical capacities may help to improve fitness and performance. Objective: To compare reaction time, stability performance capacity, and strength performance capacity of elite racing drivers with those of age-matched, physically active controls. Methods: Eight elite racing drivers and 10 physically active controls matched for age and weight were tested in a reaction and determination test requiring upper and lower extremity responses to visual and audio cues. Further tests comprised evaluation of one-leg postural stability on a two-dimensional moveable platform, measures of maximum strength performance capacity of the extensors of the leg on a leg press, and a test of force capacity of the arms in a sitting position at a steering wheel. An additional arm endurance test consisted of isometric work at the steering wheel at + 30 degrees and -30 degrees where an eccentric threshold load of 30 N.m was applied. Subjects had to hold the end positions above this threshold until exhaustion. Univariate one way analysis of variance (alpha = 0.05) including a Bonferroni adjustment was used to detect group differences between the drivers and controls. Results: The reaction time of the racing drivers was significantly faster than the controls ( p = 0.004). The following motor reaction time and reaction times in the multiple determination test did not differ between the groups. No significant differences (p> 0.05) were found for postural stability, leg extensor strength, or arm strength and endurance. Conclusions: Racing drivers have faster reaction times than age-matched physically active controls. Further development of motor sport-specific test protocols is suggested. According to the requirements of motor racing, strength and sensorimotor performance capacity can potentially be improved. Y1 - 2006 U6 - https://doi.org/10.1136/bjsm.2006.025783 SN - 0306-3674 VL - 40 SP - 906 EP - 910 PB - BMJ Publ. Group CY - London ER - TY - JOUR A1 - Busch, Aglaja A1 - Bangerter, Christian A1 - Mayer, Frank A1 - Baur, Heiner T1 - Reliability of the active knee joint position sense test and influence of limb dominance and sex JF - Scientific reports N2 - The output of a sensorimotor performance can be measured with the joint position sense (JPS) test. However, investigations of leg dominance, sex and quality measures on this test are limited. Therefore, these potential influencing factors as well as reliability and consistency measures were evaluated for angular reproduction performance and neuromuscular activity during the active knee JPS test in healthy participants. Twenty healthy participants (10 males; 10 females; age 29 +/- 8 years; height 165 +/- 39 cm; body mass 69 +/- 13 kg) performed a seated knee JPS test with a target angle of 50 degrees. Measurements were conducted in two sessions separated by two weeks and consisted of two blocks of continuous angular reproduction (three minutes each block). The difference between reproduced and target angle was identified as angular error measured by an electrogoniometer. During reproduction, the neuromuscular activity of the quadriceps muscle was assessed by surface electromyography. Neuromuscular activity was normalized to submaximal voluntary contraction (subMVC) and displayed per muscle and movement phase. Differences between leg dominance and sex were calculated using Friedman-test (alpha = 0.05). Reliability measures including intraclass correlation coefficient (ICC), Bland-Altman analysis (bias +/- limits of agreement (LoA)) and minimal detectable change (MDC) were analysed. No significant differences between leg dominance and sex were found in angular error and neuromuscular activity. Angular error demonstrated inter-session ICC scores of 0.424 with a bias of 2.4 degrees (+/- 2.4 degrees LoA) as well as MDC of 6.8 degrees and moderate intra-session ICC (0.723) with a bias of 1.4 degrees (+/- 1.65 degrees LoA) as well as MDC of 4.7 degrees. Neuromuscular activity for all muscles and movement phases illustrated inter-session ICC ranging from 0.432 to 0.809 with biases between - 2.5 and 13.6% subMVC and MDC from 13.4 to 63.9% subMVC. Intra-session ICC ranged from 0.705 to 0.987 with biases of - 7.7 to 2.4% subMVC and MDC of 2.7 to 46.5% subMVC. Leg