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Background: To handle the competition demands, sparring drills are used for specific technical–tactical training as well as physical–physiological conditioning in combat sports. While the effects of different area sizes and number of within-round sparring partners on physiological and perceptive responses in combats sports were examined in previous studies, technical and tactical aspects were not investigated. This study investigated the effect of different within-round sparring partners number (i.e., at a time; 1 vs. 1, 1 vs. 2, and 1 vs. 4) and area sizes (2 m × 2 m, 4 m × 4 m, and 6 m × 6 m) variation on the technical–tactical aspects of small combat games in kickboxing.
Method: Twenty male kickboxers (mean ± standard deviation, age: 20.3 ± 0.9 years), regularly competing in regional and national events randomly performed nine different kickboxing combats, lasting 2 min each. All combats were video recorded and analyzed using the software Dartfish.
Results: Results showed that the total number of punches was significantly higher in 1 versus 4 compared with 1 versus 1 (p = 0.011, d = 0.83). Further, the total number of kicks was significantly higher in 1 versus 4 compared with 1 versus 1 and 1 versus 2 (p < 0.001; d = 0.99 and d = 0.83, respectively). Moreover, the total number of kick combinations was significantly higher in 1 versus 4 compared with 1 versus 1 and 1 versus 2 (p < 0.001; d = 1.05 and d = 0.95, respectively). The same outcome was significantly lower in 2 m × 2 m compared with 4 m × 4 m and 6 m × 6 m areas (p = 0.010 and d = − 0.45; p < 0.001 and d = − 0.6, respectively). The number of block-and-parry was significantly higher in 1 versus 4 compared with 1 versus 1 (p < 0.001, d = 1.45) and 1 versus 2 (p = 0.046, d = 0.61) and in 2 m × 2 m compared with 4 m × 4 m and 6 × 6 m areas (p < 0.001; d = 0.47 and d = 0.66, respectively). Backwards lean actions occurred more often in 2 m × 2 m compared with 4 m × 4 m (p = 0.009, d = 0.53) and 6 m × 6 m (p = 0.003, d = 0.60). However, the number of foot defenses was significantly lower in 2 m × 2 m compared with 6 m × 6 m (p < 0.001, d = 1.04) and 4 m × 4 m (p = 0.004, d = 0.63). Additionally, the number of clinches was significantly higher in 1 versus 1 compared with 1 versus 2 (p = 0.002, d = 0.7) and 1 versus 4 (p = 0.034, d = 0.45).
Conclusions: This study provides practical insights into how to manipulate within-round sparring partners’ number and/or area size to train specific kickboxing technical–tactical fundamentals.
Background/Purpose
Muscular reflex responses of the lower extremities to sudden gait disturbances are related to postural stability and injury risk. Chronic ankle instability (CAI) has shown to affect activities related to the distal leg muscles while walking. Its effects on proximal muscle activities of the leg, both for the injured- (IN) and uninjured-side (NON), remain unclear. Therefore, the aim was to compare the difference of the motor control strategy in ipsilateral and contralateral proximal joints while unperturbed walking and perturbed walking between individuals with CAI and matched controls.
Materials and methods
In a cross-sectional study, 13 participants with unilateral CAI and 13 controls (CON) walked on a split-belt treadmill with and without random left- and right-sided perturbations. EMG amplitudes of muscles at lower extremities were analyzed 200 ms after perturbations, 200 ms before, and 100 ms after (Post100) heel contact while walking. Onset latencies were analyzed at heel contacts and after perturbations. Statistical significance was set at alpha≤0.05 and 95% confidence intervals were applied to determine group differences. Cohen’s d effect sizes were calculated to evaluate the extent of differences.
Results
Participants with CAI showed increased EMG amplitudes for NON-rectus abdominus at Post100 and shorter latencies for IN-gluteus maximus after heel contact compared to CON (p<0.05). Overall, leg muscles (rectus femoris, biceps femoris, and gluteus medius) activated earlier and less bilaterally (d = 0.30–0.88) and trunk muscles (bilateral rectus abdominus and NON-erector spinae) activated earlier and more for the CAI group than CON group (d = 0.33–1.09).
Conclusion
Unilateral CAI alters the pattern of the motor control strategy around proximal joints bilaterally. Neuromuscular training for the muscles, which alters motor control strategy because of CAI, could be taken into consideration when planning rehabilitation for CAI.
