610 Medizin und Gesundheit
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- Punch (2)
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- Wirbelsäule (2)
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- Young athletes (2)
- Zeitschrift (2)
- academic-achievement (2)
- academy (2)
- accuracy (2)
- achilles tendinopathy (2)
- acid ceramidase (2)
- acute chronic workload ratio (2)
- acute coronary event (2)
- adaptation to external force impact (2)
- adaptive holding capacity (2)
- addiction (2)
- adjectives (2)
- adolescent sport (2)
- aerobic power (2)
- aflatoxin B1 (2)
- aftercare (2)
- aged (2)
- agility (2)
- aging brain (2)
- alcohol consumption (2)
- aldehyde oxidase (2)
- allometry (2)
- allostatic load index (2)
- alpha-2 (2)
- alphaherpesvirus (2)
- alternative rewards (2)
- amateur soccer players (2)
- ambiguities (2)
- anatoxin (2)
- anger (2)
- animal and computational models (2)
- ankles (2)
- anorexia nervosa (2)
- anterior cruciate ligament (2)
- anti-cancer drugs (2)
- anti-doping (2)
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- antibiotic inactivation (2)
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- applicants for international protection (2)
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- aquaporin (2)
- arabidopsis-thaliana (2)
- artificial intelligence for health (2)
- asylum seekers (2)
- athlete (2)
- autonomy support (2)
- back-pain screening (2)
- bacteria (2)
- bacteriophage (2)
- balance strategy (2)
- basic need satisfaction and frustration (2)
- basic psychological needs (2)
- behavioral weight loss (2)
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- decomposition (2)
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- development (2)
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- evaluation (2)
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Die interventionelle Behandlung des Vorhofflimmerns verursacht häufiger als in der Vergangenheit wahrgenommen eine Beeinträchtigung benachbarter Gewebe und Organe. Im Vordergrund der Betrachtungen dieser Arbeit stehen Schäden des Oesophagus, die aufgrund der schlechten Vorhersagbarkeit, des zeitlich verzögerten Auftretens und der fatalen Prognose bei Ausbildung einer atrio-oesophagealen Fistel besondere Relevanz haben.
Das Vorhofflimmern selbst ist nicht mit einer unmittelbaren vitalen Bedrohung verbunden, aber durch seine Komplikationen (z.B. Herzinsuffizienz, Schlaganfall) dennoch prognostisch relevant. Durch Antiarrhythmika gelingt keine Verbesserung der Rhythmuskontrolle (Arrhythmie-Freiheit), eine katheterinterventionelle Behandlung ist der medikamentösen Therapie überlegen. Durch eine frühzeitige und erfolgreiche Behandlung des Vorhofflimmerns konnte eine Verbesserung klinischer Endpunkte und der Prognose erreicht werden. Das Risiko einer invasiven Behandlung (insbesondere hinsichtlich des Auftretens prognoserelevanter Komplikationen) muss jedoch bei der Indikationsstellung und der Prozedur-Durchführung bedacht und gegenüber den günstigen Effekten der Behandlung abgewogen werden.
Untersuchungen zur Vermeidung der sehr seltenen atrio-oesophagealen Fisteln bedienen sich Surrogat-Parametern, hier bisher ausschließlich den ablationsinduzierten Schleimhaut-Läsionen des Oesophagus. Die Untersuchungen dieser Arbeit zeigen ein komplexeres Bild der (peri)-oesophagealen Schädigungen nach Vorhofflimmern-Ablation mit thermischen Energiequellen.
(1) Neue Definition der Oesophagus-Schäden: Oesophageale und perioesophageale Beeinträchtigungen treten sehr häufig auf (nach der hier verwendeten erweiterten Definition bei zwei Drittel der Patienten) und sind unabhängig von der verwendeten Ablationsenergie. Unterschiede finden sich in den Manifestationen der Oesophagus-Schäden für die verschiedenen Energie-Protokolle, ohne dass der Mechanismus hierfür aufgeklärt ist. Diese Arbeit beschreibt die unterschiedlichen Ausprägungen thermischer Oesophagus-Schäden, deren Determinanten und pathophysiologische Relevanz.
