TY - GEN A1 - Plummer, Ashley A1 - Mugele, Hendrik A1 - Steffen, Kathrin A1 - Stoll, Josefine A1 - Mayer, Frank A1 - Müller, Juliane T1 - General versus sports-specific injury prevention programs in athletes BT - A systematic review on the effects on performance T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Introduction Injury prevention programs (IPPs) are an inherent part of training in recreational and professional sports. Providing performance-enhancing benefits in addition to injury prevention may help adjust coaches and athletes’ attitudes towards implementation of injury prevention into daily routine. Conventional thinking by players and coaches alike seems to suggest that IPPs need to be specific to one’s sport to allow for performance enhancement. The systematic literature review aims to firstly determine the IPPs nature of exercises and whether they are specific to the sport or based on general conditioning. Secondly, can they demonstrate whether general, sports-specific or even mixed IPPs improve key performance indicators with the aim to better facilitate long-term implementation of these programs? Methods PubMed and Web of Science were electronically searched throughout March 2018. The inclusion criteria were randomized control trials, publication dates between Jan 2006 and Feb 2018, athletes (11–45 years), injury prevention programs and included predefined performance measures that could be categorized into balance, power, strength, speed/agility and endurance. The methodological quality of included articles was assessed with the Cochrane Collaboration assessment tools. Results Of 6619 initial findings, 22 studies met the inclusion criteria. In addition, reference lists unearthed a further 6 studies, making a total of 28. Nine studies used sports specific IPPs, eleven general and eight mixed prevention strategies. Overall, general programs ranged from 29–57% in their effectiveness across performance outcomes. Mixed IPPs improved in 80% balance outcomes but only 20–44% in others. Sports-specific programs led to larger scale improvements in balance (66%), power (83%), strength (75%), and speed/agility (62%). Conclusion Sports-specific IPPs have the strongest influence on most performance indices based on the significant improvement versus control groups. Other factors such as intensity, technical execution and compliance should be accounted for in future investigations in addition to exercise modality. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 591 Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-441131 SN - 1866-8364 IS - 591 ER - TY - THES A1 - Stoll, Josefine T1 - Gesundheitsmonitoring im Langstreckenmotorsport T1 - Pre Participation Examination in Long distance Race car drivers BT - eine Analyse von Athletenprofilen, häufigen Beschwerden und deren Ableitung für präventive Trainingsprogramme im Quer- und Längsschnitt N2 - Professionelle GT Langstreckenmotorsportler (Rennfahrer) müssen den hohen motorischen und kognitiven Ansprüchen ohne Verlust der Performance während eines Rennens endgegenwirken können. Sie müssen stets, bei hoher Geschwindigkeit fokussiert und konzentriert auf ihr Auto, die Rennstrecke und ihre Gegner reagieren können. Darüber hinaus sind Rennfahrer zusätzlich durch die notwendige Kommunikation im Auto mit den Ingenieuren und Mechanikern in der Boxengasse gefordert. Daten über die tatsächliche Beanspruchung und häufig auftretende Beschwerden und/oder Verletzung von Profiathleten liegen kaum vor. Für eine möglichst gute Performance im Auto während eines Rennens ist es notwendige neben der körperlichen Beanspruchung auch die häufigen Krankheitsbilder zu kennen. Auf Basis dessen kann eine optimale Prävention oder notwendige Therapie zur möglichst schnellen Reintegration in den Sport abgeleitet und entwickelt werden. Die vorliegende Arbeit befasst sich durch ein regelmäßiges Gesundheitsmonitoring mit der Erfassung häufiger Beschwerden und oder Verletzungen im GT Langestreckenmotorsport zur Ableitung eines präventiven (trainingstherapeutischen) und therapeutischen Konzeptes. Darüber hinaus, soll über die Einschätzung der körperlichen Leistungsfähigkeit der Athleten, auf Basis der Beanspruchung im Rennfahrzeug ein mögliches Trainingskonzept in Abhängigkeit der Saison entwickelt werden. Insgesamt wurden über 15 Jahre (2003-2017) 37 männliche Athleten aus dem GT Langstreckenmotorsport 353mal im Rahmen eines Gesundheitsmonitorings untersucht. Dabei wurden Athleten maximal 14 Jahre und mindestens 1 Jahr sportmedizinische betreut. Diese 2x im Jahr stattfindende Untersuchung beinhaltete im Wesentlichen eine sportmedizinische Untersuchung zur Einschätzung der Tauglichkeit für den Sport und die Erfassung der körperlichen Leistungsfähigkeit. Über das Gesundheitsmonitoring hinaus erfolgte die Betreuung zusätzlich an der Rennstrecke zur weiteren Erfassung der Beschwerden, Erkrankungen und Verletzungen der Athleten während ihrer sportartspezifischen Belastung. Zusammengefasst zeigen die Athleten geringe Prävalenzen und Inzidenzen der Krankheitsbilder bzw. Beschwerden. Ein Unterschied der Prävalenzen zeigt sich zwischen den Gesundheitsuntersuchungen und der Betreuung an der Rennstrecke. Die häufigsten Beschwerdebilder zeigen sich aus Orthopädie und Innerer Medizin. So sind Infekte der oberen Atemwege sowie Allergien neben Beschwerden der unteren Extremität und der Wirbelsäule am häufigsten. Demzufolge