TY - JOUR A1 - Fernandez-Fernandez, Jaime A1 - Granacher, Urs A1 - Martinez-Martin, Isidoro A1 - Garcia-Tormo, José Vicente A1 - Herrero-Molleda, Alba A1 - Barbado, David A1 - García López, Juan T1 - Physical fitness and throwing speed in U13 versus U15 male handball players JF - BMC Sports Science, Medicine and Rehabilitation N2 - Background The aim of this study was to analyze the shoulder functional profile (rotation range of motion [ROM] and strength), upper and lower body performance, and throwing speed of U13 versus U15 male handball players, and to establish the relationship between these measures of physical fitness and throwing speed. Methods One-hundred and nineteen young male handball players (under (U)-13 (U13) [n = 85]) and U15 [n = 34]) volunteered to participate in this study. The participating athletes had a mean background of sytematic handball training of 5.5 ± 2.8 years and they exercised on average 540 ± 10.1 min per week including sport-specific team handball training and strength and conditioning programs. Players were tested for passive shoulder range-of-motion (ROM) for both internal (IR) and external rotation (ER) and isometric strength (i.e., IR and ER) of the dominant/non-dominant shoulders, overhead medicine ball throw (OMB), hip isometric abductor (ABD) and adductor (ADD) strength, hip ROM, jumps (countermovement jump [CMJ] and triple leg-hop [3H] for distance), linear sprint test, modified 505 change-of-direction (COD) test and handball throwing speed (7 m [HT7] and 9 m [HT9]). Results U15 players outperformed U13 in upper (i.e., HT7 and HT9 speed, OMB, absolute IR and ER strength of the dominant and non-dominant sides; Cohen’s d: 0.76–2.13) and lower body (i.e., CMJ, 3H, 20-m sprint and COD, hip ABD and ADD; d: 0.70–2.33) performance measures. Regarding shoulder ROM outcomes, a lower IR ROM was found of the dominant side in the U15 group compared to the U13 and a higher ER ROM on both sides in U15 (d: 0.76–1.04). It seems that primarily anthropometric characteristics (i.e., body height, body mass) and upper body strength/power (OMB distance) are the most important factors that explain the throw speed variance in male handball players, particularly in U13. Conclusions Findings from this study imply that regular performance monitoring is important for performance development and for minimizing injury risk of the shoulder in both age categories of young male handball players. Besides measures of physical fitness, anthropometric data should be recorded because handball throwing performance is related to these measures. KW - Overhead athletes KW - Shoulder KW - Injury risk KW - Sport-specific performance Y1 - 2022 U6 - https://doi.org/10.1186/s13102-022-00507-0 SN - 1758-2555 VL - 14 PB - Springer CY - London ER - TY - JOUR A1 - Prieske, Olaf A1 - Dalager, Tina A1 - Looks, Vanessa A1 - Golle, Kathleen A1 - Granacher, Urs T1 - Physical fitness and psycho-cognitive performance in the young and middle-aged workforce with primarily physical versus mental work demands JF - Journal of public health : from theory to practice : official organ of the Deutscher Verband für Gesundheitswissenschaften Public Health e.V. (DVGPH) N2 - Aim The purpose of this study was to examine physical fitness and psycho-cognitive performance and their associations in young and middle-aged workers with primarily physical versus mental work demands. Subjects and methods Healthy young and middle-aged workers (73 men, age = 33 +/- 7 years; 75 women, age = 35 +/- 9 years) were recruited from German small-to-medium-sized enterprises (< 250 employees) and classified into groups with primarily mental (MD) or physical demands (PD) at work. Participants were tested for cardiorespiratory fitness, trunk flexor/extensor muscular endurance, handgrip strength, balance, leg muscle power, perceived stress, cognitive performance, and work ability. Results Ninety-four workers were allocated to the MD (53% females) and 54 to the PD (46% females) groups. The MD group showed significantly better balance, trunk extensor muscular endurance, and cognitive performance (p < 0.035, 0.35 <= d <= 0.55) and less stress compared with the PD group (p < 0.023, d = 0.38). Group-specific Spearman rank correlation analysis (r(S)) revealed significant small-to-medium-sized correlations between physical fitness and cognitive performance (- 0.205 <= r(S) <= 0.434) in the MD and PD groups. Significant small-to-medium-sized correlations were found for physical fitness and stress/work ability (0.211 <= r(S) <= 0.301) in the MD group only. Further, associations of trunk extensor muscular endurance and work ability were significantly higher in the MD group (r(S) = 0.240) compared with the PD group (r(S) = - 0.141; z = 2.16, p = 0.031). Conclusions MD workers showed better physical fitness measures (balance, trunk extensor muscular endurance) and cognitive performance and lower levels of perceived stress compared with PD workers. Small-to-medium-sized associations between physical fitness and psycho-cognitive performance measures indicate that gains in physical fitness may at least partly contribute to psycho-cognitive performance and/or vice versa, particularly in MD workers. KW - Core strength KW - Endurance KW - Stress KW - Work ability KW - Association Y1 - 2019 U6 - https://doi.org/10.1007/s10389-019-01099-9 SN - 2198-1833 SN - 1613-2238 VL - 29 IS - 1 SP - 75 EP - 84 PB - Springer CY - Berlin ; Heidelberg ER - TY - JOUR A1 - Muehlbauer, Thomas A1 - Granacher, Urs A1 - Borde, Ron A1 - Hortobagyi, Tibor T1 - Non-Discriminant Relationships between Leg Muscle Strength, Mass and Gait Performance in Healthy Young and Old Adults JF - Gerontology N2 - Background: Gait speed declines with increasing age, but it is unclear if gait speed preferentially correlates with leg muscle strength or mass. Objective: We determined the relationship between gait speed and (1) leg muscle strength measured at 3 lower extremity joints and (2) leg lean tissue mass (LTM) in healthy young (age: 25 years, n = 20) and old (age: 70 years, n = 20) adults. Methods: Subjects were tested for maximal isokinetic hip, knee, and ankle extension torque, leg LTM by bioimpedance, and gait performance (i.e., gait speed, stride length) at preferred and maximal gait speeds. Results: We found no evidence for a preferential relationship between gait performance and leg muscle strength compared with gait performance and