TY - JOUR A1 - Wochatz, Monique A1 - Engel, Tilman A1 - Müller, Steffen A1 - Mayer, Frank T1 - Alterations in scapular kinematics and scapular muscle activity after fatiguing shoulder flexion and extension movements JF - Medicine and science in sports and exercise : MSSE N2 - Repetitive overhead motions in combination with heavy loading were identified as risk factors for the development of shoulder pain. However, the underlying mechanism is not fully understood. Altered scapular kinematics as a result of muscle fatigue is suspected to be a contributor. PURPOSE: To determine scapular kinematics and scapular muscle activity at the beginning and end of constant shoulder flexion and extension loading in asymptomatic individuals. METHODS: Eleven asymptomatic adults (28±4yrs; 1.74±0.13m; 74±16kg) underwent maximum isokinetic loading of shoulder flexion (FLX) and extension (EXT) in the sagittal plane (ROM: 20- 180°; concentric mode; 180°/s) until individual peak torque was reduced by 50%. Simultaneously 3D scapular kinematics were assessed with a motion capture system and scapular muscle activity with a 3-lead sEMG of upper and lower trapezius (UT, LT) and serratus anterior (SA). Scapular position angles were calculated for every 20° increment between 20-120° humerothoracic positions. Muscle activity was quantified by amplitudes (RMS) of the total ROM. Descriptive analyses (mean±SD) of kinematics and muscle activity at begin (taskB) and end (taskE) of the loading task was followed by ANOVA and paired t-tests. RESULTS: At taskB activity ranged from 589±343mV to 605±250mV during FLX and from 105±41mV to 164±73mV during EXT across muscles. At taskE activity ranged from 594±304mV to 875±276mV during FLX and from 97±33mV to 147±57mV during EXT. Differences with increased muscle activity were seen for LT and UT during FLX (meandiff= 141±113mV for LT, p<0.01; 191±153mV for UT, p<0.01). Scapula position angles continuously increased in upward rotation, posterior tilt and external rotation during FLX and reversed during EXT both at taskB and taskE. At taskE scapula showed greater external rotation (meandiff= 3.6±3.7°, p<0.05) during FLX and decreased upward rotation (meandiff= 1.9±2.3°, p<0.05) and posterior tilt (meandiff= 1.0±2.1°, p<0.05) during EXT across humeral positions. CONCLUSIONS: Force reduction in consequence of fatiguing shoulder loading results in increased scapular muscle activity and minor alterations in scapula motion. Whether even small changes have a clinical impact by creating unfavorable subacromial conditions potentially initiating pain remains unclear. Y1 - 2020 U6 - https://doi.org/10.1249/01.mss.0000676540.02017.2c SN - 0195-9131 SN - 1530-0315 VL - 52 IS - 17 SP - 274 EP - 274 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Wochatz, Monique A1 - Schraplau, Anne A1 - Engel, Tilman A1 - Zecher, Mahli Megan A1 - Sharon, Hadar A1 - Alt, Yasmin A1 - Mayer, Frank A1 - Kalron, Alon T1 - Application of eccentric training in various clinical populations BT - Protocol for a multi-centered pilot and feasibility study in people with low back pain and people with multiple sclerosis JF - PLoS ONE N2 - Physical activity and exercise are effective approaches in prevention and therapy of multiple diseases. Although the specific characteristics of lengthening contractions have the potential to be beneficial in many clinical conditions, eccentric training is not commonly used in clinical populations with metabolic, orthopaedic, or neurologic conditions. The purpose of this pilot study is to investigate the feasibility, functional benefits, and systemic responses of an eccentric exercise program focused on the trunk and lower extremities in people with low back pain (LBP) and multiple sclerosis (MS). A six-week eccentric training program with three weekly sessions is performed by people with LBP and MS. The program consists of ten exercises addressing strength of the trunk and lower extremities. The study follows a four-group design (N = 12 per group) in two study centers (Israel and Germany): three groups perform the eccentric training program: A) control group (healthy, asymptomatic); B) people with LBP; C) people with MS; group D (people with MS) receives standard care physiotherapy. Baseline measurements are conducted before first training, post-measurement takes place after the last session both comprise blood sampling, self-reported questionnaires, mobility, balance, and strength testing. The feasibility of the eccentric training program will be evaluated using quantitative and qualitative measures related to the study process, compliance and adherence, safety, and overall program assessment. For preliminary assessment of potential intervention effects, surrogate parameters related to mobility, postural control, muscle strength and systemic effects are assessed. The presented study will add knowledge regarding safety, feasibility, and initial effects of eccentric training in people with orthopaedic and neurological conditions. The simple exercises, that are easily modifiable in complexity and intensity, are likely beneficial to other populations. Thus, multiple applications and implementation pathways for the herein presented training program are conceivable. Y1 - 2022 U6 - https://doi.org/10.1371/journal.pone.0270875 SN - 1932-6203 VL - 17 IS - 12 PB - Public Library of Science CY - San Francisco, California, USA ER - TY - JOUR A1 - Henschke, Jakob A1 - Kaplick, Hannes A1 - Wochatz, Monique A1 - Engel, Tilman T1 - Assessing the validity of inertial measurement units for shoulder kinematics using a commercial sensor-software system BT - a validation study JF - Health science reports N2 - Background and Aims Wearable inertial sensors may offer additional kinematic parameters of the shoulder compared to traditional instruments such as goniometers when elaborate and time-consuming data processing procedures are undertaken. However, in clinical practice simple-real time motion analysis is required to improve clinical reasoning. Therefore, the aim was to assess the criterion validity between a portable "off-the-shelf" sensor-software system (IMU) and optical motion (Mocap) for measuring kinematic parameters during active shoulder movements. Methods 24 healthy participants (9 female, 15 male, age 29 +/- 4 years, height 177 +/- 11 cm, weight 73 +/- 14 kg) were included. Range of motion (ROM), total range of motion (TROM), peak and mean angular velocity of both systems were assessed during simple (abduction/adduction, horizontal flexion/horizontal extension, vertical flexion/extension, and external/internal rotation) and complex shoulder movements. Criterion validity was determined using intraclass-correlation coefficients (ICC), root mean square error (RMSE) and Bland and Altmann analysis (bias; upper and lower limits of agreement). Results ROM and TROM analysis revealed inconsistent validity during simple (ICC: 0.040-0.733, RMSE: 9.7 degrees-20.3 degrees, bias: 1.2 degrees-50.7 degrees) and insufficient agreement during complex shoulder movements (ICC: 0.104-0.453, RMSE: 10.1 degrees-23.3 degrees, bias: 1.0 degrees-55.9 degrees). Peak angular velocity (ICC: 0.202-0.865, RMSE: 14.6 degrees/s-26.7 degrees/s, bias: 10.2 degrees/s-29.9 degrees/s) and mean angular velocity (ICC: 0.019-0.786, RMSE:6.1 degrees/s-34.2 degrees/s, bias: 1.6 degrees/s-27.8 degrees/s) were inconsistent. Conclusions The "off-the-shelf" sensor-software system showed overall insufficient agreement with the gold standard. Further development of commercial IMU-software-solutions may increase measurement accuracy and permit their integration into everyday clinical practice. KW - diagnostic techniques and procedures KW - kinematics KW - shoulder joint KW - validation study KW - wearable devices Y1 - 2022 U6 - https://doi.org/10.1002/hsr2.772 SN - 2398-8835 VL - 5 IS - 5 SP - 1 EP - 11 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Scharhag-Rosenberger, Friederike A1 - Wochatz, Monique A1 - Otto, Christoph A1 - Cassel, Michael A1 - Mayer, Frank A1 - Scharhag, Jürgen T1 - Blood lactate concentrations are mildly affected by mobile gas exchange measurements JF - International journal of sports medicine N2 - We sought to investigate the effects of wearing a mobile respiratory gas