werden vorrangig physio- und trainingstherapeutische Konsequenzen abgeleitet. Eine medikamentöse Therapie erfolgt im Wesentlichen während der Rennbetreuung. Zur Reduktion der orthopädischen und internistischen Beschwerden sollten präventive Maßnahmen mehr betont werden. Die körperliche Leistungsfähigkeit zeigt im Wesentlichen über die Untersuchungsjahre eine stabile Performance für die Ausdauer-, Kraft und sensomotorische Leistungsfähigkeit. Die Ausdauerleistungsfähigkeit kann in Abhängigkeit der Sportartspezifik mit einer guten bis sehr guten Ausprägung definiert werden. Die Kraftleistungsfähigkeit und die sensomotorische Leistungsfähigkeit lassen sportartspezifische Unterschiede zu und sollte körpergewichtsbezogen betrachtet werden. Ein sportmedizinisches und trainingstherapeutisches Konzept müsste demnach eine regelmäßige ärztlich-medizinische Untersuchung mit dem Fokus der Orthopädie, Inneren Medizin und Hals- Nasen-Ohren-Kunde beinhalten. Darüber hinaus sollte eine regelmäßige Erfassung der körperlichen Leistungsfähigkeit zur möglichst effektiven Ableitung von Trainingsinhalten oder Präventionsmaßnahmen berücksichtig werden. Auf Grundlage der hohen Reisetätigkeit und der ganzjährigen Saison könnte ein 1-2x jährlich stattfindendes Trainingslager, im Sinne eines Grundlagen- und Aufbautrainings zur Optimierung der Leistungsfähigkeit beitragen, das Konzept komplementieren. Zudem scheint eine ärztliche Rennbetreuung notwendig. N2 - Professional long distance race car drivers (GT- Sportscars) are highly challenged regarding physical load during racing without any lost of performance. It is needed that those athletes are able to react in time in addiction to high speed and other race car drivers on the track. Studies about common injuries or overuse are rare and not longitudinal analysed. Based on known sports specific injuries or overuse, necessary prevention strategies or therapy concept are helpful for an evident Return to Sport. This study is based on prospective longitudinal Analyses of common injuries and overuse in professional race car drivers with differentiation to prevention and therapeutic concepts. Additionally, based on physical capacity (endurance, strength, sensorymotor- control) a needed training recommendation is derived. Overall 37 male professional longdistance race car drivers were analysed over 15 years (2003-2017). Therefore 353 preparticipation examinations (PPE) and physical fitness tests were included. The number of Athletes ranged between 6-19 per year with a support from 1 to 15 years. Additionally to the PPE and physical fitness tests the needed medical care at the track during race were analysed for the years 2015 and 2016. Summarized, longdistance race car drivers are showing low Prevalence’s of injuries or overuse. Frequent complaints are infections of the upper respiratory tract, allergies and tendinopathy of the lower limb together with chronic unspecific low back pain. The therapeutic derivation on track was for the most part drug-treated. A useful consequence for the reduction of the common orthopedic and internistic complaints are preventive methods like aerobic endurance training, sleep hygiene, (eccentric) strength training and balance training. The physical capacite is stable over the years. The endurance capacity shows in dependence to the sports specific a good capacity. The strength and sensorymotor control capacity shows sports specific differences. A sports medical and preventive/ therapeutic concept in longdistance motorsports has to include regular PPE with focus on orthopedic and internistic examinations. Additionally a regularly measurement of the physical capacity (endurance, strength and sensorymotor control) is needed for evident and individual recommendations for training and prevention. Regarding the high all year intercontinental travelling and the season over the whole year a 1-2 times organized fitness camp could compliment a sports medical concept as well as medical care on the track. KW - Langstreckenmotorsport KW - Gesundheitsmonitoring KW - Prävention KW - Race car driver KW - Pre participation examination KW - race car driver KW - prevention KW - longdistance racing Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-420880 ER - TY - GEN A1 - Müller, Juliane A1 - Engel, Tilman A1 - Müller, Steffen A1 - Stoll, Josefine A1 - Baur, Heiner A1 - Mayer, Frank T1 - Effects of sudden walking perturbations on neuromuscular reflex activity and three-dimensional motion of the trunk in healthy controls and back pain symptomatic subjects N2 - Background Back pain patients (BPP) show delayed muscle onset, increased co-contractions, and variability as response to quasi-static sudden trunk loading in comparison to healthy controls (H). However, it is unclear whether these results can validly be transferred to suddenly applied walking perturbations, an automated but more functional and complex movement pattern. There is an evident need to develop research-based strategies for the rehabilitation of back pain. Therefore, the investigation of differences in trunk stability between H and BPP in functional movements is of primary interest in order to define suitable intervention regimes. The purpose of this study was to analyse neuromuscular reflex activity as well as three-dimensional trunk kinematics between H and BPP during walking perturbations. Methods Eighty H (31m/49f;29±9yrs;174±10cm;71±13kg) and 14 