@article{MainkaWisselVoelleretal.2018, author = {Mainka, Stefan and Wissel, J{\"o}rg and V{\"o}ller, Heinz and Evers, Stefan}, title = {The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients}, series = {Frontiers in Neurology}, volume = {9}, journal = {Frontiers in Neurology}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1664-2295}, doi = {10.3389/fneur.2018.00755}, pages = {8}, year = {2018}, abstract = {The use of functional music in gait training termed rhythmic auditory stimulation (RAS) and treadmill training (TT) have both been shown to be effective in stroke patients (SP). The combination of RAS and treadmill training (RAS-TT) has not been clinically evaluated to date. The aim of the study was to evaluate the efficacy of RAS-TT on functional gait in SR The protocol followed the design of an explorative study with a rater-blinded three arm prospective randomized controlled parallel group design. Forty-five independently walking SP with a hemiparesis of the lower limb or an unsafe and asymmetrical walking pattern were recruited. RAS-TT was carried out over 4 weeks with TT and neurodevelopmental treatment based on Bobath approach (NDT) serving as control interventions. For RAS-TT functional music was adjusted individually while walking on the treadmill. Pre and post-assessments consisted of the fast gait speed test (FGS), a gait analysis with the locometre (LOC), 3 min walking time test (3MWT), and an instrumental evaluation of balance (IEB). Raters were blinded to group assignments. An analysis of covariance (ANCOVA) was performed with affiliated measures from pre-assessment and time between stroke and start of study as covariates. Thirty-five participants (mean age 63.6 +/- 8.6 years, mean time between stroke and start of study 42.1 +/- 23.7 days) completed the study (11 RAS-TT, 13 TT, 11 NDT). Significant group differences occurred in the FGS for adjusted post-measures in gait velocity [F-(2,F- (34)) = 3.864, p = 0.032; partial eta(2) = 0.205] and cadence [F-(2,F- 34) = 7.656, p = 0.002; partial eta(2) = 0.338]. Group contrasts showed significantly higher values for RAS-TT. Stride length results did not vary between the groups. LOC, 3MWT, and IEB did not indicate group differences. One patient was withdrawn from TT because of pain in one arm. The study provides first evidence for a higher efficacy of RAS-TT in comparison to the standard approaches TT and NDT in restoring functional gait in SP. The results support the implementation of functional music in neurological gait rehabilitation and its use in combination with treadmill training.}, language = {en} } @misc{MainkaWisselVoelleretal.2018, author = {Mainka, Stefan and Wissel, J{\"o}rg and V{\"o}ller, Heinz and Evers, Stefan}, title = {The use of rhythmic auditory stimulation to optimize treadmill training for stroke patients}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {655}, issn = {1866-8364}, doi = {10.25932/publishup-45917}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-459179}, pages = {10}, year = {2018}, abstract = {The use of functional music in gait training termed rhythmic auditory stimulation (RAS) and treadmill training (TT) have both been shown to be effective in stroke patients (SP). The combination of RAS and treadmill training (RAS-TT) has not been clinically evaluated to date. The aim of the study was to evaluate the efficacy of RAS-TT on functional gait in SR The protocol followed the design of an explorative study with a rater-blinded three arm prospective randomized controlled parallel group design. Forty-five independently walking SP with a hemiparesis of the lower limb or an unsafe and asymmetrical walking pattern were recruited. RAS-TT was carried out over 4 weeks with TT and neurodevelopmental treatment based on Bobath approach (NDT) serving as control interventions. For RAS-TT functional music was adjusted individually while walking on the treadmill. Pre and post-assessments consisted of the fast gait speed test (FGS), a gait analysis with the locometre (LOC), 3 min walking time test (3MWT), and an instrumental evaluation of balance (IEB). Raters were blinded to group assignments. An analysis of covariance (ANCOVA) was performed with affiliated measures from pre-assessment and time between stroke and start of study as covariates. Thirty-five participants (mean age 63.6 +/- 8.6 years, mean time between stroke and start of study 42.1 +/- 23.7 days) completed