(2) Die Detektion (zum Teil subtiler) Oesophagus-Schäden ist maßgeblich von der Intensität der Nachsorge abhängig. Eine Beschränkung auf subjektive Schilderungen (z.B. Schmerzen beim Schluckakt, Sodbrennen) ist irreführend, die Mehrzahl der Veränderungen bleibt asymptomatisch, die Symptome der ausgebildeten atrio-oesophagealen Fistel (meist nach mehreren Wochen) bereits mit einer sehr schlechten Prognose belastet. Eine Endoskopie der Speiseröhre findet in den meisten elektrophysiologischen Zentren nicht oder nur bei anhaltenden Symptomen statt und kann ausschließlich Mukosa-Läsionen nachweisen. Damit wird das Ausmaß des oesophagealen und perioesophagealen Schadens bei Weitem unterschätzt. Veränderungen des perioesophagealen Raums, deren klinische Relevanz (noch) unklar ist, werden nicht erfasst, und damit ein Wandödem und Schäden im Gewebe zwischen linkem Vorhof und Speiseröhre (einschl. Nerven und Gefäßen) ignoriert.
Die Studien tragen auch zur Neubewertung etablierter Messgrößen und Risikofaktoren der Oesophagus-Schäden bei.
(3) Das Temperaturmonitoring im Oesophagus anhand der Maximalabweichungen ist erst für Extremwerte aussagekräftig und dadurch nicht hilfreich, Oesophagus-Läsionen zu vermeiden. Die komplexe Analyse der Temperatur-Rohdaten (bisher nur offline möglich) liefert in der AUC für RF-Ablationen einen prädiktiven Parameter für Oesophagus-Schäden, der eine Strukturierung der weiteren endoskopischen Diagnostik erlaubt. Ein vergleich¬barer Wert für die Cryoablationen konnte in den Analysen nicht gefunden werden.
(4) Eine chronische Entzündung des unteren Oesophagus-Drittels behindert nicht nur das Abheilen einer thermischen Oesophagus-Läsion, sondern kann das Auftreten solcher Läsionen durch die Ablation begünstigen. Die große Zahl vorbestehender Oesophagus-Veränderungen, die eine erhöhte Vulnerabilität anzeigen, und die Bedeutung für die Ent¬stehung thermischer Läsionen können der Ansatzpunkt präventiver Maßnahmen sein.
Ergänzend werden Ausprägungen der Oesophagus-Schäden durch umfangreiche Diagnostik erfasst und beschrieben, die aus pathophysiologischen Überlegungen relevant sein können.
(5) Die systematische Erweiterung der bildgebenden Diagnostik auf den perioesophagealen Raum durch Endosonographie zeigte, dass Schleimhaut-Läsionen alleine nur einen geringen Teil der Oesophagus-Schäden darstellen. Schleimhaut-Läsionen infolge einer instrumentellen Verletzung sind nicht mit dem Risiko der Ausbildung einer atrio-oesophagealen Fistel verbunden und unterstreichen die pathophysiologische Relevanz der perioesophagealen Veränderungen.
(6) Eine funktionelle Diagnostik thermischer Schäden des perioesophagealen Vagus-Plexus identifiziert Patienten mit Oesophagus-Schäden, die bildgebend nicht erfasst wurden, jedoch in ihren Auswirkungen (Nahrungsretention und gastro-oesophagealer Reflux) zur Läsionsprogression beitragen können.
Background: The characteristics of osteoporosis are decreased bone mass and destruction towards the microarchitecture of bone tissue, which raises the risk of fracture. Psychosocialstress and osteoporosis are linked by sympathetic nervous system, hypothalamic-pituitary-adrenal axis, and other endocrine factors. Psychosocial stress causes a series of effects on the organism, and this long-term depletion at the cellular level is considered to be mitochondrial allostatic load, including mitochondrial dysfunction and oxidative stress. Extracellular vesicles (EVs) are involved in the mitochondrial allostatic load process and may as biomarkers in this setting. As critical participants during cell-to-cell communications, EVs serve as transport vehicles for nucleic acid and proteins, alter the phenotypic and functional characteristics of their target cells, and promote cell-to-cell contact. And hence, they play a significant role in the diagnosis and therapy of many diseases, such as osteoporosis.