analysis system during a treadmill test on blood lactate (bLa) concentrations and commonly applied bLa thresholds. A total of 16 recreational athletes (31 +/- 3 years, V0205: 58 6 ml min(-1)-kg(-1)) performed one multistage treadmill test with and one without gas exchange measurements (GEM and noGEM). The whole bLa curve, the lactate threshold (LT), the individual anaerobic thresholds according to Stegmann(IAT(sr)) and Dickhuth (IAT(Di)), and a fixed bLa concentration of 4 mmob.l(-1) (OBLA) were evaluated. The bLa curve was shifted slightly leftward in GEM compared to noGEM (P<0.05), whereas the heart rate response was not different between conditions (P= 0.89). There was no difference between GEM and noGEM for LT (2.61 +/- 0.34 vs. 2.64 +/- 0.39 m(-1) s(-1) P=0.49) and IAT(st) (3.47 +/- 0.42 vs. 3.55 +/- 0.47m-s(-1), P=0.12). However, IATD(Di) (3.57 +/- 0.39 vs. 3.66 +/- 0.44m-s(-1), P<0.01) and OBLA (3.85 +/- 0.46 vs. 3.96 +/- 0.47m-s-1, P<0.01) occurred at slower running velocities in GEM. The bLa response to treadmill tests is mildly affected by wearing a mobile gas analysis system. This also applies to bLa thresholds located at higher exercise intensities. While the magnitude of the effects is of little importance for recreational athletes, it might be relevant for elite athletes and scientific studies. KW - cardiopulmonary exercise testing KW - performance diagnostics KW - lactate threshold KW - VO2mdx KW - metabolic device Y1 - 2014 U6 - https://doi.org/10.1055/s-0033-1354386 SN - 0172-4622 SN - 1439-3964 VL - 35 IS - 7 SP - 590 EP - 594 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Khajooei, Mina A1 - Wochatz, Monique A1 - Baritello, Omar A1 - Mayer, Frank T1 - Effects of shoes on children’s fundamental motor skills performance JF - Footwear science : official journal of the Footwear Biomechanics Group N2 - 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. KW - Spatiotemporal KW - kinetics KW - jumping KW - stability KW - gait Y1 - 2019 U6 - https://doi.org/10.1080/19424280.2019.1696895 SN - 1942-4280 SN - 1942-4299 VL - 12 IS - 1 SP - 55 EP - 62 PB - Taylor & Francis CY - Abingdon ER - TY - JOUR A1 - Engel, Tilman A1 - Schraplau, Anne A1 - Wochatz, Monique A1 - Kopinski, Stephan A1 - Sonnenburg, Dominik A1 - Schomöller, Anne A1 - Risch, Lucie A1 - Kaplick, Hannes A1 - Mayer, Frank T1 - Feasability of An Eccentric Isokinetic Protocol to Induce Trunk Muscle Damage: A Pilot Study JF - Sports Medicine International Open N2 - Eccentric exercise is discussed as a treatment option for clinical populations, but specific responses in terms of muscle damage and systemic inflammation after repeated loading of large muscle groups have not been conclusively characterized. Therefore, this study tested the feasibility of an isokinetic protocol for repeated maximum eccentric loading of the trunk muscles. Nine asymptomatic participants (5 f/4 m; 34±6 yrs; 175±13 cm; 76±17 kg) performed three isokinetic 2-minute all-out trunk strength tests (1x concentric (CON), 2x eccentric (ECC1, ECC2), 2 weeks apart; flexion/extension, 60°/s, ROM 55°). Outcomes were peak torque, torque decline, total work, and indicators of muscle damage and inflammation (over 168 h). Statistics were done using the Friedman test (Dunn’s post-test). For ECC1 and ECC2, peak torque and total work were increased and torque decline reduced compared to CON. Repeated ECC bouts yielded unaltered torque and work outcomes. Muscle damage markers were highest after ECC1 (soreness 48 h, creatine kinase 72 h; p<0.05). Their overall responses (area under the curve) were abolished post-ECC2 compared to post-ECC1 (p<0.05). Interleukin-6 was higher post-ECC1 than CON, and attenuated post-ECC2 (p>0.05). Interleukin-10 and tumor necrosis factor-α were not detectable. All markers showed high inter-individual variability. The protocol was feasible to induce muscle damage indicators after exercising a large muscle group, but the pilot results indicated only weak systemic inflammatory responses in asymptomatic adults. KW - exercise KW - eccentric KW - muscle fatigue KW - trunk muscles KW - isokinetics KW - repeated bout effect