leg LTM in healthy young and old adults. In old adults, hip extensor strength only predicted habitual gait speed (R-2 = 0.29, p = 0.015), whereas ankle plantarflexion strength only predicted maximal gait speed and stride length (both R-2 = 0.40, p = 0.003). Conclusions: Gait speed did not preferentially correlate with leg muscle strength or leg LTM, favoring neither outcome for predicting mobility. Thus, we recommend that both leg muscle strength and leg LTM should be tested and trained complementarily. Further, hip and ankle extension torque predicted gait performance, and thus we recommend to test and train healthy old adults by functional integrated multiarticular rather than monoarticular lower extremity strength exercises. KW - Body composition KW - Muscle torque KW - Walking KW - Seniors Y1 - 2017 U6 - https://doi.org/10.1159/000480150 SN - 0304-324X SN - 1423-0003 VL - 64 IS - 1 SP - 11 EP - 18 PB - Karger CY - Basel ER - TY - JOUR A1 - Brahms, Clemens Markus A1 - Hortobágyi, Tibor A1 - Kressig, Reto W. A1 - Granacher, Urs T1 - The Interaction between mobility status and exercise specificity in older adults JF - Exercise and sport sciences reviews N2 - Many adults older than 60 yr experience mobility limitations. Although physical exercise improves older adults' mobility, differences in baseline mobility produce large variations in individual responses to interventions, and these responses could further vary by the type and dose of exercise. Here, we propose an exercise prescription model for older adults based on their current mobility status. KW - exercise prescription KW - training intervention KW - walking speed KW - activities KW - of daily living KW - elderly Y1 - 2021 U6 - https://doi.org/10.1249/JES.0000000000000237 SN - 0091-6331 SN - 1538-3008 VL - 49 IS - 1 SP - 15 EP - 22 PB - Lippincott Williams & Wilkins CY - Hagerstown, Md. ER - TY - JOUR A1 - Hortobágyi, Tibor A1 - Vetrovsky, Tomas A1 - Balbim, Guilherme Moraes A1 - Sorte Silva, Narlon Cassio Boa A1 - Manca, Andrea A1 - Deriu, Franca A1 - Kolmos, Mia A1 - Kruuse, Christina A1 - Liu-Ambrose, Teresa A1 - Radak, Zsolt A1 - Vaczi, Mark A1 - Johansson, Hanna A1 - Rocha dos Santos, Paulo Cezar A1 - Franzen, Erika A1 - Granacher, Urs T1 - The impact of aerobic and resistance training intensity on markers of neuroplasticity in health and disease JF - Ageing research reviews : ARR N2 - Objective: To determine the effects of low- vs. high-intensity aerobic and resistance training on motor and cognitive function, brain activation, brain structure, and neurochemical markers of neuroplasticity and the association thereof in healthy young and older adults and in patients with multiple sclerosis, Parkinson's disease, and stroke. Design: Systematic review and robust variance estimation meta-analysis with meta-regression. Data sources: Systematic search of MEDLINE, Web of Science, and CINAHL databases. Results: Fifty studies with 60 intervention arms and 2283 in-analyses participants were included. Due to the low number of studies, the three patient groups were combined and analyzed as a single group. Overall, low- (g=0.19, p = 0.024) and high-intensity exercise (g=0.40, p = 0.001) improved neuroplasticity. Exercise intensity scaled with neuroplasticity only in healthy young adults but not in healthy older adults or patient groups. Exercise-induced improvements in neuroplasticity were associated with changes in motor but not cognitive outcomes. Conclusion: Exercise intensity is an important variable to dose and individualize the exercise stimulus for healthy young individuals but not necessarily for healthy older adults and neurological patients. This conclusion warrants caution because studies are needed that directly compare the effects of low- vs. high-intensity exercise on neuroplasticity to determine if such changes are mechanistically and incrementally linked to improved cognition and motor function. KW - Aging KW - Exercise KW - Intensity Dose -response relationship KW - Cognition motor KW - function Y1 - 2022 U6 - https://doi.org/10.1016/j.arr.2022.101698 SN - 1568-1637 SN - 1872-9649 VL - 80 PB - Elsevier CY - Clare ER - TY - JOUR A1 - Lacroix, Andre A1 - Hortobagyi, Tibor A1 - Beurskens, Rainer A1 - Granacher, Urs T1 - Effects of Supervised vs. Unsupervised Training Programs on Balance and Muscle Strength in Older Adults: A Systematic Review and Meta-Analysis JF - Sports medicine N2 - Objectives The objective of this systematic review and meta-analysis was to quantify the effectiveness of supervised vs. unsupervised balance and/or resistance training programs on measures of balance and muscle strength/ power in healthy older adults. In addition, the impact of supervision on training-induced adaptive processes was evaluated in the form of dose-response relationships by analyzing randomized controlled trials that compared supervised with unsupervised trials. Data Sources A computerized systematic literature search was performed in the electronic databases PubMed, Web of Science, and SportDiscus to detect articles examining the role of supervision in balance and/or resistance training in older adults. Study Eligibility Criteria The initially identified 6041 articles were systematically screened. Studies were included if they examined balance and/or resistance training in adults aged >= 65 years with no relevant diseases and registered at least one behavioral balance (e.g., time during single leg stance) and/or muscle strength/ power outcome (e.g., time for 5-Times-Chair-Rise-Test). Finally, 11 studies were eligible for inclusion in this meta-analysis. Study Appraisal Weighted mean standardized mean differences between subjects (SMDbs) of supervised vs. unsupervised balance/resistance training studies were calculated. The included studies were coded for the following variables: number of participants, sex, age, number and type of interventions, type of balance/strength tests, and change (%) from pre- to post-intervention values. Additionally, we coded training according to the following modalities: period, frequency, volume, modalities of supervision (i.e., number of supervised/unsupervised sessions within the supervised or unsupervised training groups, respectively). Heterogeneity was computed using I 2 and chi(2) statistics. The methodological quality of the included studies was evaluated using the Physiotherapy Evidence Database scale. Results Our analyses revealed