Aim: This narrative review attempts to outline the features of EVs, investigate their involvement in both psychosocial stress and osteoporosis, and analyze if EVs can be potential mediators between both.
Methods: The online database from PubMed, Google Scholar, and Science Direct were searched for keywords related to the main topic of this study, and the availability of all the selected studies was verified. Afterward, the findings from the articles were summarized and synthesized.
Results: Psychosocial stress affects bone remodeling through increased neurotransmitters such as glucocorticoids and catecholamines, as well as increased glucose metabolism. Furthermore, psychosocial stress leads to mitochondrial allostatic load, including oxidative stress, which may affect bone remodeling. In vitro and in vivo data suggest EVs might involve in the link between psychosocial stress and bone remodeling through the transfer of bioactive substances and thus be a potential mediator of psychosocial stress leading to osteoporosis.
Conclusions: According to the included studies, psychosocial stress affects bone remodeling, leading to osteoporosis. By summarizing the specific properties of EVs and the function of EVs in both psychosocial stress and osteoporosis, respectively, it has been demonstrated that EVs are possible mediators of both, and have the prospects to be useful in innovative research areas.
Im Zuge der Corona-Pandemie ist die alte Debatte über eine stärkere Berücksichtigung von gesundheitsschädlichem Vorverhalten Versicherter neu entflammt. Sollen nichtgeimpfte Versicherte bei einer Erkrankung mit Covid-19 an ihren Behandlungskosten beteiligt werden?[1] Mit § 52 SGB V existiert zwar eine Vorschrift, die es den Krankenkassen ermöglicht, Versicherte an den Kosten ihrer Krankenbehandlung zu beteiligen, eine Beteiligung nichtgeimpfter Versicherter an den Kosten ihrer Coronakrankheit wirft aber materiell-rechtlich und prozessual Probleme auf. Der Gesetzgeber könnte allerdings bei Wahrung des Verhältnismäßigkeitsprinzips und des allgemeinen Gleichheitssatzes eine Vorschrift zur Kostenbeteiligung Versicherter bei Nichtimpfung gegen Covid-19 einführen und das Solidarprinzip auf diese Weise neu justieren. Der Grundsatz der Eigenverantwortung ist Kernbestandteil und nicht Fremdkörper des Solidarprinzips. Das solidarische Finanzierungskonzept der gesetzlichen Krankenversicherung (GKV) ist langfristig nur tragfähig, wenn jeder Versicherte die ihm zumutbaren Möglichkeiten ergreift, um seine Gesundheit zu erhalten und den Eintritt von Krankheit zu vermeiden (vgl. § 1 S. 3 SGB V).
To grant high-quality evidence-based research in the field of exercise sciences, it is often necessary for various institutions to collaborate over longer distances and internationally. Here, not only with regard to the recent COVID-19-pandemic, digital means provide new options for remote scientific exchanges. This thesis is meant to analyse and test digital opportunities to support the dissemination of knowledge and instruction of investigators about defined examination protocols in an international multi-center context.
The project consisted of three studies. The first study, a questionnaire-based survey, aimed at learning about the opinions and preferences of digital learning or social media among students of sport science faculties in two universities each in Germany, the UK and Italy. Based on these findings, in a second study, an examination video of an ultrasound determination of the intima-media-thickness and diameter of an artery was distributed by a messenger app to doctors and nursing personnel as simulated investigators and efficacy of the test setting was analysed. Finally, a third study integrated the use of an augmented reality device for direct remote supervision of the same ultrasound examinations in a long-distance international setting with international experts from the fields of engineering and sports science and later remote supervision of augmented reality equipped physicians performing a given task.
