TY - JOUR A1 - Hortobágyi, Tibor A1 - Lesinski, Melanie A1 - Gäbler, Martijn A1 - VanSwearingen, Jessie M. A1 - Malatesta, Davide A1 - Granacher, Urs T1 - Effects of three types of exercise interventions on healthy old adults’ gait speed BT - a systematic review and meta-analysis JF - Sports medicine N2 - Background: Habitual walking speed predicts many clinical conditions later in life, but it declines with age. However, which particular exercise intervention can minimize the age-related gait speed loss is unclear. Purpose: Our objective was to determine the effects of strength, power, coordination, and multimodal exercise training on healthy old adults' habitual and fast gait speed. Methods: We performed a computerized systematic literature search in PubMed and Web of Knowledge from January 1984 up to December 2014. Search terms included 'Resistance training', 'power training', 'coordination training', 'multimodal training', and 'gait speed (outcome term). Inclusion criteria were articles available in full text, publication period over past 30 years, human species, journal articles, clinical trials, randomized controlled trials, English as publication language, and subject age C65 years. The methodological quality of all eligible intervention studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. We computed weighted average standardized mean differences of the intervention-induced adaptations in gait speed using a random-effects model and tested for overall and individual intervention effects relative to no-exercise controls. Results: A total of 42 studies (mean PEDro score of 5.0 +/- 1.2) were included in the analyses (2495 healthy old adults; age 74.2 years [64.4-82.7]; body mass 69.9 +/- 4.9 kg, height 1.64 +/- 0.05 m, body mass index 26.4 +/- 1.9 kg/m(2), and gait speed 1.22 +/- 0.18 m/s). The search identified only one power training study, therefore the subsequent analyses focused only on the effects of resistance, coordination, and multimodal training on gait speed. The three types of intervention improved gait speed in the three experimental groups combined (n = 1297) by 0.10 m/s (+/- 0.12) or 8.4 % (+/- 9.7), with a large effect size (ES) of 0.84. Resistance (24 studies; n = 613; 0.11 m/s; 9.3 %; ES: 0.84), coordination (eight studies, n = 198; 0.09 m/s; 7.6 %; ES: 0.76), and multimodal training (19 studies; n = 486; 0.09 m/s; 8.4 %, ES: 0.86) increased gait speed statistically and similarly. Conclusions: Commonly used exercise interventions can functionally and clinically increase habitual and fast gait speed and help slow the loss of gait speed or delay its onset. KW - resistance training KW - exercise intervention KW - gait speed KW - power training KW - mobility disability Y1 - 2015 U6 - https://doi.org/10.1007/s40279-015-0371-2 SN - 1179-2035 SN - 0112-1642 N1 - Erratum in: Sports Med. 2016 Mar;46(3):453. doi: 10.1007/s40279-016-0498-9. VL - 45 SP - 1627 EP - 1643 PB - Springer CY - Berlin ER - TY - JOUR A1 - Golle, Kathleen A1 - Granacher, Urs A1 - Hoffmann, Martin A1 - Wick, Ditmar A1 - Mühlbauer, Thomas T1 - Effect of living area and sports club participation on physical fitness in children: a 4 year longitudinal study JF - BMC public health N2 - Background: Cross-sectional studies detected associations between physical fitness, living area, and sports participation in children. Yet, their scientific value is limited because the identification of cause-and-effect relationships is not possible. In a longitudinal approach, we examined the effects of living area and sports club participation on physical fitness development in primary school children from classes 3 to 6. Methods: One-hundred and seventy-two children (age: 9-12 years; sex: 69 girls, 103 boys) were tested for their physical fitness (i.e., endurance [9-min run], speed [50-m sprint], lower- [triple hop] and upper-extremity muscle strength [1-kg ball push], flexibility [stand-and-reach], and coordination [star coordination run]). Living area (i.e., urban or rural) and sports club participation were assessed using parent questionnaire. Results: Over the 4 year study period, urban compared to rural children showed significantly better performance development for upper- (p = 0.009, ES = 0.16) and lower-extremity strength (p < 0.001, ES = 0.22). Further, significantly better performance development were found for endurance (p = 0.08, ES = 0.19) and lower-extremity strength (p = 0.024, ES = 0.23) for children continuously participating in sports clubs