the study (11 RAS-TT, 13 TT, 11 NDT). Significant group differences occurred in the FGS for adjusted post-measures in gait velocity [F-(2,F- (34)) = 3.864, p = 0.032; partial eta(2) = 0.205] and cadence [F-(2,F- 34) = 7.656, p = 0.002; partial eta(2) = 0.338]. Group contrasts showed significantly higher values for RAS-TT. Stride length results did not vary between the groups. LOC, 3MWT, and IEB did not indicate group differences. One patient was withdrawn from TT because of pain in one arm. The study provides first evidence for a higher efficacy of RAS-TT in comparison to the standard approaches TT and NDT in restoring functional gait in SP. The results support the implementation of functional music in neurological gait rehabilitation and its use in combination with treadmill training.}, language = {en} } @article{AzadianMajlesiJafarnezhadgeroetal.2020, author = {Azadian, Elaheh and Majlesi, Mahdi and Jafarnezhadgero, Amir Ali and Granacher, Urs}, title = {The impact of hearing loss on three-dimensional lower limb joint torques during walking in prepubertal boys}, series = {Journal of bodywork and movement therapies}, volume = {24}, journal = {Journal of bodywork and movement therapies}, number = {2}, publisher = {Elsevier}, address = {Amsterdam}, issn = {1360-8592}, doi = {10.1016/j.jbmt.2019.10.013}, pages = {123 -- 129}, year = {2020}, abstract = {Introduction: In children, the impact of hearing loss on biomechanical gait parameters is not well understood. Thus, the objectives of this study were to examine three-dimensional lower limb joint torques in deaf compared to age-matched healthy (hearing) children while walking at preferred gait speed. Methods: Thirty prepubertal boys aged 8-14 were enrolled in this study and divided into a group with hearing loss (deaf group) and an age-matched healthy control. Three-dimensional joint torques were analyzed during barefoot walking at preferred speed using Kistler force plates and a Vicon motion capture system. Results: Findings revealed that boys with hearing loss showed lower joint torques in ankle evertors, knee flexors, abductors and internal rotators as well as in hip internal rotators in both, the dominant and non-dominant lower limbs (all p < 0.05; d = 1.23-7.00; 14-79\%). Further, in the dominant limb, larger peak ankle dorsiflexor (p < 0.001; d = 1.83; 129\%), knee adductor (p < 0.001; d = 3.20; 800\%), and hip adductor torques (p < 0.001; d = 2.62; 350\%) were found in deaf participants compared with controls. Conclusion: The observed altered lower limb torques during walking are indicative of unstable gait in children with hearing loss. More research is needed to elucidate whether physical training (e.g., balance and/or gait training) has the potential to improve walking performance in this patient group. (C) 2019 Elsevier Ltd. All rights reserved.}, language = {en} } @article{GranacherLacroixRoettgeretal.2014, author = {Granacher, Urs and Lacroix, Andre and Roettger, Katrin and Gollhofer, Albert and M{\"u}hlbauer, Thomas}, title = {Relationships between trunk muscle strength, spinal mobility, and balance performance in older adults}, series = {Journal of aging and physical activity}, volume = {22}, journal = {Journal of aging and physical activity}, number = {4}, publisher = {Human Kinetics Publ.}, address = {Champaign}, issn = {1063-8652}, doi = {10.1123/JAPA.2013-0108}, pages = {490 -- 498}, year = {2014}, abstract = {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.}, language = {en} } @misc{GschwindBridenbaughReinhardetal.2017, author = {Gschwind, Yves J. and Bridenbaugh, Stephanie A. and Reinhard, Sarah and Granacher, Urs and Monsch, Andreas U. and Kressig, Reto W.}, title = {Ginkgo biloba special extract LI 1370 improves dual-task walking in patients with MCI}, series = {Postprints der Universit{\"a}t Potsdam : Mathematisch Naturwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Mathematisch Naturwissenschaftliche Reihe}, number = {870}, issn = {1866-8372}, doi = {10.25932/publishup-43479}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-434796}, pages = {609 -- 619}, year = {2017}, abstract = {Background In patients with mild cognitive impairment (MCI), gait instability, particularly in dual-task situations, has been associated with impaired executive function and an increased fall risk. Ginkgo biloba extract (GBE) could be an effective mean to improve gait stability. Aims This study investigated