that in older adults, supervised balance/resistance training was superior compared with unsupervised balance/resistance training in improving measures of static steady-state balance (mean SMDbs = 0.28, p = 0.39), dynamic steady-state balance (mean SMDbs = 0.35, p = 0.02), proactive balance (mean SMDbs = 0.24, p = 0.05), balance test batteries (mean SMDbs = 0.53, p = 0.02), and measures of muscle strength/power (mean SMDbs = 0.51, p = 0.04). Regarding the examined dose-response relationships, our analyses showed that a number of 10-29 additional supervised sessions in the supervised training groups compared with the unsupervised training groups resulted in the largest effects for static steady-state balance (mean SMDbs = 0.35), dynamic steady-state balance (mean SMDbs = 0.37), and muscle strength/power (mean SMDbs = 1.12). Further, >= 30 additional supervised sessions in the supervised training groups were needed to produce the largest effects on proactive balance (mean SMDbs = 0.30) and balance test batteries (mean SMDbs = 0.77). Effects in favor of supervised programs were larger for studies that did not include any supervised sessions in their unsupervised programs (mean SMDbs: 0.28-1.24) compared with studies that implemented a few supervised sessions in their unsupervised programs (e.g., three supervised sessions throughout the entire intervention program; SMDbs: -0.06 to 0.41). Limitations The present findings have to be interpreted with caution because of the low number of eligible studies and the moderate methodological quality of the included studies, which is indicated by a median Physiotherapy Evidence Database scale score of 5. Furthermore, we indirectly compared dose-response relationships across studies and not from single controlled studies. Conclusions Our analyses suggest that supervised balance and/or resistance training improved measures of balance and muscle strength/power to a greater extent than unsupervised programs in older adults. Owing to the small number of available studies, we were unable to establish a clear dose-response relationship with regard to the impact of supervision. However, the positive effects of supervised training are particularly prominent when compared with completely unsupervised training programs. It is therefore recommended to include supervised sessions (i.e., two out of three sessions/week) in balance/resistance training programs to effectively improve balance and muscle strength/power in older adults. Y1 - 2017 U6 - https://doi.org/10.1007/s40279-017-0747-6 SN - 0112-1642 SN - 1179-2035 VL - 47 SP - 2341 EP - 2361 PB - Springer CY - Northcote ER - TY - JOUR A1 - Prieske, Olaf A1 - Dalager, Tina A1 - Herz, Michael A1 - Hortobagyi, Tibor A1 - Sjogaard, Gisela A1 - Sogaard, Karen A1 - Granacher, Urs T1 - Effects of Physical Exercise Training in the Workplace on Physical Fitness: A Systematic Review and Meta-analysis JF - Sports medicine N2 - Background There is evidence that physical exercise training (PET) conducted at the workplace is effective in improving physical fitness and thus health. However, there is no current systematic review available that provides high-level evidence regarding the effects of PET on physical fitness in the workforce. Objectives To quantify sex-, age-, and occupation type-specific effects of PET on physical fitness and to characterize dose-response relationships of PET modalities that could maximize gains in physical fitness in the working population. Data Sources A computerized systematic literature search was conducted in the databases PubMed and Cochrane Library (2000-2019) to identify articles related to PET in workers. Study Eligibility Criteria Only randomized controlled trials with a passive control group were included if they investigated the effects of PET programs in workers and tested at least one fitness measure. Study Appraisal and Synthesis Methods Weighted mean standardised mean differences (SMDwm) were calculated using random effects models. A multivariate random effects meta-regression was computed to explain the influence of key training modalities (e.g., training frequency, session duration, intensity) on the effectiveness of PET on measures of physical fitness. Further, subgroup univariate analyses were computed for each training modality. Additionally, methodological quality of the included studies was rated with the help of the Physiotherapy Evidence Database (PEDro) Scale. Results Overall, 3423 workers aged 30-56 years participated in 17 studies (19 articles) that were eligible for inclusion. Methodological quality of the included studies was moderate with a median PEDro score of 6. Our analyses revealed significant, small-sized effects of PET on cardiorespiratory fitness (CRF), muscular endurance, and muscle power (0.29 <= SMDwm <= 0.48). Medium effects were found for CRF and muscular endurance in younger workers (<= 45 years) (SMDwm = 0.71) and white-collar workers (SMDwm = 0.60), respectively. Multivariate random effects meta-regression for CRF revealed that none of the examined training modalities predicted the effects of PET on CRF (R-2 = 0). Independently computed subgroup analyses showed significant PET effects on CRF when conducted for 9-12 weeks (SMDwm = 0.31) and for 17-20 weeks (SMDwm = 0.74). Conclusions PET effects on physical fitness in healthy workers are moderated by age (CRF) and occupation type (muscular endurance). Further, independently computed subgroup analyses indicated that the training period of the PET programs may play an important role in improving CRF in workers. Y1 - 2019 U6 - https://doi.org/10.1007/s40279-019-01179-6 SN - 0112-1642 SN - 1179-2035 VL - 49 IS - 12 SP - 1903 EP - 1921 PB - Springer CY - Northcote ER - TY - JOUR A1 - Hortobagyi, Tibor A1 - Lesinski, Melanie A1 - Fernandez-del-Olmo, Miguel A1 - Granacher, Urs T1 - Small and inconsistent effects of whole body vibration on athletic performance: a systematic review and meta-analysis JF - European journal of applied physiology N2 - We quantified the acute and chronic effects of whole body vibration on athletic performance or its proxy measures in competitive and/or elite athletes. Systematic literature review and meta-analysis. Whole body vibration combined with exercise had an overall 0.3 % acute effect on maximal voluntary leg force (-6.4 %, effect size = -0.43, 1 study), leg power (4.7 %, weighted mean effect size = 0.30, 6 