KW - inflammation KW - exercise induced muscle damage KW - interleukin-6 KW - internleukin-10 KW - tumor necrosis factor-α Y1 - 2021 U6 - https://doi.org/10.1055/a-1757-6724 SN - 2367-1890 VL - 6 SP - E9 EP - E17 PB - Thieme CY - Stuttgart ET - 1 ER - TY - JOUR A1 - Schomöller, Anne A1 - Risch, Lucie A1 - Kaplick, Hannes A1 - Wochatz, Monique A1 - Engel, Tilman A1 - Schraplau, Anne A1 - Sonnenburg, Dominik A1 - Huppertz, Alexander A1 - Mayer, Frank T1 - Inter-rater and inter-session reliability of lumbar paraspinal muscle composition in a mobile MRI device JF - BJR : an international journal of radiology, radiation oncology and all related sciences / British Institute of Radiology N2 - Objective: To assess the reliability of measurements of paraspinal muscle transverse relaxation times (T2 times) between two observers and within one observer on different time points.
Methods: 14 participants (9f/5m, 33 +/- 5 years, 176 +/- 10 cm, 73 +/- 12 kg) underwent 2 consecutive MRI scans (M1,M2) on the same day, followed by 1 MRI scan 13-14 days later (M3) in a mobile 1.5 Tesla MRI. T2 times were calculated in T-2 weighted turbo spin- echo-sequences at the spinal level of the third lumbar vertebrae (11 slices, 2 mm slice thickness, 1 mm interslice gap, echo times: 20, 40, 60, 80, 100 ms) for M. erector spinae (ES) and M. multifidius (MF). The following reliability parameter were calculated for the agreement of T2 times between two different investigators (OBS1 & OBS2) on the same MRI (inter rater reliability, IR) and by one investigator between different MRI of the same participant (intersession variability, IS): Test-Retest Variability (TRV, Differences/Mean*100); Coefficient of Variation (CV, Standard deviation/Mean*100); Bland-Altman Analysis (systematic bias = Mean of the Differences; Upper/Lower Limits of Agreement = Bias+/-1.96*SD); Intraclass Correlation Coefficient 3.1 (ICC) with absolute agreement, as well as its 95% confidence interval.
Results: Mean TRV for IR was 2.6% for ES and 4.2% for MF. Mean TRV for IS was 3.5% (ES) and 5.1% (MF). Mean CV for IR was 1.9 (ES) and 3.0 (MF). Mean CV for IS was 2.5% (ES) and 3.6% (MF). A systematic bias of 1.3 ms (ES) and 2.1 ms (MF) were detected for IR and a systematic bias of 0.4 ms (ES) and 0.07 ms (MF) for IS. ICC for IR was 0.94 (ES) and 0.87 (MF). ICC for IS was 0.88 (ES) and 0.82 (MF).
Conclusion: Reliable assessment of paraspinal muscle T2 time justifies its use for scientific purposes. The applied technique could be recommended to use for future studies that aim to assess changes of T2 times, e.g. after an intense bout of eccentric exercises. Y1 - 2021 U6 - https://doi.org/10.1259/bjr.20210141 SN - 0007-1285 SN - 1748-880X VL - 94 IS - 1127 PB - Wiley CY - Bognor Regis ER - TY - JOUR A1 - Wochatz, Monique A1 - Rabe, Sophie A1 - Wolter, Martin A1 - Engel, Tilman A1 - Mueller, Steffen A1 - Mayer, Frank T1 - Muscle activity of upper and lower trapezius and serratus anterior during unloaded and maximal loaded shoulder flexion and extension JF - International Biomechanics N2 - Altered scapular muscle activity is mostly described under unloaded and submaximal loaded conditions in impingement patients. However, there is no clear evidence on muscle activity with respect to movement phases under maximum load in healthy subjects. Therefore, this study aimed to investigate scapular muscle activity under unloaded and maximum loaded isokinetic shoulder flexion and extension in regard to the movement phase. Fourteen adults performed unloaded (continuous passive motion [CPM]) as well as maximum loaded (concentric [CON], eccentric [ECC]) isokinetic shoulder flexion (Flex) and extension (Ext). Simultaneously, scapular muscle activity was measured by EMG. Root mean square was calculated for the whole ROM and four movement phases. Data were analyzed descriptively and by two-way repeated measures ANOVA. CPMFlex resulted in a linear increase of muscle activity for all muscles. Muscle activity during CONFlex and ECCFlex resulted in either constant activity levels or in an initial increase followed by a plateau in the second half of movement. CPMExt