the effect of GBE on spatiotemporal gait parameters of MCI patients while walking under single and dual-task conditions. Methods Fifty patients aged 50-85 years with MCI and associated dual-task-related gait impairment participated in this randomised, double-blind, placebo-controlled, exploratory phase IV drug trial. Intervention group (IG) patients received GBE (Symfona (R) forte 120 mg) twice-daily for 6 months while control group (CG) patients received placebo capsules. A 6-month open-label phase with identical GBE dosage followed. Gait was quantified at months 0, 3, 6 and 12. Results After 6 months, dual-task-related cadence increased in the IG compared to the CG (p = 0.019, d = 0.71). No significant changes, but GBE-associated numerical non-significant trends were found after 6-month treatment for dual-task-related gait velocity and stride time variability. Discussion Findings suggest that 120 mg of GBE twice-daily for at least 6 months may improve dual-task-related gait performance in patients with MCI. Conclusions The observed gait improvements add to the understanding of the self-reported unspecified improvements among MCI patients when treated with standardised GBE.}, language = {en} } @article{JafarnezhadgeroFatollahiGranacher2022, author = {Jafarnezhadgero, Amir Ali and Fatollahi, Amir and Granacher, Urs}, title = {Eight weeks of exercising on sand has positive effects on biomechanics of walking and muscle activities in individuals with pronated feet}, series = {Sports : open access journal}, volume = {10}, journal = {Sports : open access journal}, number = {5}, publisher = {MDPI}, address = {Basel}, issn = {2075-4663}, doi = {10.3390/sports10050070}, pages = {16}, year = {2022}, abstract = {This study aimed to investigate the effects of eight weeks of barefoot running exercise on sand versus control on measures of walking kinetics and muscle activities in individuals with diagnosed pronated feet. Sixty physically active male adults with pronated feet were randomly allocated into an intervention or a waiting control group. The intervention group conducted an 8-weeks progressive barefoot running exercise program on sand (e.g., short sprints) with three weekly sessions. Pre and post intervention, participants walked at a constant speed of 1.3 m/s +/- 5\% on a 18 m walkway with a force plate embedded in the middle of the walkway. Results showed significant group-by-time interactions for peak impact vertical and lateral ground reaction forces. Training but not control resulted in significantly lower peak impact vertical and lateral ground reaction forces. Significant group-by-time interactions were observed for vastus lateralis activity during the loading phase. Training-induced increases were found for the vastus lateralis in the intervention but not in the control group. This study revealed that the applied exercise program is a suitable means to absorb ground reaction forces (e.g., lower impact vertical and lateral peaks) and increase activities of selected lower limb muscles (e.g., vastus lateralis) when walking on stable ground.}, language = {en} } @article{KhajooeiWochatzBaritelloetal.2020, author = {Khajooei, Mina and Wochatz, Monique and Baritello, Omar and Mayer, Frank}, title = {Effects of shoes on children's fundamental motor skills performance}, series = {Footwear science : official journal of the Footwear Biomechanics Group}, volume = {12}, journal = {Footwear science : official journal of the Footwear Biomechanics Group}, number = {1}, publisher = {Taylor \& Francis}, address = {Abingdon}, issn = {1942-4280}, doi = {10.1080/19424280.2019.1696895}, pages = {55 -- 62}, year = {2020}, abstract = {Progression or impediment of fundamental motor skills performance (FMSP) in children depends on internal and environmental factors. Shoes as an environmental constraint are believed to affect these movements as children showed to perform qualitatively better with sports shoes than flip-flop sandals. However, locomotor performance assessments based on biomechanical variables are limited. Therefore, the objective of this experiment was to assess the biomechanical effects of wearing shoes while performing fundamental motor skills in children. Barefoot and shod conditions were tested in healthy children between the age of 4 and 7 years. They were asked to perform basic and advanced motor skills including double-leg stance, horizontal jumps, walking as well as