dominance and sex seem not to influence angular reproduction performance and neuromuscular activity. Poor to excellent relative reliability paired with an acceptable consistency confirm findings of previous studies. Comparisons to pathological populations should be conducted with caution. Y1 - 2023 U6 - https://doi.org/10.1038/s41598-022-26932-2 SN - 2045-2322 VL - 13 PB - Macmillan Publishers Limited, part of Springer Nature CY - London ER - TY - JOUR A1 - Busch, Aglaja A1 - Blasimann, Angela A1 - Henle, Philipp A1 - Baur, Heiner T1 - Neuromuscular activity during stair descent in ACL reconstructed patients BT - a pilot study JF - The Knee N2 - Background: The anterior cruciate ligament (ACL) rupture is a severe knee injury. Altered kinematics and kinetics in ACL reconstructed (ACL-R) patients compared to healthy participants (ACL-I) are known and attributed to an altered sensorimotor control. However, studies on neuromuscular control often lack homogeneous patient cohorts. The objective was to examine neuromuscular activity during stair descent in patients one year after ACL reconstruction. Method: Neuromuscular activity of vastus medialis (VM) and lateralis (VL), biceps femoris (BF) and semitendinosus (ST) was recorded by electromyography in 10 ACL-R (age: 26 +/- 10 years; height: 175 +/- 6 cm; mass: 75 +/- 14 kg) and 10 healthy matched controls (age: 31 +/- 7 years; height: 175 +/- 7 cm; mass: 68 +/- 10 kg). A 10-minute walking treadmill warm-up was used for submaximal normalization. Afterwards participants descended 10 times a six-step stairway at a self-selected speed. The movement was separated into pre-activation (PRE), weight acceptance (WA) and push-off phase (PO). Normalized root mean squares for each muscle, limb and movement phase were calculated. Kruskal-Wallis ANOVA compared ACL-R injured and contralateral leg and the ACL-I leg (alpha = 0.05). Results: Significant increased normalised activity in ST during WA in ACL-R injured leg compared to ACL-I and during PO in VL in the ACL-R contralateral leg compared to ACL-I. Decreased activity was shown in VM in ACL-R injured compared to contralateral leg (p < 0.05). Conclusion: Altered neuromuscular activations are present one year after ACL reconstruction compared to the contralateral and healthy matched control limb. Current standard rehabilitation programs may not be able to fully restore sensorimotor control and demand further investigations. (C) 2018 Elsevier B.V. All rights reserved. KW - Knee KW - Neuromuscular control KW - Sensorimotor control KW - Electromyography KW - Rehabilitation Y1 - 2019 U6 - https://doi.org/10.1016/j.knee.2018.12.011 SN - 0968-0160 SN - 1873-5800 VL - 26 IS - 2 SP - 310 EP - 316 PB - Elsevier CY - Amsterdam ER - TY - GEN A1 - Busch, Aglaja A1 - Blasimann, Angela A1 - Mayer, Frank A1 - Baur, Heiner T1 - Alterations in sensorimotor function after ACL reconstruction during active joint position sense testing. A systematic review T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background The anterior cruciate ligament (ACL) rupture can lead to impaired knee function. Reconstruction decreases the mechanical instability but might not have an impact on sensorimotor alterations. Objective Evaluation of the sensorimotor function measured with the active joint position sense (JPS) test in anterior cruciate ligament (ACL) reconstructed patients compared to the contralateral side and a healthy control group. Methods The databases MEDLINE, CINAHL, EMBASE, PEDro, Cochrane Library and SPORTDiscus were systematically searched from origin until April 2020. Studies published in English, German, French, Spanish or Italian language were included. Evaluation of the sensorimotor performance was restricted to the active joint position sense test in ACL reconstructed participants or healthy controls. The Preferred Items for Systematic Reviews and Meta-Analyses guidelines were followed. Study quality was evaluated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data was descriptively synthesized. Results Ten studies were included after application of the selective criteria. Higher angular deviation, reaching significant difference (p < 0.001) in one study, was shown up to three months after surgery in the affected limb. Six months post-operative significantly less error (p < 0.01) was found in the reconstructed leg compared to the contralateral side and healthy controls. One or more years after ACL reconstruction significant differences were inconsistent along the studies. Conclusions Altered sensorimotor function was present after ACL reconstruction. Due to inconsistencies and small magnitudes, clinical relevance might be questionable. JPS testing can be performed in acute injured persons and prospective studies could enhance knowledge of sensorimotor function throughout the rehabilitative processes. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 717 KW - Body limbs KW - Knees KW - Sensory perception KW - Anterior cruciate ligament reconstruction KW - Legs KW - Tendons KW - Surgical and invasive medical procedures KW - Systematic reviews Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-521775 SN - 1866-8364 ER - TY - JOUR A1 - Busch, Aglaja A1 - Blasimann, Angela A1 - Mayer, Frank A1 - Baur, Heiner T1 - Alterations in sensorimotor function after ACL reconstruction during active joint position sense testing. A systematic review JF - PLOS ONE N2 - Background The anterior cruciate ligament (ACL) rupture can lead to impaired knee function. Reconstruction decreases the mechanical instability but might not have an impact on sensorimotor alterations. Objective Evaluation of the sensorimotor function measured with the active joint position sense (JPS) test in anterior cruciate ligament (ACL) reconstructed patients compared to the contralateral side and a healthy control group. Methods The databases MEDLINE, CINAHL, EMBASE, PEDro, Cochrane Library and SPORTDiscus were systematically searched from origin until April 2020. Studies published in English, German, French, Spanish or Italian language were included. Evaluation of the sensorimotor performance was restricted to the active joint position sense test in ACL reconstructed participants or healthy controls. The Preferred Items for Systematic Reviews and Meta-Analyses guidelines were followed. Study quality was evaluated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data was descriptively synthesized. Results Ten studies were included after application of the selective criteria. Higher angular deviation, reaching significant difference (p < 0.001) in one study, was shown up to three months after surgery in the affected limb. Six months post-operative significantly less error (p < 0.01) was found in the reconstructed leg compared to the contralateral side and healthy controls. One or more years after ACL reconstruction significant differences were inconsistent along the studies. Conclusions Altered sensorimotor function was present after ACL reconstruction. Due to inconsistencies and small magnitudes, clinical relevance might be questionable. JPS testing can be performed in acute injured persons and prospective studies could enhance knowledge of sensorimotor function throughout the rehabilitative processes. KW - Body limbs KW - Knees KW - Sensory perception KW - Anterior cruciate ligament reconstruction KW - Legs KW - Tendons KW - Surgical and invasive medical procedures KW - Systematic reviews Y1 - 2021 U6 - https://doi.org/10.1371/journal.pone.0253503 SN - 1932-6203 VL - 16 IS - 6 PB - PLOS CY - San Francisco ER - TY - JOUR A1 - Cassel, Michael A1 - Baur, Heiner A1 - Hirschmueller, Anja A1 - Carlsohn, Anja A1 - Fröhlich, Katja A1 - Mayer, Frank T1 - Prevalence of Achilles and patellar tendinopathy and their association to intratendinous changes in adolescent athletes JF - Scandinavian journal of medicine & science in sports N2 - Achilles (AT) and patellar tendons (PT) are commonly affected by tendinopathy in adult athletes but prevalence of symptoms and morphological changes in adolescents is unclear. The study aimed to determine prevalence of tendinopathy and intratendinous changes in ATs and PTs of adolescent athletes. A total of 760 adolescent athletes (13.0 +/- 1.9 years; 160 +/- 13cm; 50 +/- 14kg) were examined. History, local clinical examination, and longitudinal Doppler ultrasound analysis for both ATs and PTs were performed including identification of intratendinous echoic changes and