TY - JOUR A1 - Mugele, Hendrik A1 - Plummer, Ashley A1 - Baritello, Omar A1 - Towe, Maggie A1 - Brecht, Pia A1 - Mayer, Frank T1 - Accuracy of training recommendations based on a treadmill multistage incremental exercise test JF - PLOS ONE N2 - Competitive runners will occasionally undergo exercise in a laboratory setting to obtain predictive and prescriptive information regarding their performance. The present research aimed to assess whether the physiological demands of lab-based treadmill running (TM) can simulate that of over-ground (OG) running using a commonly used protocol. Fifteen healthy volunteers with a weekly mileage of ≥ 20 km over the past 6 months and treadmill experience participated in this cross-sectional study. Two stepwise incremental tests until volitional exhaustion was performed in a fixed order within one week in an Outpatient Clinic research laboratory and outdoor athletic track. Running velocity (IATspeed), heart rate (IATHR) and lactate concentration at the individual anaerobic threshold (IATbLa) were primary endpoints. Additionally, distance covered (DIST), maximal heart rate (HRmax), maximal blood lactate concentration (bLamax) and rate of perceived exertion (RPE) at IATspeed were analyzed. IATspeed, DIST and HRmax were not statistically significantly different between conditions, whereas bLamax and RPE at IATspeed showed statistical significance (p < 0.05). Apart from RPE at IATspeed, IATspeed, DIST, HRmax and bLamax strongly correlate between conditions (r = 0.815–0.988). High reliability between conditions provides strong evidence to suggest that running on a treadmill are physiologically comparable to that of OG and that training recommendations and be made with assurance. KW - individual anaerobic threshold KW - lactate threshold KW - soccer players KW - performance KW - validity KW - reliability KW - runners Y1 - 2018 U6 - https://doi.org/10.1371/journal.pone.0204696 SN - 1932-6203 VL - 13 IS - 10 SP - 1 EP - 12 PB - PLOS CY - San Francisco ER - TY - JOUR A1 - Mueller, Juliane A1 - Stoll, Josefine A1 - Mueller, Steffen A1 - Mayer, Frank T1 - Dose-response relationship of core-specific sensorimotor interventions in healthy, welltrained participants BT - study protocol for a (MiSpEx) randomized controlled trial JF - Trials N2 - Background: Core-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk, improve athletic performance and prevent back pain. However, the dose-response relationship and, therefore, the dose required to improve trunk function is still under debate. The purpose of the present trial will be to compare four different intervention strategies of sensorimotor exercises that will result in improved trunk function. Methods/design: A single-blind, four-armed, randomized controlled trial with a 3-week (home-based) intervention phase and two measurement days pre and post intervention (M1/M2) is designed. Experimental procedures on both measurement days will include evaluation of maximum isokinetic and isometric trunk strength (extension/flexion, rotation) including perturbations, as well as neuromuscular trunk activity while performing strength testing. The primary outcome is trunk strength (peak torque). Neuromuscular activity (amplitude, latencies as a response to perturbation) serves as secondary outcome. The control group will perform a standardized exercise program of four sensorimotor exercises (three sets of 10 repetitions) in each of six training sessions (30 min duration) over 3 weeks. The intervention groups’ programs differ in the number of exercises, sets per exercise and, therefore, overall training amount (group I: six sessions, three exercises, two sets; group II: six sessions, two exercises, two sets; group III: six sessions, one exercise, three sets). The intervention programs of groups I, II and III include additional perturbations for all exercises to increase both the difficulty and the efficacy of the exercises performed. Statistical analysis will be performed after examining the underlying assumptions for parametric and non-parametric testing. Discussion: The results of the study will be clinically relevant, not only for researchers but also for (sports) therapists, physicians, coaches, athletes and the general population who have the aim