compared to their non-participating peers. Conclusions: Our findings suggest that sport club programs with appealing arrangements appear to represent a good means to promote physical fitness in children living in rural areas. KW - Motor performance KW - Youth KW - Primary school KW - Maturation Y1 - 2014 U6 - https://doi.org/10.1186/1471-2458-14-499 SN - 1471-2458 VL - 14 PB - BioMed Central CY - London ER - TY - JOUR A1 - Prieske, Olaf A1 - Wick, Ditmar A1 - Granacher, Urs T1 - Intrasession and intersession reliability in maximal and explosive isometric torque production of the elbow flexors JF - Journal of strength and conditioning research : the research journal of the NSCA N2 - The purpose of this study was to assess intrasession and intersession reliability of maximal and explosive isometric torque production of the elbow flexors and its respective neuromuscular activation pattern. Subjects (13 men, age: 24.8 +/- 3.1 years, height: 1.9 +/- 0.1 m, body mass: 83.7 +/- 12.7 kg; and 6 women, age: 26.5 +/- 1.4 years, height: 1.7 +/- 0.1 m, body mass: 62.7 +/- 7.0 kg) were tested and retested 2-7 days later performing unilateral maximal isometric elbow flexions. Absolute (coefficient of variation[CV], test-retest variability[TRV], Bland-Altman plots with 95% limits of agreement) and relative reliability statistics (intraclass correlation coefficient) were calculated for various mechanical (i.e., maximal isometric torque, rate of torque development, impulse) and electromyographical measures (i.e., mean average voltage) at different time intervals relative to onset of torque (i. e., 30, 50, 100, 200, 300, 400, 100-200 ms). Intraclass correlation coefficient values were >= 0.61 for all mechanical and electromyographical measures and time intervals indicating good to excellent intrasession and intersession reliability. BlandAltman plots confirmed these findings by showing that only 0-2 (<= 3.3%) data points were beyond the limits of agreement. Regarding torque and electromyographic measures, CV (11.9-32.3%) and TRV (18.4-53.8%) values were high during the early intervals of torque development (<= 100 ms) indicating high variability. During the later intervals (>100 ms), lower CV (i. e., 5.0-29.9%) and TRV values (i.e., 5.4-34.6%) were observed indicating lower variability. The present study revealed that neuromuscular performance during explosive torque production of the elbow flexors is reproducible in time intervals >100 ms after onset of isometric actions, whereas during earlier time intervals variability is high. KW - maximal isometric contraction KW - explosive force production KW - electromyography KW - test-retest reliability Y1 - 2014 SN - 1064-8011 SN - 1533-4287 VL - 28 IS - 6 SP - 1771 EP - 1777 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Mühlbauer, Thomas A1 - Mettler, Claude A1 - Roth, Ralf A1 - Granacher, Urs T1 - One-leg standing performance and muscle activity: Are there limb differences? JF - Journal of applied biomechanics N2 - The purpose of this study was to compare static balance performance and muscle activity during one-leg standing on the dominant and nondominant leg under various sensory conditions with increased levels of task difficulty. Thirty healthy young adults (age: 23 +/- 2 years) performed one-leg standing tests for 30 s under three sensory conditions (ie, eyes open/firm ground; eyes open/foam ground [elastic pad on top of the balance plate]; eyes closed/firm ground). Center of pressure displacements and activity of four lower leg muscles (ie, m. tibialis anterior [TA], m. soleus [SOL], m. gastrocnemius medialis [GAS], m. peroneus longus [PER]) were analyzed. An increase in sensory task difficulty resulted in deteriorated balance performance (P < .001, effect size [ES] = .57-2.54) and increased muscle activity (P < .001, ES = .50-1.11) for all but two muscles (ie, GAS, PER). However, regardless of the sensory condition, one-leg standing on the dominant as compared with the nondominant limb did not produce statistically significant differences in various balance (P > .05, ES = .06-.22) and electromyographic (P > .05, ES = .03-.13) measures. This indicates that the dominant and the nondominant leg can be used interchangeably during static one-leg balance testing in healthy young adults. KW - postural control KW - electromyography KW - sensory input KW - task difficulty Y1 - 2014 U6 - https://doi.org/10.1123/jab.2013-0230 SN - 1065-8483 SN - 1543-2688 VL - 30 IS - 3 SP - 407 EP - 414 PB - Human