vascularization. Diagnosis of tendinopathy was complied clinically in case of positive history of tendon pain and tendon pain on palpation. Achilles tendinopathy was diagnosed in 1.8% and patellar tendinopathy in 5.8%. Vascularizations were visible in 3.0% of ATs and 11.4% of PTs, hypoechogenicities in 0.7% and 3.2% as well as hyperechogenicities in 0% and 0.3%, respectively. Vascularizations and hypoechogenicities were statistically significantly more often in males than in females (P0.02). Subjects with patellar tendinopathy had higher prevalence of structural intratendinous changes than those without PT symptoms (P0.001). In adolescent athletes, patellar tendinopathy is three times more frequent compared with Achilles tendinopathy. Longitudinal studies are necessary to investigate physiological or pathological origin of vascularizations and its predictive value in development of tendinopathy. KW - Prevalence KW - tendinopathy KW - sonography KW - Doppler ultrasound KW - vascularization KW - hypoechogenicities KW - hyperechogenicities KW - adolescent athletes Y1 - 2015 U6 - https://doi.org/10.1111/sms.12318 SN - 0905-7188 SN - 1600-0838 VL - 25 IS - 3 SP - e310 EP - e318 PB - Wiley-Blackwell CY - Hoboken ER - TY - GEN A1 - Hirschmueller, Anja A1 - Baur, Heiner A1 - Braun, Sepp A1 - Kreuz, Peter C. A1 - Suedkamp, Norbert P A1 - Niemeyer, Philipp T1 - Rehabilitation after autologous chondrocyte implantation for isolated cartilage defects of the knee N2 - Autologous chondrocyte implantation for treatment of isolated cartilage defects of the knee has become well established. Although various publications report technical modifications, clinical results, and cell-related issues, little is known about appropriate and optimal rehabilitation after autologous chondrocyte implantation. This article reviews the literature on rehabilitation after autologous chondrocyte implantation and presents a rehabilitation protocol that has been developed considering the best available evidence and has been successfully used for several years in a large number of patients who underwent autologous chondrocyte implantation for cartilage defects of the knee. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 367 KW - autologous chondrocyte implantation KW - cartilage repair KW - cartilage defect KW - cell transplantation KW - knee joint KW - rehabilitation Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-403170 ER - TY - JOUR A1 - Hirschmueller, Anja A1 - Frey, Victoria A1 - Konstantinidis, Lukas A1 - Baur, Heiner A1 - Dickhuth, Hans-Hermann A1 - Suedkamp, Norbert P. A1 - Helwig, Peter T1 - Prognostic value of achilles tendon doppler sonography in asymptomatic runners JF - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine N2 - HIRSCHMULLER, A., V. FREY, L. KONSTANTINIDIS, H. BAUR, H-H. DICKHUTH, N. P. SUDKAMP, and P. HELWIG. Prognostic Value of Achilles Tendon Doppler Sonography in Asymptomatic Runners. Med. Sci. Sports Exerc., Vol. 44, No. 2, pp. 199-205, 2012. Introduction: Midportion Achilles tendinopathy (MPT) is a common problem in running athletes. Nevertheless, its etiology is not fully understood, and no valid prognostic criterion to predict the development of MPT could be identified to date. The purpose of the present study, therefore, was to evaluate whether power Doppler ultrasonography (PDU) is a suitable method to identify a predisposition to MPT in yet asymptomatic runners. Methods: At 23 major running events, 634 asymptomatic long-distance runners were tested for Achilles tendon thickness, vascularization, and structural abnormalities using a high-resolution PDU device (Toshiba Aplio SSA-770A/80, 12 MHz). In addition, their medical history and anthropometric data were documented. All subjects were contacted 6 and 12 months later and asked about any new symptoms. The collected anamnestic, anthropometric, and ultrasonographic data were subjected to regression analysis to determine their predictive value concerning the manifestation of midportion Achilles tendon complaints (P < 0.05). Results: The highest odds ratio (OR) for manifestation of MPT within 1 yr was found for intratendinous blood flow ("neovascularization,'' OR = 6.9, P < 0.001). An increased risk was also identified for