The first study with 229 participating students revealed a high preference for YouTube to receive video-based knowledge as well as a preference for using WhatsApp and Facebook for peer-to-peer contacts for learning purposes and to exchange and discuss knowledge. In the second study, video-based instructions send by WhatsApp messenger
showed high approval of the setup in both study groups, one with doctors familiar with the use of ultrasound technology as well as one with nursing staff who were not familiar with the device, with similar results in overall time of performance and the measurements of the femoral arteries. In the third and final study, experts from different continents were connected remotely to the examination site via an augmented reality device with good transmission quality. The remote supervision to doctors ́ examination produced a good interrater correlation. Experiences with the augmented reality-based setting were rated as highly positive by the participants. Potential benefits of this technique were seen in the fields of education, movement analysis, and supervision.
Concluding, the findings of this thesis were able to suggest modern and addressee- centred digital solutions to enhance the understanding of given examinations techniques of potential investigators in exercise science research projects. Head-mounted augmented reality devices have a special value and may be recommended for collaborative research projects with physical examination–based research questions. While the established setting should be further investigated in prospective clinical studies, digital competencies of future researchers should already be enhanced during the early stages of their education.
Mit dem Alter kann eine Zunahme leichtgradiger Entzündungsprozesse beobachtet werden, von denen angenommen wird, dass sie den typischen, altersbedingten Verlust an Muskelmasse, -kraft und -funktion „befeuern“. Diese als Inflammaging bezeichneten Prozesse können auf ein komplexes Zusammenspiel aus einem dysfunktionalen (viszeralen) Fettgewebe, einer Dysbiose und damit einhergehender mikrobiellen Translokation und geringeren Abwehrfähigkeit sowie einer insgesamt zunehmenden Immunseneszenz zurückgeführt werden. In Summa begünstigt ein pro-inflammatorisches Milieu metabolische Störungen und chronische, altersassoziierte Erkrankungen, die das Entzündungsgeschehen aufrechterhalten oder vorantreiben. Neben einem essenziellen Bewegungsmangel trägt auch eine westlich geprägte, industrialisierte Ernährungsweise zum Entzündungsgeschehen und zur Entwicklung chronischer Erkrankungen bei. Daher liegt die Vermutung nahe, dem Entzündungsgeschehen mit ausreichend Bewegung und einer anti-inflammatorischen Ernährung entgegenzuwirken. In dieser Hinsicht werden insbesondere Omega-3-Fettsäuren (Omega-3) mit anti-inflammatorischen Eigenschaften verbunden. Obwohl ein Zusammenhang zwischen dem ernährungsbedingten Inflammationspotenzial bzw. der Zufuhr von Omega-3 und dem Inflammationsprofil bereits untersucht wurde, fehlen bislang Untersuchungen insbesondere bei älteren Erwachsenen, die den Link zwischen dem Inflammationspotenzial der Ernährung und Sarkopenie-relevanten Muskelparametern herstellen.
Aufgrund des Proteinmehrbedarfs zum Erhalt der funktionellen Muskulatur im Alter wurde bereits eine Vielzahl an Sport- und Ernährungsinterventionen durchgeführt, die eine Verbesserung des Muskelstatus mit Hilfe von strukturiertem Krafttraining und einer proteinreichen Ernährung zeigen. Es gibt zudem Hinweise, dass Omega-3 auch die Proteinsynthese verstärken könnten. Unklar ist jedoch, inwiefern eine anti-inflammatorische Ernährung mit Fokus auf Omega-3 sowohl die Entzündungsprozesse als auch den Muskelproteinmetabolismus und die neuromuskuläre Funktionalität im Alter günstig unterstützen kann. Dies vor allem im Hinblick auf die Muskelleistung, die eng mit der Sturzneigung und der Autonomie im Alltag verknüpft ist, aber in Interventionsstudien mit älteren Erwachsenen bisher wenig Berücksichtigung erhielt. Darüber hinaus werden häufig progressive Trainingselemente genutzt, die nach Studienabschluss oftmals wenig Anschluss im Lebensalltag der Betroffenen finden und somit wenig nachhaltig sind. Ziel dieser Arbeit war demnach die Evaluierung einer proteinreichen und zusätzlich mit Omega-3 supplementierten Ernährung in Kombination mit einem wöchentlichen Vibrationstraining und altersgemäßen Bewegungsprogramm auf Inflammation und neuromuskuläre Funktion bei älteren, selbständig lebenden Erwachsenen.