studies), flexibility (4.6 %, effect size = -0.12 to 0.22, 2 studies), and athletic performance (-1.9 %, weighted mean effect size = 0.26, 6 studies) in 191 (103 male, 88 female) athletes representing eight sports (overall effect size = 0.28). Whole body vibration combined with exercise had an overall 10.2 % chronic effect on maximal voluntary leg force (14.6 %, weighted mean effect size = 0.44, 5 studies), leg power (10.7 %, weighted mean effect size = 0.42, 9 studies), flexibility (16.5 %, effect size = 0.57 to 0.61, 2 studies), and athletic performance (-1.2 %, weighted mean effect size = 0.45, 5 studies) in 437 (169 male, 268 female) athletes (overall effect size = 0.44). Whole body vibration has small and inconsistent acute and chronic effects on athletic performance in competitive and/or elite athletes. These findings lead to the hypothesis that neuromuscular adaptive processes following whole body vibration are not specific enough to enhance athletic performance. Thus, other types of exercise programs (e.g., resistance training) are recommended if the goal is to improve athletic performance. KW - Exercise KW - Muscle KW - Force KW - Power KW - Skill KW - Reflex KW - Endocrine KW - Metabolism Y1 - 2015 U6 - https://doi.org/10.1007/s00421-015-3194-9 SN - 1439-6319 SN - 1439-6327 VL - 115 IS - 8 SP - 1605 EP - 1625 PB - Springer CY - New York ER - TY - JOUR A1 - Jararnezhadgero, AmirAli A1 - Mamashli, Elaheh A1 - Granacher, Urs T1 - An Endurance-Dominated Exercise Program Improves Maximum Oxygen Consumption, Ground Reaction Forces, and Muscle Activities in Patients With Moderate Diabetic Neuropathy JF - Frontiers in physiology / Frontiers Research Foundation N2 - Background: The prevalence of diabetes worldwide is predicted to increase from 2.8% in 2000 to 4.4% in 2030. Diabetic neuropathy (DN) is associated with damage to nerve glial cells, their axons, and endothelial cells leading to impaired function and mobility. Objective: We aimed to examine the effects of an endurance-dominated exercise program on maximum oxygen consumption (VO2max), ground reaction forces, and muscle activities during walking in patients with moderate DN. Methods: Sixty male and female individuals aged 45–65 years with DN were randomly assigned to an intervention (IG, n = 30) or a waiting control (CON, n = 30) group. The research protocol of this study was registered with the Local Clinical Trial Organization (IRCT20200201046326N1). IG conducted an endurance-dominated exercise program including exercises on a bike ergometer and gait therapy. The progressive intervention program lasted 12 weeks with three sessions per week, each 40–55 min. CON received the same treatment as IG after the post-tests. Pre- and post-training, VO2max was tested during a graded exercise test using spiroergometry. In addition, ground reaction forces and lower limbs muscle activities were recorded while walking at a constant speed of ∼1 m/s. Results: No statistically significant baseline between group differences was observed for all analyzed variables. Significant group-by-time interactions were found for VO2max (p < 0.001; d = 1.22). The post-hoc test revealed a significant increase in IG (p < 0.001; d = 1.88) but not CON. Significant group-by-time interactions were observed for peak lateral and vertical ground reaction forces during heel contact and peak vertical ground reaction force during push-off (p = 0.001–0.037; d = 0.56–1.53). For IG, post-hoc analyses showed decreases in peak lateral (p < 0.001; d = 1.33) and vertical (p = 0.004; d = 0.55) ground reaction forces during heel contact and increases in peak vertical ground reaction force during push-off (p < 0.001; d = 0.92). In terms of muscle activity, significant group-by-time interactions were found for vastus lateralis and gluteus medius during the loading phase and for vastus medialis during the mid-stance phase, and gastrocnemius medialis during the push-off phase (p = 0.001–0.044; d = 0.54–0.81). Post-hoc tests indicated significant intervention-related increases in vastus lateralis (p = 0.001; d = 1.08) and gluteus medius (p = 0.008; d = 0.67) during the loading phase and vastus medialis activity during mid-stance (p = 0.001; d = 0.86). In addition, post-hoc tests showed decreases in gastrocnemius medialis during the push-off phase in IG only (p < 0.001; d = 1.28). Conclusions: This study demonstrated that an endurance-dominated exercise program has the potential to improve VO2max and diabetes-related abnormal gait in patients with DN. The observed decreases in peak vertical ground reaction force during the heel contact of walking could be due to increased vastus lateralis and gluteus medius activities during the loading phase. Accordingly, we recommend to implement endurance-dominated exercise programs in type 2 diabetic patients because it is feasible, safe and effective by improving aerobic capacity and gait characteristics. KW - oxygen consumption KW - kinetics KW - electromyography KW - diabetic KW - gait Y1 - 2021 U6 - https://doi.org/10.3389/fphys.2021.654755 SN - 1664-042X VL - 12 SP - 1 EP - 15 PB - Frontiers Research Foundation CY - Lausanne, Schweiz 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 - Arazi, Hamid A1 - Asadi, Abbas A1 - Khalkhali, Farhood A1 - Boullosa, Daniel A1 - Hackney, Anthony C. A1 - Granacher, Urs A1 - Zouhal, Hassane T1 - Association Between the Acute to Chronic Workload Ratio and Injury Occurrence in Young Male Team Soccer Players BT - A Preliminary Study N2 - This study aimed to investigate the relationship between the acute to chronic workload ratio (ACWR), based upon participant session rating of perceived exertion (sRPE), using two models [(1) rolling averages (ACWRRA); and (2) exponentially weighted moving averages (ACWREWMA)] and the injury rate in young male team soccer players aged 17.1 ± 0.7 years during a competitive mesocycle. Twenty-two players were enrolled in this study and performed four training sessions per week with 2 days of recovery and 1 match day per week. During each training session and each weekly match, training time and sRPE were recorded. In addition, training impulse (TRIMP), monotony, and strain were subsequently calculated. The rate of injury was recorded for each soccer player over a period of 4 weeks (i.e., 28 days) using a daily questionnaire. The results showed that over the course of the study, the number of non-contact injuries was significantly