Schomoller, A, Schugardt, M, Kotsch, P, and Mayer, F. The effect of body composition on cycling power during an incremental test in young athletes. J Strength Cond Res 35(11): 3225-3231, 2021-As body composition (BC) is a modifiable factor influencing sports performance, it is of interest for athletes and coaches to optimize BC to fulfill the specific physical demands of one sport discipline. The purpose of this study is to test the impact of body fat (BF) and fat-free mass (FFM) on aerobic performance in young athletes. Body composition parameters were evaluated among gender and age groups of young athletes undergoing their mandatory health examination. The maximal power (in Watts per kilogram body mass) of a stepwise incremental ergometer test was compared between 6 BC types: high BF, high FFM, high BF and high FFM, normal BC values, low BF, and low FFM. With increasing age (11-13 vs. 14-16 years) BF decreased and FFM increased in both genders. Both BC parameters, as well as body mass, correlated moderately with performance output (r = 0.36-0.6). Subjects with high BF or high FFM or both had significantly lower ergometer test results compared with those with low BF and FFM in all age and gender groups (p < 0.05). The finding that high levels of BF and FFM are detrimental for cycle power output is important to consider in disciplines that demand high levels of aerobic and anaerobic performance.
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.
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. <br /> 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. <br /> 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). <br /> 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.
Einleitung
Ältere Patienten mit Herzklappenerkrankungen werden zunehmend häufig mit der kathetergestützten Aortenklappenimplantation (Transcatheter Aortic Valve Implantation, TAVI) oder dem MitraClip®-Verfahren behandelt. In der kardiologischen Rehabilitation nimmt infolgedessen die Patientenpopulation der Hochbetagten stetig zu. Die funktionale Gesundheit dieser Patienten wird durch häufig auftretende, sogenannte geriatrische Syndrome wie Multimorbidität, Mangelernährung, Gebrechlichkeit oder Sturzereignisse beeinflusst. Insbesondere die eingeschränkte Mobilität und Mangelernährung sind wichtige Prädiktoren für die Prognose der Patienten nach TAVI.
Etablierte Verfahren, um die körperliche Leistungsfähigkeit von kardiologischen Rehabilitanden zu beurteilen, sind die Belastungsergometrie und der 6-Minuten-Gehtest. Allerdings ist nahezu die Hälfte der hochbetagten Patienten nicht in der Lage, eine Belastungsergometrie durchzuführen. Bislang erfolgt in der kardiologischen Rehabilitation keine differenzierte Erfassung des funktionellen Status hinsichtlich Mobilität, Kraft und Gleichgewicht, um die geriatrischen Syndrome individuell zu beurteilen. Darüber hinaus werden keine Assessments zur Erfassung des Ernährungsstatus eingesetzt.
Daher war es das Ziel der vorliegenden Arbeit, die Ausprägung des funktionellen und nutritiven Status älterer Patienten anhand geeigneter Assessments in der kardiologischen Rehabilitation zu ermitteln.
Methode
Zwischen Oktober 2018 und Juni 2019 nahmen Patienten im Alter von 75 Jahren oder älter nach TAVI, atrioventrikulärer Intervention mittels MitraClip®-Verfahren (AVI) oder perkutaner Koronarintervention (PCI) an der Studie teil. Zu Beginn der kardiologischen Rehabilitation wurden soziodemografische Daten, echokardiografische Parameter (z. B. links und rechtsventrikuläre Ejektionsfraktion, Herzrhythmus) und Komorbiditäten (z. B. Diabetes mellitus, Niereninsuffizienz, orthopädische Erkrankungen) erhoben, um die Patientenpopulation zu beschreiben. Zusätzlich wurde die Gebrechlichkeit der Rehabilitanden mit dem Index von Stortecky et al., bestehend aus den Komponenten Kognition, Mobilität, Ernährung und Aktivitäten des täglichen Lebens, beurteilt.
Der 6-Minuten-Gehtest diente zur Ermittlung der körperlichen Leistungsfähigkeit der Patienten. Die Mobilität wurde mit Hilfe des Timed-Up-and-Go-Tests, die Ganggeschwindigkeit mit dem Gait Speed Test und die Handkraft mit dem Hand Grip Test erfasst.
Für die Objektivierung des Gleichgewichts wurde eine Kraftmessplatte (uni- und bipedaler Stand mit geöffneten und geschlossenen Augen) erprobt, die bislang bei älteren Rehabilitanden noch nicht eingesetzt wurde.
Der Ernährungsstatus wurde mit dem Mini Nutritional Assessment-Short Form und den ernährungsbezogenen Laborparametern (Hämoglobin, Serumalbumin, Eiweißkonzentration) erfasst.
Die Eignung der Assessments bewerteten wir anhand folgender Kriterien: Durchführbarkeit (bei ≥ 95 % der Patienten durchführbar), Sicherheit (< 95 % Stürze oder andere unerwünschte Ereignisse) und der Pearson-Korrelationen zwischen den funktionellen Tests und dem Goldstandard 6-Minuten-Gehtest sowie den Laborparametern und dem Mini Nutritional Assessment-Short Form.