Hierzu wurden zunächst mögliche Zusammenhänge zwischen dem ernährungsbedingten Inflammationspotenzial, ermittelt anhand des Dietary Inflammatory Index, und dem Muskelstatus sowie dem Inflammationsprofil im Alter eruiert. Dazu dienten die Ausgangswerte von älteren, selbständig lebenden Erwachsenen einer postprandialen Interventionsstudie (POST-Studie), die im Querschnitt analysiert wurden. Die Ergebnisse bestätigten, dass eine pro-inflammatorische Ernährung sich einerseits in einem stärkeren Entzündungsgeschehen widerspiegelt und andererseits mit Sarkopenie-relevanten Parametern, wie einer geringeren Muskelmasse und Gehgeschwindigkeit, ungünstig assoziiert ist. Darüber hinaus zeigten sich diese Zusammenhänge auch in Bezug auf die Handgreifkraft bei den inaktiven, älteren Erwachsenen der Studie.
Anschließend wurde in einer explorativ ausgerichteten Pilot-Interventionsstudie (AIDA-Studie) in einem dreiarmigen Design untersucht, inwieweit sich eine Supplementierung mit Omega-3 unter Voraussetzung einer optimierten Proteinzufuhr und altersgemäßen Sportintervention mit Vibrationstraining auf die neuromuskuläre Funktion und Inflammation bei selbständig lebenden, älteren Erwachsenen auswirkt. Nach acht Wochen Intervention zeigte sich, dass eine mit Omega-3 supplementierte, proteinreiche Ernährung die Muskelleistung insbesondere bei den älteren Männern steigerte. Während sich die Kontrollgruppe nach acht Wochen Sportintervention nicht verbesserte, bestätigte sich zusätzlich eine Verbesserung der Beinkraft und der Testzeit beim Stuhl-Aufsteh-Test der älteren Erwachsenen mit einer proteinreichen Ernährung in Kombination mit der Sportintervention.
Darüber hinaus wurde deutlich, dass die zusätzliche Omega-3-Supplementierung insbesondere bei den Männern eine Reduktion der pro-inflammatorischen Zytokine im Serum zur Folge hatte. Allerdings spiegelten sich diese Beobachtungen nicht auf Genexpressionsebene in mononukleären Immunzellen oder in der LPS-induzierten Sekretion der Zytokine und Chemokine in Vollblutzellkulturen wider. Dies erfordert weitere Untersuchungen.
Satisfaction and frustration of the needs for autonomy, competence, and relatedness, as assessed with the 24-item Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), have been found to be crucial indicators of individuals’ psychological health. To increase the usability of this scale within a clinical and health services research context, we aimed to validate a German short version (12 items) of this scale in individuals with depression including the examination of the relations from need frustration and need satisfaction to ill-being and quality of life (QOL). This cross-sectional study involved 344 adults diagnosed with depression (Mage (SD) = 47.5 years (11.1); 71.8% females). Confirmatory factor analyses indicated that the short version of the BPNSFS was not only reliable, but also fitted a six-factor structure (i.e., satisfaction/frustration X type of need). Subsequent structural equation modeling showed that need frustration related positively to indicators of ill-being and negatively to QOL. Surprisingly, need satisfaction did not predict differences in ill-being or QOL. The short form of the BPNSFS represents a practical instrument to measure need satisfaction and frustration in people with depression. Further, the results support recent evidence on the importance of especially need frustration in the prediction of psychopathology.