of improving trunk function. KW - Sensorimotor training KW - Perturbation KW - Exercise KW - MiSpEx Y1 - 2018 U6 - https://doi.org/10.1186/s13063-018-2799-9 SN - 1745-6215 VL - 19 IS - 424 PB - BioMed Central CY - London ER - TY - JOUR A1 - Appiah-Dwomoh, Edem Korkor A1 - Müller, Steffen A1 - Mayer, Frank T1 - Reproducibility of Static and Dynamic Postural Control Measurement in Adolescent Athletes with Back Pain JF - Rehabilitation Research and Practice N2 - Static (one-legged stance) and dynamic (star excursion balance) postural control tests were performed by 14 adolescent athletes with and 17 without back pain to determine reproducibility. The total displacement, mediolateral and anterior-posterior displacements of the centre of pressure in mm for the static, and the normalized and composite reach distances for the dynamic tests were analysed. Intraclass correlation coefficients, 95% confidence intervals, and a Bland-Altman analysis were calculated for reproducibility. Intraclass correlation coefficients for subjects with (0.54 to 0.65), (0.61 to 0.69) and without (0.45 to 0.49), (0.52 to 0.60) back pain were obtained on the static test for right and left legs, respectively. Likewise, (0.79 to 0.88), (0.75 to 0.93) for subjects with and (0.61 to 0.82), (0.60 to 0.85) for those without back pain were obtained on the dynamic test for the right and left legs, respectively. Systematic bias was not observed between test and retest of subjects on both static and dynamic tests. The one-legged stance and star excursion balance tests have fair to excellent reliabilities on measures of postural control in adolescent athletes with and without back pain. They can be used as measures of postural control in adolescent athletes with and without back pain. KW - Excursion Balance Test KW - Female Collegiate Soccer KW - Test-Retest Reliability KW - Lower-Extremity Injury KW - Lumbar Spine KW - Performance KW - Basketball KW - Children KW - Prevalence KW - Stability Y1 - 2018 U6 - https://doi.org/10.1155/2018/8438350 SN - 2090-2875 SN - 2090-2867 VL - 2018 SP - 1 EP - 8 PB - Hindawi CY - New York ER - TY - JOUR A1 - Risch, Lucie A1 - Stoll, Josefine A1 - Schomöller, Anne A1 - Engel, Tilman A1 - Mayer, Frank A1 - Cassel, Michael T1 - Intraindividual Doppler Flow Response to Exercise Differs Between Symptomatic and Asymptomatic Achilles Tendons JF - Frontiers in physiology N2 - 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.” KW - achilles tendinopathy KW - tendinosis KW - neovascularization KW - ultrasound KW - advanced dynamic flow KW - sonography Y1 - 2021 U6 - https://doi.org/10.3389/fphys.2021.617497 SN - 1664-042X VL - 12 SP - 1 EP - 8 PB - Frontiers Research Foundation CY - Lausanne, Schweiz ER - TY - JOUR A1 - Puschmann, Anne-Katrin A1 - Drießlein, David A1 - Beck, Heidrun A1 - Arampatzis, Adamantios A1 - Moreno Catalá, Maria A1 - Schiltenwolf, Marcus A1 - Mayer, Frank A1 - Wippert, Pia-Maria T1 - Stress and Self-Efficacy as Long-Term Predictors for Chronic Low Back Pain BT - A Prospective Longitudinal Study JF - Journal of Pain Research N2 - Purpose: Psychosocial variables are known risk factors for the development and chronification of low back pain (LBP). Psychosocial stress is one of these risk factors. Therefore, this study aims to identify the most important types of stress predicting LBP. Self-efficacy was included as a potential protective factor related to both, stress and pain. Participants and Methods: This prospective observational study assessed n = 1071 subjects with low back pain over 2 years. Psychosocial stress was evaluated in a broad manner using instruments assessing perceived stress, stress experiences in work and social contexts, vital exhaustion and life-event stress. Further, self-efficacy and pain (characteristic pain intensity and disability) were assessed. Using least absolute shrinkage selection operator regression, important predictors of characteristic pain intensity and pain-related disability at 1-year and 2-years follow-up were analyzed. Results: The final sample for the statistic procedure consisted of 588 subjects (age: 39.2 (± 13.4) years; baseline pain intensity: 27.8 (± 18.4); disability: 14.3 (± 17.9)). In the 1-year follow-up, the stress types “tendency to worry”, “social