higher than that for contact injuries (2.5 vs. 0.5, p = 0.01). There were also significant positive correlations between sRPE and training time (r = 0.411, p = 0.039), ACWRRA (r = 0.47, p = 0.049), and ACWREWMA (r = 0.51, p = 0.038). In addition, small-to-medium correlations were detected between ACWR and non-contact injury occurrence (ACWRRA, r = 0.31, p = 0.05; ACWREWMA, r = 0.53, p = 0.03). Explained variance (r²) for non-contact injury was significantly greater using the ACWREWMA model (ranging between 21 and 52%) compared with ACWRRA (ranging between 17 and 39%). In conclusion, the results of this study showed that the ACWREWMA model is more sensitive than ACWRRA to identify non-contact injury occurrence in male team soccer players during a short period in the competitive season. KW - training load KW - rate of perceived exertion KW - rolling averages KW - weighted moving averages KW - football Y1 - 2020 U6 - https://doi.org/10.3389/fphys.2020.00608 SN - 1664-042X VL - 11 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Ahmadi, Hamid A1 - Herat, Nehara A1 - Alizadeh, Shahab A1 - Button, Duane C. A1 - Granacher, Urs A1 - Behm, David G. T1 - Effect of an inverted seated position with upper arm blood flow restriction on measures of elbow flexors neuromuscular performance JF - PLOS ONE / Public Library of Science N2 - Purpose The objective of the investigation was to determine the concomitant effects of upper arm blood flow restriction (BFR) and inversion on elbow flexors neuromuscular responses. Methods Randomly allocated, 13 volunteers performed four conditions in a within-subject design: rest (control, 1-min upright position without BFR), control (1-min upright with BFR), 1-min inverted (without BFR), and 1-min inverted with BFR. Evoked and voluntary contractile properties, before, during and after a 30-s maximum voluntary contraction (MVC) exercise intervention were examined as well as pain scale. Results Inversion induced significant pre-exercise intervention decreases in elbow flexors MVC (21.1%, Z2p = 0.48, p = 0.02) and resting evoked twitch forces (29.4%, Z2p = 0.34, p = 0.03). The 30-s MVC induced significantly greater pre- to post-test decreases in potentiated twitch force (Z2p = 0.61, p = 0.0009) during inversion (75%) than upright (65.3%) conditions. Overall, BFR decreased MVC force 4.8% (Z2p = 0.37, p = 0.05). For upright position, BFR induced 21.0% reductions in M-wave amplitude (Z2p = 0.44, p = 0.04). There were no significant differences for electromyographic activity or voluntary activation as measured with the interpolated twitch technique. For all conditions, there was a significant increase in pain scale between the 40-60 s intervals and post-30-s MVC (upright< inversion, and without BFR< BFR). Conclusion The concomitant application of inversion with elbow flexors BFR only amplified neuromuscular performance impairments to a small degree. Individuals who execute forceful contractions when inverted or with BFR should be cognizant that force output may be impaired. Y1 - 2021 U6 - https://doi.org/10.1371/journal.pone.0245311 SN - 1932-6203 VL - 16 IS - 5 PB - PLoS CY - San Fransisco ER - TY - JOUR A1 - Lesinski, Melanie A1 - Herz, Michael A1 - Schmelcher, Alina A1 - Granacher, Urs T1 - Effects of resistance training on physical fitness in healthy children and adolescents BT - an umbrella review JF - Sports medicine N2 - Background Over the past decades, an exponential growth has occurred with regards to the number of scientific publications including meta-analyses on youth resistance training (RT). Accordingly, it is timely to summarize findings from meta-analyses in the form of an umbrella review. Objectives To systematically review and summarise the findings of published meta-analyses that investigated the effects of RT on physical fitness in children and adolescents. Design Systematic umbrella review of meta-analyses. Data Sources Meta-analyses were identified using systematic literature searches in the databases PubMed, Web of Science, and Cochrane Library. Eligibility Criteria for Selecting Meta-analyses Meta-analyses that examined the effects of RT on physical fitness (e.g., muscle strength, muscle power) in healthy youth (<= 18 years). Results Fourteen meta-analyses were included in this umbrella review. Eleven of these meta-analyses reported between-subject effect sizes which are important to eliminate bias due to growth and maturation. RT produced medium-to-large effects on muscle strength, small-to-large effects on muscle power, small-to-medium effects on linear sprint, a medium effect on agility/change-of-direction speed, small-to-large effects on throwing performance, and a medium effect on sport-specific enhancement. There were few consistent moderating effects of maturation, age, sex, expertise level, or RT type on muscle strength and muscle power across the included meta-analyses. The analysed meta-analyses showed low-to-moderate methodological quality (AMSTAR2) as well as presented evidence of low-to-very low quality (GRADE). Conclusion This umbrella review proved the effectiveness of RT in youth on a high evidence level. The magnitude of effects varies according to the respective outcome measure and it appears to follow the principle of training specificity. Larger effect sizes were found for strength-related outcome measures. Future studies should consistently report data on participants' maturational status. More research is needed with prepubertal children and girls, irrespective of their maturational status. Y1 - 2020 U6 - https://doi.org/10.1007/s40279-020-01327-3 SN - 0112-1642 SN - 1179-2035 VL - 50 IS - 11 SP - 1901 EP - 1928 PB - Springer CY - Northcote ER - TY - JOUR A1 - Jafarnezhadgero, Amir Ali A1 - Madadi-Shad, Morteza A1 - Alavi-Mehr, Seyed Majid A1 - Granacher, Urs T1 - The long-term use of foot orthoses affects walking kinematics and kinetics of children with flexible flat feet BT - A randomized controlled trial JF - PLoS ONE N2 - Background Due to inconclusive evidence on the effects of foot orthoses treatment on lower limb kinematics and kinetics in children, studies are needed that particularly evaluate the long-term use of foot orthoses on lower limb alignment during walking. Thus, the main objective of this study was to evaluate the effects of long-term treatment with arch support foot orthoses versus a sham condition on lower extremity kinematics and kinetics during