Satisfaction and frustration of the needs for autonomy, competence, and relatedness, as assessed with the 24-item Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), have been found to be crucial indicators of individuals’ psychological health. To increase the usability of this scale within a clinical and health services research context, we aimed to validate a German short version (12 items) of this scale in individuals with depression including the examination of the relations from need frustration and need satisfaction to ill-being and quality of life (QOL). This cross-sectional study involved 344 adults diagnosed with depression (Mage (SD) = 47.5 years (11.1); 71.8% females). Confirmatory factor analyses indicated that the short version of the BPNSFS was not only reliable, but also fitted a six-factor structure (i.e., satisfaction/frustration X type of need). Subsequent structural equation modeling showed that need frustration related positively to indicators of ill-being and negatively to QOL. Surprisingly, need satisfaction did not predict differences in ill-being or QOL. The short form of the BPNSFS represents a practical instrument to measure need satisfaction and frustration in people with depression. Further, the results support recent evidence on the importance of especially need frustration in the prediction of psychopathology.
The field of exercise psychology has established robust evidence on the health benefits of physical activity. However, interventions to promote sustained exercise behavior have often proven ineffective. This dissertation addresses challenges in the field, particularly the neglect of situated and affective processes in understanding and changing exercise behavior. Dual process models, considering both rational and affective processes, have gained recognition. The Affective Reflective Theory of Physical Inactivity and Exercise (ART) is a notable model in this context, positing that situated processes in-the-moment of choice influence exercise decisions and subsequent exercise behavior.
The dissertation identifies current challenges within exercise psychology and proposes methodological and theoretical advancements. It emphasizes the importance of momentary affective states and situated processes, offering alternatives to self-reported measures and advocating for a more comprehensive modeling of individual variability. The focus is on the affective processes during exercise, theorized to reappear in momentary decision-making, shaping overall exercise behavior.
The first publication introduces a new method by using automated facial action analysis to measure variable affective responses during exercise. It explores how these behavioral indicators covary with self-reported measures of affective valence and perceived exertion. The second publication delves into situated processes at the moment of choice between exercise and non-exercise options, revealing that intraindividual factors play a crucial role in explaining exercise-related choices. The third publication presents an open-source research tool, the Decisional Preferences in Exercising Test (DPEX), designed to capture repeated situated decisions and predict exercise behavior based on past experiences.
The findings challenge previous assumptions and provide insights into the complex interplay of affective responses, situated processes, and exercise choices. The dissertation underscores the need for individualized interventions that manipulate affective responses during exercise and calls for systematic testing to establish causal links to automatic affective processes and subsequent exercise behavior. This dissertation highlights the necessity for methodological and conceptual refinements in understanding and promoting exercise behavior, ultimately contributing to the broader goal of combating increasing inactivity trends.
Background and aims:
To succeed in competition, elite team and individual athletes often seek the development of both, high levels of muscle strength and power as well as cardiorespiratory endurance. In this context, concurrent training (CT) is a commonly applied and effective training approach. While being exposed to high training loads, youth athletes (≤ 18 years) are yet underrepresented in the scientific literature. Besides, immunological responses to CT have received little attention. Therefore, the aims of this work were to examine the acute (< 15min) and delayed (≥ 6 hours) effects of dif-ferent exercise order in CT on immunological stress responses, muscular fitness, metabolic response, and rating of perceived exertion (RPE) in highly trained youth male and female judo athletes.
Methods:
A total of twenty male and thirteen female participants, with an average age of 16 ± 1.8 years and 14.4 ± 2.1 years, respectively, were included in the study. They were randomly assigned to two CT sessions; power-endurance versus endurance-power (i.e., study 1), or strength-endurance versus endurance-strength (i.e., study 2). Markers of immune response (i.e., white-blood-cells, granulocytes, lymphocytes, mon-ocytes, and lymphocytes, granulocyte-lymphocyte-ratio, and systemic-inflammation-index), muscular fitness (i.e., counter-movement jump [CMJ]), metabolic responses (i.e., blood lactate, glucose), and RPE were collected at different time points (i.e., PRE12H, PRE, MID, POST, POST6H, POST22H).