decreased with the progression of movement, whereas CONExt and ECCExt initially decreased and either levelled off or increased in the second half of movement. Scapular muscle activity of unloaded shoulder flexion and extension changed under maximum load showing increased activity levels and an altered pattern over the course of movement. KW - shoulder KW - scapular muscle activity KW - isokinetic testing KW - electromyography Y1 - 2017 U6 - https://doi.org/https://doi.org/10.1080/23335432.2017.1364668 VL - 4 IS - 2 SP - 68 EP - 76 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Wochatz, Monique A1 - Tilgner, Nina A1 - Mueller, Steffen A1 - Rabe, Sophie A1 - Eichler, Sarah A1 - John, Michael A1 - Völler, Heinz A1 - Mayer, Frank T1 - Reliability and validity of the Kinect V2 for the assessment of lower extremity rehabilitation exercises JF - Gait & posture N2 - Research question: The purpose of this study was to evaluate the test-retest reliability of lower extremity kinematics during squat, hip abduction and lunge exercises captured by the Kinect and to evaluate the agreement to a reference 3D camera-based motion system. Methods: Twenty-one healthy individuals performed five repetitions of each lower limb exercise on two different days. Movements were simultaneously assessed by the Kinect and the reference 3D motion system. Joint angles and positions of the lower limb were calculated for sagittal and frontal plane. For the inter-session reliability and the agreement between the two systems standard error of measurement (SEM), bias with limits of agreement (LoA) and Pearson Correlation Coefficient (r) were calculated. Results: Parameters indicated varying reliability for the assessed joint angles and positions and decreasing reliability with increasing task complexity. Across all exercises, measurement deviations were shown especially for small movement amplitudes. Variability was acceptable for joint angles and positions during the squat, partially acceptable during the hip abduction and predominately inacceptable during the lunge. The agreement between systems was characterized by systematic errors. Overestimations by the Kinect were apparent for hip flexion during the squat and hip abduction/adduction during the hip abduction exercise as well as for the knee positions during the lunge. Knee and hip flexion during hip abduction and lunge were underestimated by the Kinect. Significance: The Kinect system can reliably assess lower limb joint angles and positions during simple exercises. The validity of the system is however restricted. An application in the field of early orthopedic rehabilitation without further development of post-processing techniques seems so far limited. KW - Reproducibility KW - Agreement KW - Markerless motion capture system KW - Telerehabilitation Y1 - 2018 U6 - https://doi.org/10.1016/j.gaitpost.2019.03.020 SN - 0966-6362 SN - 1879-2219 VL - 70 SP - 330 EP - 335 PB - Elsevier CY - Clare ER - TY - JOUR A1 - Risch, Lucie A1 - Wochatz, Monique A1 - Messerschmidt, Janin A1 - Engel, Tilman A1 - Mayer, Frank A1 - Cassel, Michael T1 - Reliability of evaluating achilles tendon vascularization assessed with doppler ultrasound advanced dynamic flow JF - Journal of ultrasound in medicine N2 - The reliability of quantifying intratendinous vascularization by high-sensitivity Doppler ultrasound advanced dynamic flow has not been examined yet. Therefore, this study aimed to investigate the intraobserver and interobserver reliability of evaluating Achilles tendon vascularization by advanced dynamic flow using established scoring systems. Methods-Three investigators evaluated vascularization in 67 recordings in a test-retest design, applying the Ohberg score, a modified Ohberg score, and a counting score. Intraobserver and interobserver agreement for the Ohberg score and modified Ohberg score was analyzed by the Cohen kappa and Fleiss kappa coefficients (absolute), Kendall tau b coefficient, and Kendall coefficient of concordance (W; relative). The reliability of the counting score was analyzed by intraclass correlation coefficients (ICC) 2.1 and 3.1, the standard