Kinetics Publ. CY - Champaign ER - TY - JOUR A1 - Granacher, Urs A1 - Mühlbauer, Thomas A1 - Gschwind, Y. J. A1 - Pfenninger, B. A1 - Kressig, R. W. T1 - Assessment and training of strength and balance for fall prevention in the elderly. Recommendations of an interdisciplinary expert panel JF - Zeitschrift für Gerontologie und Geriatrie N2 - The proportion of elderly people in societies of western industrialized countries is continuously rising. Biologic aging induces deficits in balance and muscle strength/power in old age, which is responsible for an increased prevalence of falls. Therefore, nationwide and easy-to-administer fall prevention programs have to be developed in order to contribute to the autonomy and quality of life in old age and to help reduce the financial burden on the public health care system due to the treatment of fall-related injuries. This narrative (qualitative) literature review deals with a) the reasons for an increased prevalence of falls in old age, b) important clinical tests for fall-risk assessment, and c) evidence-based intervention/training programs for fall prevention in old age. The findings of this literature review are based on a cost-free practice guide that is available to the public (via the internet) and that was created by an expert panel (i.e., geriatricians, exercise scientists, physiotherapists, geriatric therapists). The present review provides the scientific foundation of the practice guide. KW - Fall risk KW - Resistance training KW - Preventive therapy KW - Exercise therapy KW - Frail elderly Y1 - 2014 U6 - https://doi.org/10.1007/s00391-013-0509-5 SN - 0948-6704 SN - 1435-1269 VL - 47 IS - 6 SP - 513 EP - 525 PB - Springer CY - Heidelberg ER - TY - JOUR A1 - Granacher, Urs A1 - Schellbach, Jörg A1 - Klein, Katja A1 - Prieske, Olaf A1 - Baeyens, Jean-Pierre A1 - Mühlbauer, Thomas T1 - Effects of core strength training using stable versus unstable surfaces on physical fitness in adolescents BT - a randomized controlled trial JF - BMC sports science, medicine & rehabilitation N2 - Background It has been demonstrated that core strength training is an effective means to enhance trunk muscle strength (TMS) and proxies of physical fitness in youth. Of note, cross-sectional studies revealed that the inclusion of unstable elements in core strengthening exercises produced increases in trunk muscle activity and thus provide potential extra training stimuli for performance enhancement. Thus, utilizing unstable surfaces during core strength training may even produce larger performance gains. However, the effects of core strength training using unstable surfaces are unresolved in youth. This randomized controlled study specifically investigated the effects of core strength training performed on stable surfaces (CSTS) compared to unstable surfaces (CSTU) on physical fitness in school-aged children. Methods Twenty-seven (14 girls, 13 boys) healthy subjects (mean age: 14 ± 1 years, age range: 13–15 years) were randomly assigned to a CSTS (n = 13) or a CSTU (n = 14) group. Both training programs lasted 6 weeks (2 sessions/week) and included frontal, dorsal, and lateral core exercises. During CSTU, these exercises were conducted on unstable surfaces (e.g., TOGU© DYNAIR CUSSIONS, THERA-BAND© STABILITY TRAINER). Results Significant main effects of Time (pre vs. post) were observed for the TMS tests (8-22%, f = 0.47-0.76), the jumping sideways test (4-5%, f = 1.07), and the Y balance test (2-3%, f = 0.46-0.49). Trends towards significance were found for the standing long jump test (1-3%, f = 0.39) and the stand-and-reach test (0-2%, f = 0.39). We could not detect any significant main effects of Group. Significant Time x Group interactions were detected for the stand-and-reach test in favour of the CSTU group (2%, f = 0.54). Conclusions Core strength training resulted in significant increases in proxies of physical fitness in adolescents. However, CSTU as compared to CSTS had only limited additional effects (i.e., stand-and-reach test). Consequently, if the goal of training is to enhance physical fitness, then CSTU has limited advantages over CSTS. KW - Resistance training KW - Trunk muscle strength KW - Physical fitness Y1 - 2014 U6 - https://doi.org/10.1186/2052-1847-6-40 SN - 2052-1847 VL - 6 PB - BioMed Central CY - London ER - TY - JOUR A1 - Granacher, Urs A1 - Lacroix, Andre A1 - Roettger, Katrin A1 - Gollhofer, Albert A1 - Mühlbauer, Thomas T1 - Relationships between trunk muscle strength, spinal