counter-movement jumps, single-leg stance and sprinting. Postural control and ground reaction data were measured with two embedded force plates. A 3D motion capture system was used to analyse the spatiotemporal parameters of walking and sprinting. Findings showed that the parameters of single- and double-leg stance, horizontal and counter-movement jump did not differ between barefoot and shod conditions. Most of the spatiotemporal variables including cadence, stride length, stride time, and contact time of walking and sprinting were statistically different between the barefoot and shod conditions. Consequently, tested shoes did not change performance and biomechanics of postural control and jumping tasks; however, the spatiotemporal gait parameters indicate changes in walking and sprinting characteristics with shoes in children.}, language = {en} } @misc{GranacherLacroixMuehlbaueretal.2017, author = {Granacher, Urs and Lacroix, Andre and M{\"u}hlbauer, Thomas and Roettger, Katrin and Gollhofer, Albert}, title = {Effects of core instability strength training on trunk muscle strength, spinal mobility, dynamic balance and functional mobility in older adults}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-399994}, pages = {9}, year = {2017}, abstract = {Background: Age-related postural misalignment, balance deficits and strength/power losses are associated with impaired functional mobility and an increased risk of falling in seniors. Core instability strength training (CIT) involves exercises that are challenging for both trunk muscles and postural control and may thus have the potential to induce benefits in trunk muscle strength, spinal mobility and balance performance. Objective: The objective was to investigate the effects of CIT on measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility in seniors. Methods: Thirty-two older adults were randomly assigned to an intervention group (INT; n = 16, aged 70.8 +/- 4.1 years) that conducted a 9-week progressive CIT or to a control group (n = 16, aged 70.2 +/- 4.5 years). Maximal isometric strength of the trunk flexors/extensors/lateral flexors (right, left)/rotators (right, left) as well as of spinal mobility in the sagittal and the coronal plane was measured before and after the intervention program. Dynamic balance (i.e. walking 10 m on an optoelectric walkway, the Functional Reach test) and functional mobility (Timed Up and Go test) were additionally tested. Results: Program compliance was excellent with participants of the INT group completing 92\% of the training sessions. Significant group x test interactions were found for the maximal isometric strength of the trunk flexors (34\%, p < 0.001), extensors (21\%, p < 0.001), lateral flexors (right: 48\%, p < 0.001; left: 53\%, p < 0.001) and left rotators (42\%, p < 0.001) in favor of the INT group. Further, training-related improvements were found for spinal mobility in the sagittal (11\%, p < 0.001) and coronal plane (11\%, p = 0.06) directions, for stride velocity (9\%, p < 0.05), the coefficient of variation in stride velocity (31\%, p < 0.05), the Functional Reach test (20\%, p < 0.05) and the Timed Up and Go test (4\%, p < 0.05) in favor of the INT group. Conclusion: CIT proved to be a feasible exercise program for seniors with a high adherence rate. Age-related deficits in measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility can be mitigated by CIT. This training regimen could be used as an adjunct or even alternative to traditional balance and/or resistance training.}, language = {en} } @misc{GranacherMuehlbauerBridenbaughetal.2017, author = {Granacher, Urs and M{\"u}hlbauer, Thomas and Bridenbaugh, Stephanie A. and Wolf, Madeleine and Roth, Ralf and Gschwind, Yves and Wolf, Irene and Mata, Rui and Kressig, Reto W.