error of measurement (SEM), and Bland-Altman analysis (bias and limits of agreement [LoA]). Results-Intraobserver and interobserver agreement (absolute/relative) ranged from 0.61 to 0.87/0.87 to 0.95 and 0.11 to 0.66/0.76 to 0.89 for the Ohberg score and from 0.81 to 0.87/0.92 to 0.95 and 0.64 to 0.80/0.88 to 0.93 for the modified Ohberg score, respectively. The counting score revealed an intraobserver ICC of 0.94 to 0.97 (SEM, 1.0-1.5; bias, -1; and LoA, 3-4 vessels). The interobserver ICC for the counting score ranged from 0.91 to 0.98 (SEM, 1.0-1.9; bias, 0; and LoA, 3-5 vessels). Conclusions-The modified Ohberg score and counting score showed excellent reliability and seem convenient for research and clinical practice. The Ohberg score revealed decent intraobserver but unexpected low interobserver reliability and therefore cannot be recommended. KW - advanced dynamic flow KW - intratendinous blood flow KW - musculoskeletal KW - reliability KW - ultrasound Y1 - 2017 U6 - https://doi.org/10.1002/jum.14414 SN - 0278-4297 SN - 1550-9613 VL - 37 IS - 3 SP - 737 EP - 744 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Wochatz, Monique A1 - Rabe, Sophie A1 - Wolter, Martin A1 - Engel, Tilman A1 - Mueller, Steffen A1 - Mayer, Frank T1 - Reproducibility of scapular muscle activity in isokinetic shoulder flexion and extension JF - Journal of electromyography and kinesiology N2 - Repetitive overhead movements have been identified as a main risk factor to develop shoulder complaints with scapular muscle activity being altered. Reliable assessment of muscle activity is essential to differentiate between symptomatic and asymptomatic individuals. Therefore, the present study aimed to investigate the intra-and inter-session reliability of scapular muscle activity during maximal isokinetic shoulder flexion and extension. Eleven asymptomatic adults performed maximum effort isokinetic shoulder flexion and extension (concentric and eccentric at 60 degrees/s) in a test-retest design. Muscle activity of the upper and lower trapezius and serratus anterior was assessed by sEMG. Root Mean Square was calculated for whole ROM and single movement phases of absolute and normalized muscle activity. Absolute (Bland-Altman analysis (Bias, LoA), Minimal detectable change (MDC)) and relative reliability parameters (Intraclass correlation coefficient (ICC), coefficient of variation (CV)/test-retest variability (TRV)) were utilized for the evaluation of reproducibility. Intra-session reliability revealed ICCs between 0.56 and 0.98, averaged CVs of 18% and average MDCs of 81 mV. Inter-session reliability resulted in ICCs between 0.13 and 0.93, averaged TRVs of 21%, average MDCs of 15% and systematic and random error between -8 +/- 60% and 12 +/- 36%. Scapular muscle activity assessed in overhead movements can be measured reliably under maximum load conditions, though variability is dependent on the movement phase. Measurement variability does not exceed magnitudes of altered scapular muscle activities as reported in previous studies. Therefore, maximum load application is a promising approach for the evaluation of changes in scapular control related to pathologies. (C) 2017 Elsevier Ltd. All rights reserved. Y1 - 2017 U6 - https://doi.org/10.1016/j.jelekin.2017.04.006 SN - 1050-6411 SN - 1873-5711 VL - 34 SP - 86 EP - 92 PB - Elsevier CY - Oxford ER - TY - JOUR A1 - Wochatz, Monique A1 - Rabe, Sophie A1 - Engel, Tilman A1 - Müller, Steffen A1 - Mayer, Frank T1 - Scapular kinematics during unloaded and maximal loaded isokinetic concentric and eccentric shoulder flexion and extension movements JF - Journal of electromyography & kinesiology : official journal of the International Society of Electrophysiology and Kinesiology N2 - Characterization of scapular kinematics under demanding load conditions might aid to distinguish between physiological and clinically relevant alterations. Previous investigations focused only on submaximal external load situations. How scapular movement changes with maximal load remains unclear. Therefore, the present study aimed to evaluate 3D scapular kinematics during unloaded and maximal loaded shoulder flexion and extension. Twelve asymptomatic individuals performed shoulder flexion and extension movements under unloaded and maximal concentric and eccentric loaded isokinetic conditions. 