TY - JOUR A1 - Müller, Steffen A1 - Stoll, Josefine A1 - Müller, Juliane A1 - Mayer, Frank T1 - Validity of isokinetic trunk measurements with respect to healthy adults, athletes and low back pain patients JF - Isokinetics and exercise science : official journal of the European Isokinetic Society N2 - Background: Isokinetic measurements are widely used to assess strength capacity in a clinical or research context. Nevertheless, the validity of isokinetic measures for identifying strength deficits and the evaluation of therapeutic process regarding different pathologies is yet to be established. Therefore, the purpose of this review is to evaluate the validity of isokinetic measures in a specific case: that of muscular capacity in low back pain (LBP). Methods: A literature search (PubMed; ISI Web of Knowledge; The Cochrane Library) covering the last 10 years was performed. Relevant papers regarding isokinetic trunk strength measures in healthy and patients with low back pain (PLBP) were searched. Peak torque values [Nm] and peak torque normalized to body weight [Nm/kg BW] were extracted for healthy and PLBP. Ranked mean values across studies were calculated for the concentric peak torque at 60 degrees/s as well as the flexion/extension (F/E) ratio. Results: 34 publications (31 flexion/extension; 3 rotation) were suitable for reporting detailed isokinetic strength measures in healthy or LBP (untrained adults, adolescents, athletes). Adolescents and athletes were different compared to normal adults in terms of absolute trunk strength values and the F/E ratio. Furthermore, isokinetic measures evaluating therapeutic process and isokinetic rehabilitation training were infrequent in literature (8 studies). Conclusion: Isokinetic measurements are valid for measuring trunk flexion/extension strength and F/E ratio in athletes, adolescents and (untrained) adults with/without LBP. The validity of trunk rotation is questionable due to a very small number of publications whereas no reliable source regarding lateral flexion could be traced. Therefore, isokinetic dynamometry may be utilized for identifying trunk strength deficits in healthy adults and PLBP. KW - Isokinetic KW - validity KW - low back pain KW - peak torque KW - trunk Y1 - 2012 U6 - https://doi.org/10.3233/IES-2012-00482 SN - 0959-3020 VL - 20 IS - 4 SP - 255 EP - 266 PB - IOS Press CY - Amsterdam ER - TY - CHAP A1 - Müller, Steffen A1 - Cassel, Michael A1 - Müller, Juliane A1 - Stoll, Josefine A1 - Baur, Heiner A1 - Mayer, Frank T1 - Trunk strength in adolescent athletes with Spondylolisthesis with/without back pain during training: Pilot study T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine Y1 - 2014 SN - 0195-9131 SN - 1530-0315 VL - 46 IS - 5 SP - 642 EP - 642 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Müller, Juliane A1 - Müller, Steffen A1 - Stoll, Josefine A1 - Baur, Heiner A1 - Mayer, Frank T1 - Trunk extensor and flexor strength capacity in healthy young elite athletes aged 11-15 Years JF - Journal of strength and conditioning research : the research journal of the NSCA N2 - Mueller, J, Mueller, S, Stoll, J, Baur, H, and Mayer, F. Trunk extensor and flexor strength capacity in healthy young elite athletes aged 11-15 years. J Strength Cond Res 28(5): 1328-1334, 2014-Differences in trunk strength capacity because of gender and sports are well documented in adults. In contrast, data concerning young athletes are sparse. The purpose of this study was to assess the maximum trunk strength of adolescent athletes and to investigate differences between genders and age groups. A total of 520 young athletes were recruited. Finally, 377 (n = 233/144 M/F; 13 +/- 1 years; 1.62 +/- 0.11 m height; 51 +/- 12 kg mass; training: 4.5 +/- 2.6 years; training sessions/week: 4.3 +/- 3.0; various sports) young athletes were included in the final data analysis. Furthermore, 5 age groups were differentiated (age groups: 11, 12, 13, 14, and 15 years; n = 90, 150, 42, 43, and 