Results (study 1):
There were significant time*order interactions for white-blood-cells, lymphocytes, granulocytes, monocytes, granulocyte-lymphocyte-ratio, and systemic-inflammation-index. The power-endurance order resulted in significantly larger PRE-to-POST increases in white-blood-cells, monocytes, and lymphocytes while the endur-ance-power order resulted in significantly larger PRE-to-POST increases in the granu-locyte-lymphocyte-ratio and systemic-inflammation-index. Likewise, significantly larger increases from PRE-to-POST6H in white-blood-cells and granulocytes were observed following the power-endurance order compared to endurance-power. All markers of immune response returned toward baseline values at POST22H. Moreover, there was a significant time*order interaction for blood glucose and lactate. Following the endur-ance-power order, blood lactate and glucose increased from PRE-to-MID but not from PRE-to-POST. Meanwhile, in the power-endurance order blood lactate and glucose increased from PRE-to-POST but not from PRE-to-MID. A significant time*order inter-action was observed for CMJ-force with larger PRE-to-POST decreases in the endur-ance-power order compared to power-endurance order. Further, CMJ-power showed larger PRE-to-MID performance decreases following the power-endurance order, com-pared to the endurance-power order. Regarding RPE, significant time*order interactions were noted with larger PRE-to-MID values following the endurance-power order and larger PRE-to-POST values following the power-endurance order.
Results (study 2):
There were significant time*order interactions for lymphocytes, monocytes, granulocyte-lymphocyte-ratio, and systemic-inflammation-index. The strength-endurance order resulted in significantly larger PRE-to-POST increases in lymphocytes while the endurance-strength order resulted in significantly larger PRE-to-POST increases in the granulocyte-lymphocyte-ratio and systemic-inflammation-index. All markers of the immune system returned toward baseline values at POST22H. Moreover, there was a significant time*order interaction for blood glucose and lactate. From PRE-to-MID, there was a significantly greater increase in blood lactate and glu-cose following the endurance-strength order compared to strength-endurance order. Meanwhile, from PRE-to-POST there was a significantly higher increase in blood glu-cose following the strength-endurance order compared to endurance-strength order. Regarding physical fitness, a significant time*order interaction was observed for CMJ-force and CMJ-power with larger PRE-to-MID increases following the endurance-strength order compared to the strength-endurance order. For RPE, significant time*order interactions were noted with larger PRE-to-MID values following the endur-ance-power order and larger PRE-to-POST values following the power-endurance or-der.
Conclusions:
The primary findings from both studies revealed order-dependent effects on immune responses. In male youth judo athletes, the results demonstrated greater immunological stress responses, both immediately (≤ 15 min) and delayed (≥ 6 hours), following the power-endurance order compared to the endurance-power order. For female youth judo athletes, the results indicated higher acute, but not delayed, order-dependent changes in immune responses following the strength-endurance order compared to the endurance-strength order. It is worth noting that in both studies, all markers of immune system response returned to baseline levels within 22 hours. This suggests that successful recovery from the exercise-induced immune stress response was achieved within 22 hours. Regarding metabolic responses, physical fitness, and perceived exertion, the findings from both studies indicated acute (≤ 15 minutes) alterations that were dependent on the exercise order. These alterations were primarily influ-enced by the endurance exercise component. Moreover, study 1 provided substantial evidence suggesting that internal load measures, such as immune markers, may differ from external load measures. This indicates a disparity between immunological, perceived, and physical responses following both concurrent training orders. Therefore, it is crucial for practitioners to acknowledge these differences and take them into consideration when designing training programs.
Krafttraining ist ein etabliertes Mittel für die Entwicklung körperlicher Fitness und sport-artspezifischer Leistungen in verschiedenen Sportarten. Dabei scheint dem Krafttraining auch im Hinblick auf den langfristigen Leistungsaufbau im Nachwuchsleistungssport Rudern eine besondere Rolle zuzukommen. Die vorliegende Arbeit widmet sich der Optimie-rung der Leistungsdiagnostik sowie der Bewertung der Effektivität von Krafttrainingsmethoden zur Verbesserung der körperlichen Fitness und der sportartspezifischen Leistung im Nachwuchsleistungsrudern.