mobility, and balance performance in older adults JF - Journal of aging and physical activity N2 - This study investigated associations between variables of trunk muscle strength (TMS), spinal mobility, and balance in seniors. Thirty-four seniors (sex: 18 female, 16 male; age: 70 +/- 4 years; activity level: 13 +/- 7 hr/week) were tested for maximal isometric strength (MIS) of the trunk extensors, flexors, lateral flexors, rotators, spinal mobility, and steady-state, reactive, and proactive balance. Significant correlations were detected between all measures of TMS and static steady-state balance (r = .43.57, p < .05). Significant correlations were observed between specific measures of TMS and dynamic steady-state balance (r = .42.55, p < .05). No significant correlations were found between all variables of TMS and reactive/proactive balance and between all variables of spinal mobility and balance. Regression analyses revealed that TMS explains between 1-33% of total variance of the respective balance parameters. Findings indicate that TMS is related to measures of steady-state balance which may imply that TMS promoting exercises should be integrated in strength training for seniors. KW - elderly KW - core KW - gait KW - postural balance KW - force KW - physical performance Y1 - 2014 U6 - https://doi.org/10.1123/JAPA.2013-0108 SN - 1063-8652 SN - 1543-267X VL - 22 IS - 4 SP - 490 EP - 498 PB - Human Kinetics Publ. CY - Champaign ER - TY - JOUR A1 - Mühlbauer, Thomas A1 - Granacher, Urs A1 - Jockel, Björn A1 - Kittel, Réne T1 - Analyse der Muskelaktivität therapeutischer Kletterübungen JF - Sportverletzung, Sportschaden : Grundlagen, Prävention, Rehabilitation N2 - Background: Therapeutic climbing exercises are employed for the treatment of shoulder-and knee-joint injuries. However, there is a void in the literature regarding muscle activation levels during the performance of these exercises. Thus, the purpose of this study was to investigate differences in muscle activation during therapeutic climbing exercises depending on the degree of task difficulty. Participants/Material and Methods: A sample of 10 healthy subjects (sex: 4 females, 6 males; age: 27 +/- 3 years; climbing experience: 5 +/- 3 years) performed three shoulder girdle (i.e., wide shoulder pull, narrow shoulder pull, shoulder row) and two leg extensor (i.e., ascending frontal, ascending sidewards) exercises. Electromyographic (EMG) data were recorded on the right side for eleven muscles and then normalised using the maximum voluntary contractions for each muscle. Results: With increasing task difficulty, muscle activity in all but one muscle (i.e., m. trapezius ascendens) increased significantly for the three shoulder girdle exercises. For the two leg extensor exercises, an increase in task difficulty produced a tendency towards yet not significantly higher muscle activity. Conclusion: Shoulder row was the most effective therapeutic climbing exercise in the ability to activate muscles while showing the highest EMG signals. The absence of significant differences in muscle activity between the two leg extensor exercises indicates their equivalent use for muscle activation during therapy. KW - therapy KW - climbing KW - electromyography KW - shoulder girdle KW - leg extensors KW - musculature Y1 - 2013 U6 - https://doi.org/10.1055/s-0033-1335595 SN - 0932-0555 SN - 1439-1236 VL - 27 IS - 3 SP - 162 EP - 168 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Prieske, Olaf A1 - Mühlbauer, Thomas A1 - Müller, Steffen A1 - Krüger, Tom A1 - Kibele, Armin A1 - Behm, David George A1 - Granacher, Urs T1 - Effects of surface instability on neuromuscular performance during drop jumps and landings JF - European journal of applied physiology N2 - The purpose of this study was to investigate the effects of surface instability on measures of performance and activity of leg and trunk muscles during drop jumps and landings. Drop jumps and landings were assessed on a force plate under stable and unstable (balance pad on top of the force plate) conditions. Performance measures (contact time, jump height, peak ground reaction force) and electromyographic (EMG) activity of leg and trunk muscles were tested in 27 subjects (age 23 +/- A 3 years) during different time intervals (preactivation phase, braking phase, push-off phase). The performance of drop jumps under unstable compared to stable conditions produced a decrease in jump height (9 %, p < 0.001, f = 0.92) and an increase in peak