isolation”, “work discontent” as well as vital exhaustion and negative life events were identified as risk factors for both pain intensity and pain-related disability. Within the 2-years follow-up, Lasso models identified the stress types “tendency to worry”, “social isolation”, “social conflicts”, and “perceived long-term stress” as potential risk factors for both pain intensity and disability. Furthermore, “self-efficacy” (“internality”, “self-concept”) and “social externality” play a role in reducing pain-related disability. Conclusion: Stress experiences in social and work-related contexts were identified as important risk factors for LBP 1 or 2 years in the future, even in subjects with low initial pain levels. Self-efficacy turned out to be a protective factor for pain development, especially in the long-term follow-up. Results suggest a differentiation of stress types in addressing psychosocial factors in research, prevention and therapy approaches. KW - low back pain KW - psychosocial risk factors KW - stress KW - self-efficacy KW - MiSpEx Y1 - 2019 U6 - https://doi.org/10.2147/JPR.S223893 SN - 1178-7090 VL - 13 SP - 613 EP - 621 PB - Dove Medical Press CY - Albany, Auckland ER - TY - JOUR A1 - Wippert, Pia-Maria A1 - Niederer, Daniel A1 - Drießlein, David A1 - Beck, Heidrun A1 - Banzer, Winfried Eberhard A1 - Schneider, Christian A1 - Schiltenwolf, Marcus A1 - Mayer, Frank T1 - Psychosocial Moderators and Mediators of Sensorimotor Exercise in Low Back Pain: A Randomized Multicenter Controlled Trial JF - Frontiers in Psychiatry N2 - The effects of exercise interventions on unspecific chronic low back pain (CLBP) have been investigated in many studies, but the results are inconclusive regarding exercise types, efficiency, and sustainability. This may be because the influence of psychosocial factors on exercise induced adaptation regarding CLBP is neglected. Therefore, this study assessed psychosocial characteristics, which moderate and mediate the effects of sensorimotor exercise on LBP. A single-blind 3-arm multicenter randomized controlled trial was conducted for 12-weeks. Three exercise groups, sensorimotor exercise (SMT), sensorimotor and behavioral training (SMT-BT), and regular routines (CG) were randomly assigned to 662 volunteers. Primary outcomes (pain intensity and disability) and psychosocial characteristics were assessed at baseline (M1) and follow-up (3/6/12/24 weeks, M2-M5). Multiple regression models were used to analyze whether psychosocial characteristics are moderators of the relationship between exercise and pain, meaning that psychosocial factors and exercise interact. Causal mediation analysis were conducted to analyze, whether psychosocial characteristics mediate the exercise effect on pain. A total of 453 participants with intermittent pain (mean age = 39.5 ± 12.2 years, f = 62%) completed the training. It was shown, that depressive symptomatology (at M4, M5), vital exhaustion (at M4), and perceived social support (at M5) are significant moderators of the relationship between exercise and the reduction of pain intensity. Further depressive mood (at M4), social-satisfaction (at M4), and anxiety (at M5 SMT) significantly moderate the exercise effect on pain disability. The amount of moderation was of clinical relevance. In contrast, there were no psychosocial variables which mediated exercise effects on pain. In conclusion it was shown, that psychosocial variables can be moderators in the relationship between sensorimotor exercise induced adaptation on CLBP which may explain conflicting results in the past regarding the merit of exercise interventions in CLBP. Results suggest further an early identification of psychosocial risk factors by diagnostic tools, which may essential support the planning of personalized exercise therapy. Level of Evidence: Level I. Clinical Trial Registration: DRKS00004977, LOE: I, MiSpEx: grant-number: 080102A/11-14. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00004977. KW - low-back-pain KW - motor-control-exercise KW - multidisciplinary-therapy KW - MiSpEx-network KW - yellow flags Y1 - 2021 U6 - https://doi.org/10.3389/fpsyt.2021.629474 SN - 1664-0640 VL - 12 SP - 1 EP - 16 PB - Frontiers Research Foundation CY - Lausanne, Schweiz ER -