Die erste Studie im Rahmen dieser kumulativen Arbeit beinhaltet die Analyse eines sport-artspezifischen Anforderungsprofils der Sportart Rudern. Die Studienergebnisse zeigen, dass die Energiebereitstellung im Ruderwettkampf zu einem großen Anteil aus aeroben und zu einem geringen Anteil aus anaeroben Stoffwechselprozessen erfolgt. Während der vier Phasen des rudertechnischen Leitbildes werden nahezu alle großen Muskelgruppen beansprucht. Aufgrund der hohen Trainingsumfänge auf internationalem Leistungsniveau besteht bei Ruderern ein erhöhtes Risiko, Verletzungen im lumbalen Rückensegment, den Knien sowie den Rippen zu erleiden.
Im Rahmen der zweiten Studie wurden die Effekte von Krafttraining auf die körperliche Fitness und die sportartspezifische Leistung von Ruderern unterschiedlichen Expertisen-niveaus untersucht. Die Studienergebnisse zeigen, dass signifikante kleine Effekte des Krafttrainings auf die körperliche Fitness (Maximalkraft der unteren Gliedmaßen) und auf die sportartspezifische Leistung existieren. Subgruppenanalysen für Krafttrainingstyp und Expertisenniveau zeigten nicht signifikante Unterschiede zwischen den jeweiligen Subgruppen der Ruderer.
Die dritte Studie analysierte die Zusammenhänge zwischen der biologischen Reife, der Körperkonstitution und der körperlichen Fitness mit der Leistung auf dem Ruderergometer über 700-m bei weiblichen Nachwuchseliteruderern. Die Analyse zeigte signifikante mittle-re bis hohe Zusammenhänge zwischen der biologischen Reife, Kennwerten der Körperkonstitution, der körperlichen Fitness (z. B. Maximalkraft, Kraftausdauer) und der Leistung auf dem Ruderergometer. Zusätzlich konnte gezeigt werden, dass die Prädiktoren Körperkonstitution (Magermasse) und Kraftausdauer (Bourban-Test) die Leistung des 700-m Ruderergometertest am besten abbilden.
Die vierte Studie untersuchte die Effekte von zwei unterschiedlichen Krafttrainingsmetho-den, die jeweils über neun Wochen durchgeführt wurden, auf die körperliche Fitness und die Leistung auf dem Ruderergometer bei weiblichen Elite-Nachwuchsruderern. Die Stu-dienergebnisse zeigen, dass beide Gruppen signifikante Steigerungen auf ausgewählte Komponenten der körperlichen Fitness (z. B. Maximalkraft, Schnellkraft, anaerobe Aus-dauer und Richtungswechselgeschwindigkeit) und die sportartspezifische Leistung erzielten. Signifikant größere Zuwächse resultierten nach Krafttraining mit höheren Intensitäten [HI] bei gleichem Volumen im Vergleich zu Kraftausdauertraining [KA] in ausgewählten Komponenten der körperlichen Fitness (z. B. Maximalkraft). Im Gegensatz dazu, führte KA bei gleichem Volumen im Vergleich zu HI zu größeren Steigerungen der sportartspezifischen Leistung.
Zusammenfassend zeigen die Ergebnisse, dass Krafttraining ein effektives Mittel zur Steigerung ausgewählter Komponenten der körperlichen Fitness und der sportartspezifischen Leistung in der Sportart Rudern für RuderInnen und im Speziellen für den Nachwuchssport ist. Insbesondere im Nachwuchsleistungsrudern zeigte sich, dass HI zusätzlich zum regulären Rudertraining effektiver zur Verbesserung der körperlichen Fitness (z. B. Maximalkraft) ist als KA. Zur Verbesserung der sportartspezifischen Leistung jedoch, stellte KA im Vergleich zu HI bei weiblichen Elite-Nachwuchsruderern die effektivere Krafttrainings-methode dar. Weiterhin wird Trainern im Nachwuchsrudersport empfohlen, ausgewählte Merkmale der biologischen Reife, Körperkonstitution sowie der körperlichen Fitness (Maximalkraft, Kraftausdauer) für die Talententwicklung zu berücksichtigen.