ground reaction force (5 %, p = 0.022, f = 0.72), and time for braking phase (12 %, p < 0.001, f = 1.25). When performing drop jumps on unstable compared to stable surfaces, muscle activity was reduced in the lower extremities during the preactivation, braking and push-off phases (11-25 %, p < 0.05, 0.48 a parts per thousand currency sign f a parts per thousand currency sign 1.23). Additionally, when landing on unstable compared to stable conditions, reduced lower limb muscle activities were observed during the preactivation phase (7-60 %, p < 0.05, 0.50 a parts per thousand currency sign f a parts per thousand currency sign 3.62). Trunk muscle activity did not significantly differ between the test conditions for both jumping and landing tasks. The present findings indicate that modified feedforward mechanisms in terms of lower leg muscle activities during the preactivation phase and/or possible alterations in leg muscle activity shortly after ground contact (i.e., braking phase) are responsible for performance decrements during jumping on unstable surfaces. KW - Stretch-shortening cycle KW - Trunk muscle strength KW - Jump height KW - Electromyography Y1 - 2013 U6 - https://doi.org/10.1007/s00421-013-2724-6 SN - 1439-6319 SN - 1439-6327 VL - 113 IS - 12 SP - 2943 EP - 2951 PB - Springer CY - New York ER - TY - JOUR A1 - Gschwind, Yves J. A1 - Kressig, Reto W. A1 - Lacroix, Andre A1 - Mühlbauer, Thomas A1 - Pfenninger, Barbara A1 - Granacher, Urs T1 - A best practice fall prevention exercise program to improve balance, strength/power, and psychosocial health in older adults - study protocol for a randomized controlled trial JF - BMC geriatrics N2 - Background: With increasing age neuromuscular deficits (e.g., sarcopenia) may result in impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline. Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice. Thus, the objective of the present trial is to assess the effects of a fall prevention program that was developed by an interdisciplinary expert panel on measures of balance, strength / power, body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older adults. Additionally, the time-related effects of detraining are tested. Methods/Design: Healthy old people (n = 54) between the age of 65 to 80 years will participate in this trial. The testing protocol comprises tests for the assessment of static / dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test; countermovement jump). Further, body composition will be analysed using a bioelectrical impedance analysis system. In addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk determinants (i.e., Fall Efficacy Scale -International) will be included in the study protocol. Participants will be randomized into two intervention groups or the control / waiting group. After baseline measures, participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week, with each training session lasting 30 min. (actual training time). One intervention group will complete an extensive supervised training program, while the other intervention group will complete a short version (` 3 times 3') that is home-based and controlled by weekly phone calls. Post-tests will be conducted right after the intervention period. Additionally, detraining effects will be measured 12 weeks after program cessation. The control group / waiting group will not participate in any specific intervention during the experimental period, but will receive the extensive supervised program after the experimental period. Discussion: It is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance, strength / power, body composition, cognitive function, psychosocial well-being, and falls self-efficacy of older adults. In addition, information regarding fall risk assessment, dose-response-relations, detraining effects, and supervision of training will be provided. Further, training-induced health-relevant changes, such as improved performance in activities of daily living, cognitive function, and quality of life, as well as a reduced risk for falls may help to lower costs in the health care system. Finally, practitioners, therapists, and instructors will be provided with a scientifically evaluated feasible, safe, and easy-to-administer exercise program for fall prevention. KW - Seniors KW - Fall risk assessment KW - Resistance training KW - Postural stability Y1 - 2013 U6 - https://doi.org/10.1186/1471-2318-13-105 SN - 1471-2318 VL - 13 IS - 4 PB - BioMed Central CY - London ER -