subjects with a positive history of Achilles tendon complaints (OR = 3.8, P < 0.001). A third relevant parameter, just above the level of significance, was a spindle-shaped thickening of the tendon on PDU (Wald chi(2) = 3.42). Conclusions: PDU detection of intratendinous microvessels in the Achilles tendons of healthy runners seems to be a prognostically relevant factor concerning the manifestation of symptomatic MPT. This finding lays the foundation for an early identification of a predisposition to MPT as well as prophylactic intervention in as yet asymptomatic runners. KW - MIDPORTION KW - TENDINOPATHY KW - NEOVASCULARIZATION KW - PROGNOSIS Y1 - 2012 U6 - https://doi.org/10.1249/MSS.0b013e31822b7318 SN - 0195-9131 VL - 44 IS - 2 SP - 199 EP - 205 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Hirschmüller, Anja A1 - Baur, Heiner A1 - Müller, Steffen A1 - Helwig, Peter A1 - Dickhuth, Hans-Hermann A1 - Mayer, Frank T1 - Clinical effectiveness of customised sport shoe orthoses for overuse injuries in runners a randomised controlled study JF - British journal of sports medicine : the journal of sport and exercise medicine N2 - Background and objectives Treatment of chronic running-related overuse injuries by orthopaedic shoe orthoses is very common but not evidence-based to date. Hypothesis Polyurethane foam orthoses adapted to a participant's barefoot plantar pressure distribution are an effective treatment option for chronic overuse injuries in runners. Design Prospective, randomised, controlled clinical trial. Intervention 51 patients with running injuries were treated with custom-made, semirigid running shoe orthoses for 8 weeks. 48 served as a randomised control group that continued regular training activity without any treatment. Main outcome measures Evaluation was made by the validated pain questionnaire Subjective Pain Experience Scale, the pain disability index and a comfort index in the orthoses group (ICI). Results There were statistically significant differences between the orthoses and control groups at 8 weeks for the pain disability index (mean difference 3.2; 95% CI 0.9 to 5.5) and the Subjective Pain Experience Scale (6.6; 2.6 to 10.6). The patients with orthoses reported a rising wearing comfort (pre-treatment ICI 69/100; post-treatment ICI 83/100) that was most pronounced in the first 4 weeks (ICI 80.4/100). Conclusion Customised polyurethane running shoe orthoses are an effective conservative therapy strategy for chronic running injuries with high comfort and acceptance of injured runners. Y1 - 2011 U6 - https://doi.org/10.1136/bjsm.2008.055830 SN - 0306-3674 VL - 45 IS - 12 SP - 959 EP - 965 PB - BMJ Publ. Group CY - London ER - TY - JOUR A1 - Hirschmüller, Anja A1 - Konstantinidis, Lukas A1 - Baur, Heiner A1 - Müller, Steffen A1 - Mehlhorn, Alexander A1 - Kontermann, Julia A1 - Grosse, Ulrich A1 - Südkamp, Norbert P. A1 - Helwig, Peter T1 - Do changes in dynamic plantar pressure distribution, strength capacity and postural control after intra-articular calcaneal fracture correlate with clinical and radiological outcome? JF - Injury : international journal of the care of the injured N2 - Fractures of the calcaneus are often associated with serious permanent disability, a considerable reduction in quality of life, and high socio-economic cost. Although some studies have already reported changes in plantar pressure distribution after calcaneal fracture, no investigation has yet focused on the patient's strength and postural control. Method: 60 patients with unilateral, operatively treated, intra-articular calcaneal fractures were clinically and biomechanically evaluated >1 year postoperatively (physical examination, SF-36, AOFAS score, lower leg isokinetic strength, postural control and gait analysis including plantar pressure distribution). Results were correlated to clinical outcome and preoperative radiological findings (Bohler angle, Zwipp and Sanders Score). Results: Clinical examination revealed a statistically significant reduction in range of motion at the tibiotalar and the subtalar joint on the affected side. Additionally, there was a statistically significant reduction of plantar flexor peak torque of the injured compared to the uninjured