walking in children with flexible flat feet. Methods Thirty boys aged 8–12 years with flexible flat feet participated in this study. While the experimental group (n = 15) used medial arch support foot orthoses during everyday activities over a period of four months, the control group (n = 15) received flat 2-mm-thick insoles (i.e., sham condition) for the same time period. Before and after the intervention period, walking kinematics and ground reaction forces were collected. Results Significant group by time interactions were observed during walking at preferred gait speed for maximum ankle eversion, maximum ankle internal rotation angle, minimum knee abduction angle, maximum knee abduction angle, maximum knee external rotation angle, maximum knee internal rotation angle, maximum hip extension angle, and maximum hip external rotation angle in favor of the foot orthoses group. In addition, statistically significant group by time interactions were detected for maximum posterior, and vertical ground reaction forces in favor of the foot orthoses group. Conclusions The long-term use of arch support foot orthoses proved to be feasible and effective in boys with flexible flat feet to improve lower limb alignment during walking. KW - lower-extremity kinematics KW - medial longitudinal arch KW - limb overuse conditions KW - ground reaction force KW - low-back-pain KW - knee osteoarthritis KW - calcaneal eversion KW - standing position KW - pelvic alignment KW - sex-differences Y1 - 2018 U6 - https://doi.org/10.1371/journal.pone.0205187 SN - 1932-6203 VL - 13 IS - 10 SP - 1 EP - 19 PB - Public Library of Science CY - San Francisco ER - TY - JOUR A1 - Makhlouf, Issam A1 - Chaouachi, Anis A1 - Chaouachi, Mehdi A1 - Othman, Aymen Ben A1 - Granacher, Urs T1 - Combination of Agility and Plyometric Training Provides Similar Training Benefits as Combined Balance and Plyometric Training in Young Soccer Players JF - Frontiers in Physiology N2 - Introduction: Studies that combined balance and resistance training induced larger performance improvements compared with single mode training. Agility exercises contain more dynamic and sport-specific movements compared with balance training. Thus, the purpose of this study was to contrast the effects of combined balance and plyometric training with combined agility and plyometric training and an active control on physical fitness in youth. Methods: Fifty-seven male soccer players aged 10–12 years participated in an 8-week training program (2 × week). They were randomly assigned to a balance-plyometric (BPT: n = 21), agility-plyometric (APT: n = 20) or control group (n = 16). Measures included proxies of muscle power [countermovement jump (CMJ), triple-hop-test (THT)], muscle strength [reactive strength index (RSI), maximum voluntary isometric contraction (MVIC) of handgrip, back extensors, knee extensors], agility [4-m × 9-m shuttle run, Illinois change of direction test (ICODT) with and without the ball], balance (Standing Stork, Y-Balance), and speed (10–30 m sprints). Results: Significant time × group interactions were found for CMJ, hand grip MVIC force, ICODT without a ball, agility (4 m × 9 m), standing stork balance, Y-balance, 10 and 30-m sprint. The APT pre- to post-test measures displayed large ES improvements for hand grip MVIC force, ICODT without a ball, agility test, CMJ, standing stork balance test, Y-balance test but only moderate ES improvements with the 10 and 30 m sprints. The BPT group showed small (30 m sprint), moderate (hand grip MVIC, ICODTwithout a ball) and large ES [agility (4 m × 9 m) test, CMJ, standing stork balance test, Y-balance] improvements, respectively. Conclusion: In conclusion, both training groups provided significant improvements in all measures. It is recommended that youth incorporate balance exercises into their training and progress to agility with their strength and power training. KW - jump training KW - plyometrics KW - change of direction KW - adolescents KW - football Y1 - 2018 U6 - https://doi.org/10.3389/fphys.2018.01611 SN - 1664-042X VL - 9 SP - 1 EP - 17 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Arazi, Hamid A1 - Asadi, Abbas A1 - Khalkhali, Farhood A1 - Boullosa, Daniel A1 - Hackney, Anthony C. A1 - Granacher, Urs A1 - Zouhal, Hassane T1 - Association Between the Acute to Chronic Workload Ratio and Injury Occurrence in Young Male Team Soccer Players BT - A Preliminary Study JF - Frontiers in Physiology N2 - This study aimed to investigate the relationship between the acute to chronic workload ratio (ACWR), based upon participant session rating of perceived exertion (sRPE), using two models [(1) rolling averages (ACWRRA); and (2) exponentially weighted moving averages (ACWREWMA)] and the injury rate in young male team soccer players aged 17.1 ± 0.7 years during a competitive mesocycle. Twenty-two players were enrolled in this study and performed four training sessions per week with 2 days of recovery and 1 match day per week. During each training session and each weekly match, training time and sRPE were recorded. In addition, training impulse (TRIMP), monotony, and strain were subsequently calculated. The rate of injury was recorded for each soccer player over a period of 4 weeks (i.e., 28 days) using a daily questionnaire. The results showed that over the course of the study, the number of non-contact injuries was significantly higher than that for contact injuries (2.5 vs. 0.5, p = 0.01). There were also significant positive correlations between sRPE and training time (r = 0.411, p = 0.039), ACWRRA (r = 0.47, p = 0.049), and ACWREWMA (r = 0.51, p = 0.038). In addition, small-to-medium correlations were detected between ACWR and non-contact injury occurrence (ACWRRA, r = 0.31, p = 0.05; ACWREWMA, r = 0.53, p = 0.03). Explained variance (r 2) for non-contact injury was significantly greater using the ACWREWMA model (ranging between 21 and 52%) compared with ACWRRA (ranging between 17 and 39%). In conclusion, the results of this study showed that the ACWREWMA model is more sensitive than ACWRRA to identify non-contact injury occurrence in male team soccer players during a short period in the competitive season. KW - training load KW - rate of perceived exertion KW - rolling averages KW - weighted moving averages KW - football Y1 - 2020 U6 - https://doi.org/10.3389/fphys.2020.00995 SN - 1664-042X VL - 11 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Helm, Norman