@article{GranacherMuehlbauerGschwindetal.2014, author = {Granacher, Urs and M{\"u}hlbauer, Thomas and Gschwind, Y. J. and Pfenninger, B. and Kressig, R. W.}, title = {Assessment and training of strength and balance for fall prevention in the elderly. Recommendations of an interdisciplinary expert panel}, series = {Zeitschrift f{\"u}r Gerontologie und Geriatrie}, volume = {47}, journal = {Zeitschrift f{\"u}r Gerontologie und Geriatrie}, number = {6}, publisher = {Springer}, address = {Heidelberg}, issn = {0948-6704}, doi = {10.1007/s00391-013-0509-5}, pages = {513 -- 525}, year = {2014}, abstract = {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.}, language = {de} } @article{GranacherLacroixMuehlbaueretal.2013, author = {Granacher, Urs and Lacroix, Andre and M{\"u}hlbauer, Thomas and R{\"o}ttger, 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}, series = {Gerontology}, volume = {59}, journal = {Gerontology}, number = {2}, publisher = {Karger}, address = {Basel}, issn = {0304-324X}, doi = {10.1159/000343152}, pages = {105 -- 113}, year = {2013}, 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{LesinskiHortobagyiMuehlbaueretal.2016, author = {Lesinski, Melanie and Hortobagyi, Tibor and M{\"u}hlbauer, Thomas and Gollhofer, Albert and Granacher, Urs}, title = {Effects of Balance Training on Balance Performance in Healthy Older Adults: A Systematic Review and Meta-analysis (vol 45, pg 1721, 2015)}, series = {Sports medicine}, volume = {46}, journal = {Sports medicine}, publisher = {Springer}, address = {Northcote}, issn = {0112-1642}, doi = {10.1007/s40279-016-0500-6}, pages = {457 -- 457}, year = {2016}, language = {en} } @misc{GolleGranacherHoffmannetal.2014, author = {Golle, Kathleen and Granacher, Urs and Hoffmann, Martin and Wick, Ditmar and M{\"u}hlbauer, Thomas}, title = {Effect of living area and sports club participation on physical fitness in children}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-401418}, pages = {8}, year = {2014}, abstract = {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.}, language = {en} } @article{GranacherSchellbachKleinetal.2014, author = {Granacher, Urs and Schellbach, J{\"o}rg and Klein, Katja and Prieske, Olaf and Baeyens, Jean-Pierre and M{\"u}hlbauer, Thomas}, title = {Effects of core strength training using stable versus unstable surfaces on physical fitness in adolescents}, series = {BMC sports science, medicine \& rehabilitation}, volume = {6}, journal = {BMC sports science, medicine \& rehabilitation}, publisher = {BioMed Central}, address = {London}, issn = {2052-1847}, doi = {10.1186/2052-1847-6-40}, pages = {11}, year = {2014}, abstract = {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.}, language = {en} } @misc{GranacherGollhoferHortobagyietal.2013, author = {Granacher, Urs and Gollhofer, Albert and Hortobagyi, Tibor and Kressig, Reto W. and M{\"u}hlbauer, Thomas}, title = {The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors a systematic review}, series = {Sports medicine}, volume = {43}, journal = {Sports medicine}, number = {7}, publisher = {Springer}, address = {Auckland}, issn = {0112-1642}, doi = {10.1007/s40279-013-0041-1}, pages = {627 -- 641}, year = {2013}, abstract = {Background The aging process results in a number of functional (e.g., deficits in balance and strength/power performance), neural (e.g., loss of sensory/motor neurons), muscular (e.g., atrophy of type-II muscle fibers in particular), and bone-related (e.g., osteoporosis) deteriorations. Traditionally, balance and/or lower extremity resistance training were used to mitigate these age-related deficits. However, the effects of resistance training are limited and poorly translate into improvements in balance, functional tasks, activities of daily living, and fall rates. Thus, it is necessary to develop and design new intervention programs that are specifically tailored to counteract age-related weaknesses. Recent studies indicate that measures of trunk muscle strength (TMS) are associated with variables of static/dynamic balance, functional performance, and falls (i.e., occurrence, fear, rate, and/or risk of falls). Further, there is preliminary evidence in the literature that core strength training (CST) and Pilates exercise training (PET) have a positive influence on measures of strength, balance, functional performance, and falls in older adults. Objective The objectives of this systematic literature review are: (a) to report potential associations between TMS/trunk muscle composition and balance, functional performance, and falls in old adults, and (b) to describe and discuss the effects of CST/PET on measures of TMS, balance, functional performance, and falls in seniors. Data Sources A systematic approach was employed to capture all articles related to TMS/trunk muscle composition, balance, functional performance, and falls in seniors that were