52, respectively). Maximum strength of trunk flexors (Flex) and extensors (Ext) was assessed in all subjects during isokinetic concentric measurements (60 degrees center dot s(-1); 5 repetitions; range of motion: 55 degrees). Maximum strength was characterized by absolute peak torque (Flex(abs), Ext(abs); N center dot m), peak torque normalized to body weight (Flex(norm), Ext(norm); N center dot m center dot kg(-1) BW), and Flex(abs)/Ext(abs) ratio (RKquot). Descriptive data analysis (mean +/- SD) was completed, followed by analysis of variance (alpha = 0.05; post hoc test [Tukey-Kramer]). Mean maximum strength for all athletes was 97 +/- 34 N center dot m in Flex(abs) and 140 +/- 50 N center dot m in Ext(abs) (Flex(norm) = 1.9 +/- 0.3 N center dot m center dot kg(-1) BW, Ext(norm) = 2.8 +/- 0.6 N center dot m center dot kg(-1) BW). Males showed statistically significant higher absolute and normalized values compared with females (p < 0.001). Flex(abs) and Ext(abs) rose with increasing age almost 2-fold for males and females (Flex(abs), Ext(abs): p < 0.001). Flex(norm) and Ext(norm) increased with age for males (p < 0.001), however, not for females (Flex(norm): p = 0.26; Ext(norm): p = 0.20). RKquot (mean +/- SD: 0.71 +/- 0.16) did not reveal any differences regarding age (p = 0.87) or gender (p = 0.43). In adolescent athletes, maximum trunk strength must be discussed in a gender- and age-specific context. The Flex(abs)/Ext(abs) ratio revealed extensor dominance, which seems to be independent of age and gender. The values assessed may serve as a basis to evaluate and discuss trunk strength in athletes. KW - core KW - adolescents KW - isokinetic KW - strength performance Y1 - 2014 U6 - https://doi.org/10.1519/JSC.0000000000000280 SN - 1064-8011 SN - 1533-4287 VL - 28 IS - 5 SP - 1328 EP - 1334 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - CHAP A1 - Torlak, Firdevs A1 - Torlak, Firdevs A1 - Appiah-Dwomoh, Edem Korkor A1 - Engel, Tilman A1 - Stoll, Josefine A1 - Müller, Juliane A1 - Mayer, Frank T1 - Gender differences in lower leg muscular activity during provoked stumbling - a pilot study T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine Y1 - 2014 SN - 0195-9131 SN - 1530-0315 VL - 46 IS - 5 SP - 728 EP - 728 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - CHAP A1 - Appiah-Dwomoh, Edem Korkor A1 - Torlak, Firdevs A1 - Engel, Tilman A1 - Stoll, Josefine A1 - Müller, Juliane A1 - Mayer, Frank T1 - Does perturbed treadmill walking lead to emg-changes of the lower extremity? T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine Y1 - 2014 SN - 0195-9131 SN - 1530-0315 VL - 46 IS - 5 SP - 827 EP - 827 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Cassel, Michael A1 - Stoll, Josefine A1 - Mayer, Frank T1 - Tendinopathies of the Lower Extremities in Sport - Diagnostics and Therapy JF - Sportverletzung, Sportschaden : Grundlagen, Prävention, Rehabilitation N2 - Tendinopathies are frequently the cause of chronic, load-dependent complaints of the lower extremity. Commonly, the large tendons of the ankle and knee joints are affected, especially the Achilles and patellar tendons. Repeated overuse in sports and/or daily activities is assumed as the aetiology. Besides the clinical examination including a comprehensive anamnesis of pain and training/loading, sonographic imaging has a high training/loading relevance for the diagnosis of tendon pathologies of the lower extremity. Training concepts are considered in first line as the treatment of choice. A combination with physical therapy interventions can be useful. In cases of a more severe pathology and long-standing complaints multimodal therapeutic options should be employed. The use of surgical treatment procedures should only be taken into account in case of failed response to conservative treatment. KW - Tendinopathy KW - sonography KW - principles of therapy Y1 - 2015 U6 - https://doi.org/10.1055/s-0034-1399668 SN - 0932-0555 SN - 1439-1236 VL - 29 IS - 2 SP - 87 EP - 98 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Müller, Juliane A1 - Müller, Steffen A1 - Stoll, Josefine A1 - Rector, Michael V. A1 - Baur, Heiner A1 - Mayer, Frank T1 - Influence of Load on Three-Dimensional Segmental Trunk Kinematics in One-Handed Lifting: A Pilot Study JF - Journal of applied biomechanics N2 - Stability of the trunk is relevant in determining trunk response to different loading in everyday tasks initiated by the limbs. Descriptions of the trunk’s mechanical movement patterns in response to different loads while lifting objects are still under debate. Hence, the aim of this study was to analyze the influence of weight on 3-dimensional segmental motion of the trunk during 1-handed lifting. Ten asymptomatic subjects were included (29 ± 3 y; 1.79 ± 0.09 m; 75 ± 14 kg). Subjects lifted 3× a light and heavy load from the ground up onto a table. Three-dimensional segmental trunk motion was measured (12 markers; 3 segments: upper thoracic area [UTA], lower thoracic area [LTA], lumbar area [LA]). Outcomes were total motion amplitudes (ROM;[°]) for anterior flexion, lateral flexion, and rotation of each segment. The highest ROM was observed in the LTA segment (anterior flexion), and the smallest ROM in the UTA segment (lateral flexion). ROM differed for all planes between the 3 segments for both tasks (P < .001). There were no differences in ROM between light and heavy loads (P > .05). No interaction effects (load × segment) were observed, as ROM did not reveal differences between loading tasks. Regardless of weight, the 3 segments did reflect differences, supporting the relevance of multisegmental analysis. KW - trunk motion KW - kinematic trunk model KW - everyday task KW - MiSpEx* Y1 - 2016 U6 - https://doi.org/10.1123/jab.2015-0227 SN - 1065-8483 SN - 1543-2688 VL - 32 SP - 520 EP - 525 PB - Human Kinetics Publ. CY - Champaign ER - TY - JOUR 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 JF - BMC sports science, medicine & rehabilitation 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. KW - Pain occurrence KW - Young athletes KW - Injury KW - Training volume Y1 - 2016 U6 - https://doi.org/10.1186/s13102-016-0064-7 SN - 2052-1847 VL - 8 PB - BioMed Central CY - London ER - TY - JOUR A1 - Eichler, Sarah A1 - Rabe, Sophie A1 - Salzwedel, Annett A1 - Mueller, Steffen A1 - Stoll, Josefine A1 - Tilgner, Nina A1 - John, Michael A1 - Wegscheider, Karl A1 - Mayer, Frank A1 - Völler, Heinz T1 - Effectiveness of an interactive telerehabilitation system with home-based exercise training in patients after total hip or knee replacement: study protocol for a multicenter, superiority, no-blinded randomized controlled trial JF - Trials N2 - Background: Total hip or knee replacement is one of the most frequently performed surgical procedures. Physical rehabilitation following total hip or knee replacement is an essential part of the therapy to improve functional outcomes and quality of life. After discharge from inpatient rehabilitation, a subsequent postoperative exercise therapy is needed to maintain functional mobility. Telerehabilitation may be a potential innovative treatment approach. We aim to investigate the superiority of an interactive telerehabilitation intervention for patients after total hip or knee replacement, in comparison to usual care, regarding physical performance, functional mobility, quality of life and pain. Methods/design: This is an open, randomized controlled, multicenter superiority study with two prospective arms. One hundred and ten eligible and consenting participants with total knee or hip replacement will be recruited at admission to subsequent inpatient rehabilitation. After comprehensive, 3-week, inpatient rehabilitation, the intervention group performs a 3-month, interactive, home-based exercise training with a telerehabilitation system. For this purpose, the physiotherapist creates an individual training plan out of 38 different strength and balance exercises which were implemented