A1 - Prieske, Olaf A1 - Mühlbauer, Thomas A1 - Krüger, Tom A1 - Granacher, Urs T1 - Effects of judo-specific resistance training on kinetic and electromyographic parameters of pulling exercises in judo athletes T1 - Effekte eines judospezifischen Messplatztrainings auf kinetische und elektromyografische Parameter des Anreißens bei Wurfeingangsbewegungen von Judoka JF - Sportverletzung, Sportschaden : Grundlagen, Prävention, Rehabilitation N2 - Background In judo, rapid force production during pulling movements is an important component of athletic performance, which is why this capacity needs to be specifically exercised in judo. This study aimed at examining the effects of a judo-specific resistance training program using a judo ergometer system (PTJ) versus a traditional resistance training regime using a partner (PTP) on kinetics and muscle activity of judo-specific pulling exercises. Method Twenty-four male judo athletes (age: 22 +/- 4 years, training experience: 15 +/- 3 years) were randomly assigned to two groups. In a crossover design, the first group completed a 4-week PTJ followed by four weeks of PTP (each with three sessions per week). The second group conducted PTP prior to PTJ. PTJ and PTP were completed in addition to regular training. Before, 4 weeks and 8 weeks after training, tests were conducted to assess judo-specific pulling kinetics (i.e. maximal force, rate of force development [RFD], mechanical work) and electromyographic (EMG) shoulder/trunk muscle activity (i.e. biceps brachii muscle, deltoid muscle, trapezius muscle, erector spinae muscle) during pulling movements using a judo ergometer as well as unspecific strength tests (i.e. bench-pull, pull-ups). Results The statistical analysis revealed that in both groups ergometer pulling kinetics (p<.05, 0.83 <= d <= 1.77) and EMG activity (p<.05; 1.07 <= d <= 2.25) were significantly enhanced following 8 weeks of training. In addition, significantly larger gains in RFD, mechanical work, and EMG activity (i.e. deltoid muscle, erector spinae muscle, trapezius muscle) were found following PTJ compared to PTP (p<.05, 1.25 <= d <= 2.79). No significant enhancements were observed with the unspecific strength tests. Conclusion Our findings indicate that PTJ is superior to PTP regarding training-induced improvements in force production and muscle activity during judo-specific pulling exercises. Performance enhancements may partly be attributed to neural adaptations. No transfer effects on unspecific strength tests were detected following PTJ and PTP. N2 - Hintergrund Schnellkräftige Wurfeingangsbewegungen stellen im Judo entscheidende Voraussetzungen für den Wettkampferfolg dar, weshalb das Training der Anrissbewegung ein zentrales Element des judospezifischen Trainings darstellt. Das Ziel der Studie bestand darin, die Effekte eines Anrisstrainings mit einem Judoergometer-System (ATJ) gegenüber einem tradierten Anrisstraining mit Partner (ATP) auf kinetische und elektromyografische Parameter des Anreißens bei Wurfeingangsbewegungen von Judoka zu untersuchen. Methode Männliche leistungsorientierte Judoka (N = 24, Alter: 22 ± 4 Jahre; Trainingserfahrung: 15 ± 3 Jahre) wurden randomisiert in zwei Gruppen aufgeteilt. Im Crossover-Design absolvierte die erste Gruppe über vier Wochen ein ATJ gefolgt von vier Wochen ATP (je 3x/ Woche). Die zweite Gruppe führte beide Trainingsvarianten in umgekehrter Reihenfolge durch. ATJ und ATP wurden zusätzlich zum bestehenden Training absolviert. Vor dem Training sowie nach vier und nach acht Wochen Training wurden Tests zur Erfassung kinetischer Parameter (dynamisch-realisierte Maximalkraft, Explosivkraft, mechanische Arbeit) und elektromyografischer (EMG) Schulter-/ Rumpfmuskelaktivitäten (M. biceps brachii, M. deltoideus, M. trapezius, M. erector spinae) für die Hub- und Zugarmseite bei Wurfeingangsbewegungen am Judoergometer sowie sportartunspezifische Krafttests (d. h. Liegend-Anreißen, Klimmziehen) durchgeführt. Ergebnisse Die Ergebnisse der statistischen Analyse ergaben über den gesamten Interventionszeitraum (8 Wochen) für beide Trainingsgruppen signifikante Verbesserungen der kinetischen Parameter (p <,05; 0,83 ≤d≤ 1,77) und EMG-Aktivitäten (p <,05; 1,07 ≤d≤ 2,25). Darüber hinaus zeigten sich größere Zuwachsraten in der Explosivkraft, der mechanischen Arbeit und den Schulter-/Rumpfmuskelaktivitäten (M. deltoideus, M. erector spinae, M. trapezius) zugunsten von ATJ im Vergleich zu ATP (p <,05; 1,25 ≤d≤ 2,79). Für die sportartunspezifischen Kraftwerte wurden keine signifikanten Veränderungen festgestellt. Schlussfolgerung Die vorliegenden Ergebnisse zeigen, dass ATJ gegenüber ATP größere Steigerungsraten von kinetischen und elektromyografischen Parametern des Anreißens bei Wurfeingangsbewegungen von Judoka bewirkt. Die trainingsbedingten Leistungssteigerungen scheinen zumindest teilweise auf neuronalen Anpassungen zu beruhen. KW - combat sport KW - athletic performance KW - specific strength training KW - surface electromyography KW - Kampfsport KW - sportliche Leistung KW - spezifisches Krafttraining KW - Oberflächenelektromyografie Y1 - 2018 U6 - https://doi.org/10.1055/s-0043-122781 SN - 0932-0555 SN - 1439-1236 VL - 32 IS - 2 SP - 134 EP - 142 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Gäbler, Martijn A1 - Prieske, Olaf A1 - Hortobagyi, Tibor A1 - Granacher, Urs T1 - The Effects of Concurrent Strength and Endurance Training on Physical Fitness and Athletic Performance in Youth BT - A Systematic Review and Meta-Analysis JF - Frontiers in Physiology N2 - Combining training of muscle strength and cardiorespiratory fitness within a training cycle could increase athletic performance more than single-mode training. However, the physiological effects produced by each training modality could also interfere with each other, improving athletic performance less than single-mode training. Because anthropometric, physiological, and biomechanical differences between young and adult athletes can affect the responses to exercise training, young athletes might respond differently to concurrent training (CT) compared with adults. Thus, the aim of the present systematic review with meta-analysis was to determine the effects of concurrent strength and endurance training on selected physical fitness components and athletic performance in youth. A systematic literature search of PubMed and Web of Science