identified using the electronic databases PubMed and Web of Science (1972 to February 2013). Study Selection A systematic approach was used to evaluate the 582 articles identified for initial review. Cross-sectional (i.e., relationship) or longitudinal (i.e., intervention) studies were included if they investigated TMS and an outcome-related measure of balance, functional performance, and/or falls. In total, 20 studies met the inclusionary criteria for review. Study Appraisal and Synthesis Methods Longitudinal studies were evaluated using the Physiotherapy Evidence Database (PEDro) scale. Effect sizes (ES) were calculated whenever possible. For ease of discussion, the 20 articles were separated into three groups [i.e., cross-sectional (n = 6), CST (n = 9), PET (n = 5)]. Results The cross-sectional studies reported small-to-medium correlations between TMS/trunk muscle composition and balance, functional performance, and falls in older adults. Further, CST and/or PET proved to be feasible exercise programs for seniors with high-adherence rates. Age-related deficits in measures of TMS, balance, functional performance, and falls can be mitigated by CST (mean strength gain = 30 \%, mean effect size = 0.99; mean balance/functional performance gain = 23 \%, mean ES = 0.88) and by PET (mean strength gain = 12 \%, mean ES = 0.52; mean balance/functional performance gain = 18 \%, mean ES = 0.71). Limitations Given that the mean PEDro quality score did not reach the predetermined cut-off of >= 6 for the intervention studies, there is a need for more high-quality studies to explicitly identify the relevance of CST and PET to the elderly population. Conclusions Core strength training and/or PET can be used as an adjunct or even alternative to traditional balance and/or resistance training programs for old adults. Further, CST and PET are easy to administer in a group setting or in individual fall preventive or rehabilitative intervention programs because little equipment and space is needed to perform such exercises.}, language = {en} } @article{MuehlbauerBesemerWehrleetal.2013, author = {M{\"u}hlbauer, Thomas and Besemer, Carmen and Wehrle, Anja and Gollhofer, Albert and Granacher, Urs}, title = {Relationship between strength; balance and mobility in children aged 7-10 years}, series = {Gait \& posture}, volume = {37}, journal = {Gait \& posture}, number = {1}, publisher = {Elsevier}, address = {Clare}, issn = {0966-6362}, doi = {10.1016/j.gaitpost.2012.06.022}, pages = {108 -- 112}, year = {2013}, abstract = {The purpose of this study was to investigate the association between variables of lower extremity muscle strength, balance, and mobility assessed under various task conditions. Twenty-one healthy children (mean age: 9 +/- 1 years) were tested for their isometric and dynamic strength as well as for their steady-state, proactive, and reactive balance and mobility. Balance and mobility tests were conducted under single and dual task conditions. Significant positive correlations were detected between measures of isometric and dynamic leg muscle strength. Hardly any significant associations were observed between variables of strength and balance/mobility and between measures of steady-state, proactive, and reactive balance. Additionally, no significant correlations were detected between balance/mobility tests performed under single and dual task conditions. The predominately non-significant correlations between different balance components and mobility imply that balance and mobility performance is task specific. Further, strength and balance/mobility 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.}, 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{LacroixMuehlbauerGschwindetal.2016, author = {Lacroix, Andr{\´e} and M{\"u}hlbauer, Thomas and Gschwind, Y. J. and Pfenninger, B. and Kressig, R. W. and Br{\"u}gger, O. and Granacher, Urs}, title = {Effects of instructed counterpart independent Strength and Balance Training on Strength and Balance Performance of healthy elderly People: A randomized, controlled Study}, series = {Zeitschrift f{\~A}¼r Gerontologie und Geriatrie}, volume = {49}, journal = {Zeitschrift f{\~A}¼r Gerontologie und Geriatrie}, publisher = {Springer}, address = {Heidelberg}, issn = {0948-6704}, pages = {S12 -- S13}, year = {2016}, language = {de} } @misc{KibeleGranacherMuehlbaueretal.2015, author = {Kibele, Armin and Granacher, Urs and M{\"u}hlbauer, Thomas and Behm, David George}, title = {Stable, Unstable, and Metastable States of Equilibrium: Definitions and Applications to Human Movement}, series = {Journal of sports science \& medicine}, volume = {14}, journal = {Journal of sports science \& medicine}, number = {4}, publisher = {Department of Sports Medicine, Medical Faculty of Uludag University}, address = {Bursa}, issn = {1303-2968}, pages = {885 -- 887}, year = {2015}, language = {en} }