limb (p < 0.001) as well as a reduction in postural control that was also more pronounced on the initially injured side (standing duration 4.2 +/- 2.9 s vs. 7.6 +/- 2.1 s, p < 0.05). Plantar pressure measurements revealed a statistically significant pressure reduction at the hindfoot (p = 0.0007) and a pressure increase at the midfoot (p = 0.0001) and beneath the lateral forefoot (p = 0.037) of the injured foot. There was only a weak correlation between radiological classifications and clinical outcome but a moderate correlation between strength differences and the clinical questionnaires (CC 0.27-0.4) as well as between standing duration and the clinical questionnaires. Although thigh circumference was also reduced on the injured side, there was no important relationship between changes in lower leg circumference and strength suggesting that measurement of leg circumference may not be a valid assessment of maximum strength deficits. Self-selected walking speed was the parameter that showed the best correlation with clinical outcome (AOFAS score). Conclusion: Calcaneal fractures are associated with a significant reduction in ankle joint ROM, plantar flexion strength and postural control. These impairments seem to be highly relevant to the patients. Restoration of muscular strength and proprioception should therefore be aggressively addressed in the rehabilitation process after these fractures. KW - Intra-articular calcaneal fracture KW - Calcaneus KW - Muscle strength KW - Peak torque KW - Plantar pressure distribution KW - Proprioception KW - Postural control KW - Balance KW - Gait KW - Rehabilitation Y1 - 2011 U6 - https://doi.org/10.1016/j.injury.2010.09.040 SN - 0020-1383 VL - 42 IS - 10 SP - 1135 EP - 1143 PB - Elsevier CY - Oxford ER - TY - JOUR A1 - König, Niklas A1 - Reschke, Antje A1 - Wolter, Martin A1 - Müller, Steffen A1 - Mayer, Frank A1 - Baur, Heiner T1 - Plantar pressure trigger for reliable nerve stimulus application during dynamic H-reflex measurements JF - Gait & posture N2 - In dynamic H-reflex measurements, the standardisation of the nerve stimulation to the gait cycle is crucial to avoid misinterpretation due to altered pre-synaptic inhibition. In this pilot study, a plantar pressure sole was used to trigger the stimulation of the tibialis nerve with respect to the gait cycle. Consequently, the intersession reliability of the soleus muscle H-reflex during treadmill walking was investigated. Seven young participants performed walking trials on a treadmill at 5 km/h. The stimulating electrode was placed on the tibial nerve in the popliteal fossa. An EMG was recorded from the soleus muscle. To synchronize the stimulus to the gait cycle, initial heel strike was detected with a plantar pressure sole. Maximum H-reflex amplitude and M-wave amplitude were obtained and the Hmax/Mmax ratio was calculated. Data reveals excellent reliability, ICC = 0.89. Test-retest variability was 13.0% (+/- 11.8). The Bland-Altman analysis showed a systematic error of 2.4%. The plantar pressure sole was capable of triggering the stimulation of the tibialis nerve in a reliable way and offers a simple technique for the evaluation of reflex activity during walking. KW - Monosynaptic reflexes KW - Reflex reproducibility KW - Treadmill walking Y1 - 2013 U6 - https://doi.org/10.1016/j.gaitpost.2012.09.021 SN - 0966-6362 VL - 37 IS - 4 SP - 637 EP - 639 PB - Elsevier CY - Clare ER - TY - CHAP A1 - König, Niklas A1 - Stoll, Andreas A1 - Mayer, Frank A1 - Baur, Heiner T1 - Intrasession reliability of insole in-shoe plantar pressure measurements in different foot areas T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine Y1 - 2012 SN - 0195-9131 VL - 44 SP - 941 EP - 941 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Mayer, Frank A1 - Bonaventura, Klaus A1 - Cassel, Michael A1 - Müller, Steffen A1 - Weber, Josefine A1 - Scharhag-Rosenberger, Friederike A1 - Carlsohn, Anja A1 - Baur, Heiner A1 - Scharhag, Jürgen T1 - Medical results of preparticipation examination in adolescent athletes JF - British journal of sports medicine : the journal of sport and exercise medicine N2 - 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. Y1 - 2012 U6 - https://doi.org/10.1136/bjsports-2011-090966 