BPP (6m/8f;30±8yrs;171±10cm;67±14kg) walked (1m/s) on a split-belt treadmill while 15 right-sided perturbations (belt decelerating, 40m/s2, 50ms duration; 200ms after heel contact) were randomly applied. Trunk muscle activity was assessed using a 12-lead EMG set-up. Trunk kinematics were measured using a 3-segment-model consisting of 12 markers (upper thoracic (UTA), lower thoracic (LTA), lumbar area (LA)). EMG-RMS ([%],0-200ms after perturbation) was calculated and normalized to the RMS of unperturbed gait. Latency (TON;ms) and time to maximum activity (TMAX;ms) were analysed. Total motion amplitude (ROM;[°]) and mean angle (Amean;[°]) for extension-flexion, lateral flexion and rotation were calculated (whole stride cycle; 0-200ms after perturbation) for each of the three segments during unperturbed and perturbed gait. For ROM only, perturbed was normalized to unperturbed step [%] for the whole stride as well as the 200ms after perturbation. Data were analysed descriptively followed by a student´s t-test to account for group differences. Co-contraction was analyzed between ventral and dorsal muscles (V:R) as well as side right:side left ratio (Sright:Sleft). The coefficient of variation (CV;%) was calculated (EMG-RMS;ROM) to evaluate variability between the 15 perturbations for all groups. With respect to unequal distribution of participants to groups, an additional matched-group analysis was conducted. Fourteen healthy controls out of group H were sex-, age- and anthropometrically matched (group Hmatched) to the BPP. Results No group differences were observed for EMG-RMS or CV analysis (EMG/ROM) (p>0.025). Co-contraction analysis revealed no differences for V:R and Srigth:Sleft between the groups (p>0.025). BPP showed an increased TON and TMAX, being significant for Mm. rectus abdominus (p = 0.019) and erector spinae T9/L3 (p = 0.005/p = 0.015). ROM analysis over the unperturbed stride cycle revealed no differences between groups (p>0.025). Normalization of perturbed to unperturbed step lead to significant differences for the lumbar segment (LA) in lateral flexion with BPP showing higher normalized ROM compared to Hmatched (p = 0.02). BPP showed a significant higher flexed posture (UTA (p = 0.02); LTA (p = 0.004)) during normal walking (Amean). Trunk posture (Amean) during perturbation showed higher trunk extension values in LTA segments for H/Hmatched compared to BPP (p = 0.003). Matched group (BPP vs. Hmatched) analysis did not show any systematic changes of all results between groups. Conclusion BPP present impaired muscle response times and trunk posture, especially in the sagittal and transversal planes, compared to H. This could indicate reduced trunk stability and higher loading during gait perturbations. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 317 Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-394931 ER - TY - GEN A1 - Müller, Steffen A1 - Müller, Juliane A1 - Stoll, Josefine A1 - Prieske, Olaf A1 - Cassel, Michael A1 - Mayer, Frank T1 - Incidence of back pain in adolescent athletes BT - a prospective study N2 - Background Recently, the incidence rate of back pain (BP) in adolescents has been reported at 21%. However, the development of BP in adolescent athletes is unclear. Hence, the purpose of this study was to examine the incidence of BP in young elite athletes in relation to gender and type of sport practiced. Methods Subjective BP was assessed in 321 elite adolescent athletes (m/f 57%/43%; 13.2 ± 1.4 years; 163.4 ± 11.4 cm; 52.6 ± 12.6 kg; 5.0 ± 2.6 training yrs; 7.6 ± 5.3 training h/week). Initially, all athletes were free of pain. The main outcome criterion was the incidence of back pain [%] analyzed in terms of pain development from the first measurement day (M1) to the second measurement day (M2) after 2.0 ± 1.0 year. Participants were classified into athletes who developed back pain (BPD) and athletes who did not develop back pain (nBPD). BP (acute or within the last 7 days) was assessed with a 5-step face scale (face 1–2 = no pain; face 3–5 = pain). BPD included all athletes who reported faces 1 and 2 at M1 and faces 3 to 5 at M2. nBPD were all athletes who reported face 1 or 2 at both M1 and M2. Data was analyzed descriptively. Additionally, a Chi2 test was used to analyze gender- and sport-specific differences (p = 0.05). Results Thirty-two athletes were categorized as BPD (10%). The gender difference was 5% (m/f: 12%/7%) but did not show statistical significance (p = 0.15). The incidence of BP ranged between 6 and 15% for the different sport categories. Game sports (15%) showed the highest, and explosive strength sports (6%) the lowest incidence. Anthropometrics or training characteristics did not significantly influence BPD (p = 0.14 gender to p = 0.90 sports; r2 = 0.0825). Conclusions BP incidence was lower in adolescent athletes compared to young non-athletes and even to the general adult population. Consequently, it can be concluded that high-performance sports do not lead to an additional increase in back pain incidence during early adolescence. Nevertheless, back pain prevention programs should be implemented into daily training routines for sport categories identified as showing high incidence rates. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 310 KW - Injury KW - Pain occurrence KW - Training volume KW - Young athletes Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-101874 ER -