identified 886 records. The studies included in the analyses examined children (girls age 6–11 years, boys age 6–13 years) or adolescents (girls age 12–18 years, boys age 14–18 years), compared CT with single-mode endurance (ET) or strength training (ST), and reported at least one strength/power—(e.g., jump height), endurance—(e.g., peak V°O2, exercise economy), or performance-related (e.g., time trial) outcome. We calculated weighted standardized mean differences (SMDs). CT compared to ET produced small effects in favor of CT on athletic performance (n = 11 studies, SMD = 0.41, p = 0.04) and trivial effects on cardiorespiratory endurance (n = 4 studies, SMD = 0.04, p = 0.86) and exercise economy (n = 5 studies, SMD = 0.16, p = 0.49) in young athletes. A sub-analysis of chronological age revealed a trend toward larger effects of CT vs. ET on athletic performance in adolescents (SMD = 0.52) compared with children (SMD = 0.17). CT compared with ST had small effects in favor of CT on muscle power (n = 4 studies, SMD = 0.23, p = 0.04). In conclusion, CT is more effective than single-mode ET or ST in improving selected measures of physical fitness and athletic performance in youth. Specifically, CT compared with ET improved athletic performance in children and particularly adolescents. Finally, CT was more effective than ST in improving muscle power in youth. KW - child KW - adolescent KW - muscle strength KW - cardiorespiratory fitness KW - physical conditioning human KW - resistance training KW - youth sports Y1 - 2018 U6 - https://doi.org/10.3389/fphys.2018.01057 SN - 1664-042X VL - 9 SP - 1 EP - 13 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Mühlbauer, Thomas A1 - Besemer, Carmen A1 - Wehrle, Anja A1 - Gollhofer, Albert A1 - Granacher, Urs T1 - Relationship between strength, power and balance performance in seniors JF - Gerontology N2 - Background: Deficits in strength, power and balance represent important intrinsic risk factors for falls in seniors. Objective: The purpose of this study was to investigate the relationship between variables of lower extremity muscle strength/power and balance, assessed under various task conditions. Methods: Twenty-four healthy and physically active older adults (mean age: 70 8 5 years) were tested for their isometric strength (i.e. maximal isometric force of the leg extensors) and muscle power (i.e. countermovement jump height and power) as well as for their steady-state (i.e. unperturbed standing, 10-meter walk), proactive (i.e. Timed Up & Go test, Functional Reach Test) and reactive (i.e. perturbed standing) balance. Balance tests were conducted under single (i.e. standing or walking alone) and dual task conditions (i.e. standing or walking plus cognitive and motor interference task). Results: Significant positive correlations were found between measures of isometric strength and muscle power of the lower extremities (r values ranged between 0.608 and 0.720, p < 0.01). Hardly any significant associations were found between variables of strength, power and balance (i.e. no significant association in 20 out of 21 cases). Additionally, no significant correlations were found between measures of steady-state, proactive and reactive balance or balance tests performed under single and dual task conditions (all p > 0.05). Conclusion: The predominately nonsignificant correlations between different types of balance imply that balance performance is task specific in healthy and physically active seniors. Further, strength, power and balance as well as balance under single and dual task conditions seem to be independent of each other and may have to be tested and trained complementarily. KW - Steady-state balance KW - Proactive/reactive balance KW - Force production KW - Single/dual tasking KW - Cognitive/motor interference Y1 - 2012 U6 - https://doi.org/10.1159/000341614 SN - 0304-324X VL - 58 IS - 6 SP - 504 EP - 512 PB - Karger CY - Basel ER - TY - JOUR A1 - Grabow, Lena A1 - Young, James D. A1 - Alcock, Lynsey R. A1 - Quigley, Patrick J. A1 - Byrne, Jeannette M. A1 - Granacher, Urs A1 - Skarabot, Jakob A1 - Behm, David George T1 - Higher Quadriceps Roller Massage Forces Do Not Amplify Range-of-Motion Increases nor Impair Strength and Jump Performance JF - Journal of strength and conditioning research : the research journal of the NSCA N2 - Grabow, L, Young, JD, Alcock, LR, Quigley, PJ, Byrne, JM, Granacher, U, Škarabot, J, and Behm, DG. Higher quadriceps roller massage forces do not amplify range-of-motion increases nor impair strength and jump performance. J Strength Cond Res 32(11): 3059–3069, 2018—Roller massage (RM) has been reported to increase range of motion (ROM) without subsequent performance decrements. However, the effects of different rolling forces have not been examined. The purpose of this study was to compare the effects of sham (RMsham), moderate (RMmod), and high (RMhigh) RM forces, calculated relative to the individuals' pain perception, on ROM, strength, and jump parameters. Sixteen healthy individuals (27 ± 4 years) participated in this study. The intervention involved three 60-second quadriceps RM bouts with RMlow (3.9/10 ± 0.64 rating of perceived pain [RPP]), RMmod (6.2/10 ± 0.64 RPP), and RMhigh (8.2/10 ± 0.44 RPP) pain conditions, respectively. A within-subject design was used to assess dependent variables (active and passive knee flexion ROM, single-leg drop jump [DJ] height, DJ contact time, DJ performance index, maximum voluntary isometric contraction [MVIC] force, and force produced in the first 200 milliseconds [F200] of the knee extensors and flexors). A 2-way repeated measures analysis of variance showed a main effect of testing time in active (p < 0.001, d = 2.54) and passive (p < 0.001, d = 3.22) ROM. Independent of the RM forces, active and passive ROM increased by 7.0% (p = 0.03, d = 2.25) and 15.4% (p < 0.001, d = 3.73) from premeasure to postmeasure, respectively. Drop jump and MVIC parameters were unaffected from pretest to posttest (p > 0.05, d = 0.33–0.84). Roller massage can be efficiently used to increase ROM without substantial pain and without subsequent performance impairments. KW - self-massage therapy KW - neuromuscular rolling KW - pressure KW - self-myofascial release Y1 - 2018 U6 - https://doi.org/10.1519/JSC.0000000000001906 SN - 1064-8011 SN - 1533-4287 VL - 32 IS - 11 SP - 3059 EP - 3069 PB - Lippincott Williams & Wilkins CY - Philadelphia ER -