3D scapular kinematics assessed with a motion capture system was analyzed for 20° intervals of humeral positions from 20° to 120° flexion. Repeated measures ANOVAs were used to evaluate kinematic differences between load conditions for scapular position angles, scapulohumeral rhythm and scapular motion extent. Increased scapular upward rotation was seen during shoulder flexion and extension as well as decreased posterior tilt and external rotation during eccentric and concentric arm descents of maximal loaded compared to unloaded conditions. Load effects were further seen for the scapulohumeral rhythm with greater scapular involvement at lower humeral positions and increased scapular motion extent under maximal loaded shoulder movements. With maximal load applied to the arm physiological scapular movement pattern are induced that may imply both impingement sparing and causing mechanisms. KW - Isokinetics KW - Motion analysis KW - Scapular dyskinesis KW - Scapulohumeral rhythm KW - Scapulothoracic Y1 - 2020 U6 - https://doi.org/10.1016/j.jelekin.2021.102517 SN - 1050-6411 SN - 1873-5711 VL - 57 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Eichler, Sarah A1 - Salzwedel, Annett A1 - Rabe, Sophie A1 - Mueller, Steffen A1 - Mayer, Frank A1 - Wochatz, Monique A1 - Hadzic, Miralem A1 - John, Michael A1 - Wegscheider, Karl A1 - Völler, Heinz T1 - The Effectiveness of Telerehabilitation as a Supplement to Rehabilitation in Patients After Total Knee or Hip Replacement BT - Randomized Controlled Trial JF - JMIR Rehabilitation and Assistive Technologies N2 - Background: Telerehabilitation can contribute to the maintenance of successful rehabilitation regardless of location and time. The aim of this study was to investigate a specific three-month interactive telerehabilitation routine regarding its effectiveness in assisting patients with physical functionality and with returning to work compared to typical aftercare. Objective: The aim of the study was to investigate a specific three-month interactive telerehabilitation with regard to effectiveness in functioning and return to work compared to usual aftercare. Methods: From August 2016 to December 2017, 111 patients (mean 54.9 years old; SD 6.8; 54.3% female) with hip or knee replacement were enrolled in the randomized controlled trial. At discharge from inpatient rehabilitation and after three months, their distance in the 6-minute walk test was assessed as the primary endpoint. Other functional parameters, including health related quality of life, pain, and time to return to work, were secondary endpoints. Results: Patients in the intervention group performed telerehabilitation for an average of 55.0 minutes (SD 9.2) per week. Adherence was high, at over 75%, until the 7th week of the three-month intervention phase. Almost all the patients and therapists used the communication options. Both the intervention group (average difference 88.3 m; SD 57.7; P=.95) and the control group (average difference 79.6 m; SD 48.7; P=.95) increased their distance in the 6-minute-walk-test. Improvements in other functional parameters, as well as in quality of life and pain, were achieved in both groups. The higher proportion of working patients in the intervention group (64.6%; P=.01) versus the control group (46.2%) is of note. Conclusions: The effect of the investigated telerehabilitation therapy in patients following knee or hip replacement was equivalent to the usual aftercare in terms of functional testing, quality of life, and pain. Since a significantly higher return-to-work rate could be achieved, this therapy might be a promising supplement to established aftercare. KW - telerehabilitation KW - home-based KW - total hip replacement KW - total knee replacement KW - exercise therapy KW - aftercare KW - rehabilitation Y1 - 2019 U6 - https://doi.org/10.2196/14236 SN - 2369-2529 VL - 6 IS - 2 PB - jmir rehab CY - Toronto ER -