}, title = {Effects of a salsa dance training on balance and strength performance in older adults}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-399962}, pages = {8}, year = {2017}, abstract = {Background: Deficits in static and particularly dynamic postural control and force production have frequently been associated with an increased risk of falling in older adults. Objective: The objectives of this study were to investigate the effects of salsa dancing on measures of static/dynamic postural control and leg extensor power in seniors. Methods: Twenty-eight healthy older adults were randomly assigned to an intervention group (INT, n = 14, age 71.6 +/- 5.3 years) to conduct an 8-week progressive salsa dancing programme or a control group (CON, n = 14, age 68.9 +/- 4.7 years). Static postural control was measured during one-legged stance on a balance platform and dynamic postural control was obtained while walking on an instrumented walkway. Leg extensor power was assessed during a countermovement jump on a force plate. Results: Programme compliance was excellent with participants of the INT group completing 92.5\% of the dancing sessions. A tendency towards an improvement in the selected measures of static postural control was observed in the INT group as compared to the CON group. Significant group X test interactions were found for stride velocity, length and time. Post hoc analyses revealed significant increases in stride velocity and length, and concomitant decreases in stride time. However, salsa dancing did not have significant effects on various measures of gait variability and leg extensor power. Conclusion: Salsa proved to be a safe and feasible exercise programme for older adults accompanied with a high adherence rate. Age-related deficits in measures of static and particularly dynamic postural control can be mitigated by salsa dancing in older adults. High physical activity and fitness/mobility levels of our participants could be responsible for the nonsignificant findings in gait variability and leg extensor power.}, language = {en} } @misc{KliemeTietzMeinel2018, author = {Klieme, Eric and Tietz, Christian and Meinel, Christoph}, title = {Beware of SMOMBIES}, series = {The 17th IEEE International Conference on Trust, Security and Privacy in Computing and Communications (IEEE TrustCom 2018)/the 12th IEEE International Conference on Big Data Science and Engineering (IEEE BigDataSE 2018)}, journal = {The 17th IEEE International Conference on Trust, Security and Privacy in Computing and Communications (IEEE TrustCom 2018)/the 12th IEEE International Conference on Big Data Science and Engineering (IEEE BigDataSE 2018)}, publisher = {IEEE}, address = {New York}, isbn = {978-1-5386-4387-7}, issn = {2324-9013}, doi = {10.1109/TrustCom/BigDataSE.2018.00096}, pages = {651 -- 660}, year = {2018}, abstract = {Several research evaluated the user's style of walking for the verification of a claimed identity and showed high authentication accuracies in many settings. In this paper we present a system that successfully verifies a user's identity based on many real world smartphone placements and yet not regarded interactions while walking. Our contribution is the distinction of all considered activities into three distinct subsets and a specific one-class Support Vector Machine per subset. Using sensor data of 30 participants collected in a semi-supervised study approach, we prove that unsupervised verification is possible with very low false-acceptance and false-rejection rates. We furthermore show that these subsets can be distinguished with a high accuracy and demonstrate that this system can be deployed on off-the-shelf smartphones.}, language = {en} } @article{JararnezhadgeroMamashliGranacher2021, author = {Jararnezhadgero, AmirAli and Mamashli, Elaheh and Granacher, Urs}, title = {An Endurance-Dominated Exercise Program Improves Maximum Oxygen Consumption, Ground Reaction Forces, and Muscle Activities in Patients With Moderate Diabetic Neuropathy}, series = {Frontiers in physiology / Frontiers Research Foundation}, volume = {12}, journal = {Frontiers in physiology / Frontiers Research Foundation}, publisher = {Frontiers Research Foundation}, address = {Lausanne, Schweiz}, issn = {1664-042X}, doi = {10.3389/fphys.2021.654755}, pages = {1 -- 15}, year = {2021}, abstract = {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.}, language = {en} } @misc{JararnezhadgeroMamashliGranacher2021, author = {Jararnezhadgero, AmirAli and Mamashli, Elaheh and Granacher, Urs}, title = {An Endurance-Dominated Exercise Program Improves Maximum Oxygen Consumption, Ground Reaction Forces, and Muscle Activities in Patients With Moderate Diabetic Neuropathy}, series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, publisher = {Universit{\"a}tsverlag Potsdam}, address = {Potsdam}, issn = {1866-8364}, doi = {10.25932/publishup-54118}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-541182}, pages = {1 -- 15}, year = {2021}, abstract = {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.}, language = {en} }