SN - 0306-3674 VL - 46 IS - 7 SP - 524 EP - 530 PB - BMJ Publ. Group CY - London ER - TY - JOUR A1 - Mueller, Juliane A1 - Engel, Tilman A1 - Mueller, Steffen A1 - Kopinski, Stephan A1 - Baur, Heiner A1 - Mayer, Frank T1 - Neuromuscular response of the trunk to sudden gait disturbances: Forward vs. backward perturbation JF - Journal of electromyography and kinesiology N2 - The study aimed to analyse neuromuscular activity of the trunk comparing four different perturbations during gait. Thirteen subjects (28 +/- 3 yrs) walked (1 m/s) on a split-belt treadmill, while 4 (belt) perturbations (F1, F2, B1, B2) were randomly applied. Perturbations differed, related to treadmill belt translation, in direction (forward (F)/backward (B)) and amplitude (20 m/s(2) (1)/40 m/s(2) (2)). Trunk muscle activity was assessed with a 12-lead-EMG. EMG-RMS [%] (0-200 ms after perturbation; normalized to RMS of normal gait) was analyzed for muscles and four trunk areas (ventral left/right; dorsal left/right). Ratio of ventral: dorsal muscles were calculated. Muscle onset [ms] was determined. Data analysis was conducted descriptively, followed by ANOVA (post hoc Tukey-Kramer (alpha = 0.05)). All perturbations lead to an increase in EMG-RMS (428 +/- 289%). F1 showed the lowest and F2 the highest increase for the flexors. B2 showed the highest increase for the extensors. Significant differences between perturbations could be observed for 6 muscles, as well as the 4 trunk areas. Ratio analysis revealed no significant differences (range 1.25 (B1) to 1.71 (F2) between stimuli. Muscle response time (ventral: 87.0 +/- 21.7 ms; dorsal: 88.4 +/- 17.0 ms) between stimuli was only significant (p = 0.005) for the dorsal muscles. Magnitude significantly influences neuromuscular trunk response patterns in healthy adults. Regardless of direction ventral muscles always revealed higher relative increase of activity while compensating the walking perturbations. (C) 2016 Elsevier Ltd. All rights reserved. KW - Stumbling KW - Gait perturbation KW - EMG KW - Core KW - MiSpEx* Y1 - 2016 U6 - https://doi.org/10.1016/j.jelekin.2016.07.005 SN - 1050-6411 SN - 1873-5711 VL - 30 SP - 168 EP - 176 PB - Elsevier CY - Oxford ER - TY - JOUR A1 - Mueller, Steffen A1 - Carlsohn, Anja A1 - Mueller, Juliane A1 - Baur, Heiner A1 - Mayer, Frank T1 - Influence of Obesity on Foot Loading Characteristics in Gait for Children Aged 1 to 12 Years JF - PLoS one N2 - Background Overweight and obesity are increasing health problems that are not restricted to adults only. Childhood obesity is associated with metabolic, psychological and musculoskeletal comorbidities. However, knowledge about the effect of obesity on the foot function across maturation is lacking. Decreased foot function with disproportional loading characteristics is expected for obese children. The aim of this study was to examine foot loading characteristics during gait of normal-weight, overweight and obese children aged 1-12 years. Methods Results Mean walking velocity was 0.95 +/- 0.25 m/s with no differences between normal-weight, overweight or obese children (p = 0.0841). Results show higher foot contact area, arch index, peak pressure and force time integral in overweight and obese children (p< 0.001). Obese children showed the 1.48-fold (1 year-old) to 3.49-fold (10 year-old) midfoot loading (FTI) compared to normal-weight. Conclusion Additional body mass leads to higher overall load, with disproportional impact on the midfoot area and longitudinal foot arch showing characteristic foot loading patterns. Already the feet of one and two year old children are significantly affected. Childhood overweight and obesity is not compensated by the musculoskeletal system. To avoid excessive foot loading with potential risk of discomfort or pain in childhood, prevention strategies should be developed and validated for children with a high body mass index and functional changes in the midfoot area. The presented plantar pressure values could additionally serve as reference data to identify suspicious foot loading patterns in children. Y1 - 2016 U6 - https://doi.org/10.1371/journal.pone.0149924 SN - 1932-6203 VL - 11 SP - 1710 EP - 1717 PB - PLoS CY - San Fransisco ER -