in the system. Data about the quality and frequency of training are transmitted to the physiotherapist for further adjustment. Communication between patient and physiotherapist is possible with the system. The control group receives voluntary, usual aftercare programs. Baseline assessments are investigated after discharge from rehabilitation; final assessments 3 months later. The primary outcome is the difference in improvement between intervention and control group in 6-minute walk distance after 3 months. Secondary outcomes include differences in the Timed Up and Go Test, the Five-Times-Sit-to-Stand Test, the Stair Ascend Test, the Short-Form 36, the Western Ontario and McMaster Universities Osteoarthritis Index, the International Physical Activity Questionnaire, and postural control as well as gait and kinematic parameters of the lower limbs. Baseline-adjusted analysis of covariance models will be used to test for group differences in the primary and secondary endpoints. Discussion: We expect the intervention group to benefit from the interactive, home-based exercise training in many respects represented by the study endpoints. If successful, this approach could be used to enhance the access to aftercare programs, especially in structurally weak areas. KW - Telerehabilitation KW - Home-based KW - Total hip replacement KW - Total knee replacement KW - Exercise therapy KW - Aftercare Y1 - 2017 U6 - https://doi.org/10.1186/s13063-017-2173-3 SN - 1745-6215 VL - 18 PB - BioMed Central CY - London ER - TY - JOUR A1 - Müller, Juliane A1 - Hadzic, Miralem A1 - Mugele, Hendrik A1 - Stoll, Josefine A1 - Müller, Steffen A1 - Mayer, Frank T1 - Effect of high-intensity perturbations during core-specific sensorimotor exercises on trunk muscle activation JF - Journal of biomechanics N2 - Core-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk. However, the influence of high-intensity perturbations on training efficiency is unclear within this context. Sixteen participants (29 +/- 2 yrs; 175 +/- 8 cm; 69 +/- 13 kg) were prepared with a 12-lead bilateral trunk EMG. Warm-up on a dynamometer was followed by maximum voluntary isometric trunk (flex/ext) contraction (MVC). Next, participants performed four conditions for a one-legged stance with hip abduction on a stable surface (HA) repeated randomly on an unstable surface (HAP), on a stable surface with perturbation (HA + P), and on an unstable surface with perturbation (HAP + P). Afterwards, bird dog (BD) was performed under the same conditions (BD, BDP, BD + P, BDP + P). A foam pad under the foot (HA) or the knee (BD) was used as an unstable surface. Exercises were conducted on a moveable platform. Perturbations (ACC 50 m/sec(2);100 ms duration;10rep.) were randomly applied in the anterior-posterior direction. The root mean square (RMS) normalized to MVC (%) was calculated (whole movement cycle). Muscles were grouped into ventral right and left (VR;VL), and dorsal right and left (DR;DL). Ventral Dorsal and right-left ratios were calculated (two way repeated-measures ANOVA;alpha = 0,05). Amplitudes of all muscle groups in bird dog were higher compared to hip abduction (p <= 0.0001; Range: BD: 14 +/- 3% (BD;VR) to 53 +/- 4%; HA: 7 +/- 2% (HA;DR) to 16 +/- 4% (HA;DR)). EMG-RMS showed significant differences (p < 0.001) between conditions and muscle groups per exercise. Interaction effects were only significant for HA (p = 0.02). No significant differences were present in EMG ratios (p > 0.05). Additional high-intensity perturbations during core-specific sensorimotor exercises lead to increased neuromuscular activity and therefore higher exercise intensities. However, the beneficial effects on trunk function remain unclear. Nevertheless, BD is more suitable to address trunk muscles. KW - Split-belt treadmill KW - EMG KW - Core stability KW - MiSpEx Y1 - 2017 U6 - https://doi.org/10.1016/j.jbiomech.2017.12.013 SN - 0021-9290 SN - 1873-2380 VL - 70 SP - 212 EP - 218 PB - Elsevier CY - Oxford ER -