Ergebnisse
Es wurden 124 Patienten (82 ± 4 Jahre, 48 % Frauen, 5 ± 2 Komorbiditäten, 9 ± 3 Medikamente) nach TAVI (n = 59), AVI (n = 21) und PCI (n = 44) konsekutiv in die Studie eingeschlossen.
Etwa zwei Drittel aller Patienten der Gesamtpopulation waren als gebrechlich zu klassifizieren, bei einer mittleren Punktzahl von 2,9 ± 1,4. Annähernd die Hälfte der Patienten zeigte eine eingeschränkte körperliche Leistungsfähigkeit aufgrund einer reduzierten 6-Minuten-Gehstrecke (48 % < 350 m) sowie eine eingeschränkte Mobilität im Timed-Up-and-Go-Test (55 % > 10 s). Es wurden eine mittlere Gehstrecke von 339 ± 131 m und eine durchschnittliche Zeit im Timed-Up-and-Go-Test von 11,4 ± 6,3 s erzielt. Darüber hinaus wies ein Viertel der Patienten eine eingeschränkte Ganggeschwindigkeit (< 0,8 m/s) auf und etwa 35 % von Ihnen zeigten eine reduzierte Handkraft (Frauen/Männer < 16/27 kg). Im Mittel wurde eine Geschwindigkeit von 1,0 ± 0,2 m/s im Gait Speed Test sowie eine Handkraft von 24 ± 9 kg im Hand Grip Test erreicht. Ein Risiko einer Mangelernährung konnte bei 38 % (< 12 Punkte) der Patienten nachgewiesen werden bei einer mittleren Punktzahl von 11,8 ± 2,2 im Mini Nutritional Assessment-Short Form.
Im Vergleich zwischen den einzelnen Subpopulationen bestanden keine statistisch signifikanten Unterschiede in den Ergebnissen der funktionellen Assessments. Bezüglich des Ernährungsstatus wiesen allerdings die Patienten nach AVI einen statistisch signifikant niedrigeren Punktewert im Mini Nutritional Assessment-Short Form (10,3 ± 3,0 Punkte) auf als die Patienten nach TAVI (12,0 ± 1,8 Punkte) und PCI (12,1 ± 2,1 Punkte), wobei etwa 57 % der Patienten nach AVI, 38 % nach TAVI und 50 % nach PCI ein Risiko einer Mangelernährung zeigten.
Mit Ausnahme der Tests auf der Kraftmessplatte waren alle Assessments durchführbar und sicher. Während 86 % der Patienten den bipedalen Stand mit geschlossenen Augen auf der Kraftmessplatte durchführen konnten und damit nahezu den Grenzwert von 95 % erreichten, war der unipedale Stand mit 12 % an durchführbaren Messungen weit von diesem entfernt.
Der Gait Speed Test (r = 0,79), Timed-Up-and-Go-Test (r = 0,68) und Hand Grip Test (r = 0,33) korrelierten signifikant mit dem 6-Minuten-Gehtest, Hämoglobin (r = 0,20) und Albumin (r = 0,24) korrelierten mit dem Mini Nutritional Assessment-Short Form.
Schlussfolgerung
Über die bestehende Multimorbidität und Multimedikation hinaus wiesen die untersuchten Patienten vor allem eine eingeschränkte Mobilität und ein Risiko einer Mangelernährung auf, wobei die Subpopulation nach AVI besonders betroffen war.
Um den Bedürfnissen hochbetagter Rehabilitanden nach kathetergestützer Intervention gerecht zu werden, ist eine individuelle Behandlung der einzelnen Defizite erforderlich, mit besonderer Berücksichtigung der Komorbiditäten sowie der geriatrischen Kofaktoren. Aufgrund des multidisziplinären Ansatzes erfüllt die kardiologische Rehabilitation bereits die Voraussetzung, hochbetagte Patienten bedarfsgerecht zu behandeln, jedoch mangelt es an Assessments, um die individuellen Defizite der Patienten zu identifizieren
Der Gait Speed Test, der Timed-Up-and-Go-Test und der Hand Grip Test sollten daher in den klinischen Alltag der kardiologischen Rehabilitation implementiert werden, um die körperliche Funktion und Leistungsfähigkeit älterer Patienten detailliert zu beurteilen. In Kombination dieser Assessments mit dem Mini Nutritional Assessment-Short Form können die individuellen funktionellen und nutritiven Bedürfnisse der Patienten während der Rehabilitation erkannt und mit geeigneten Maßnahmen die weitere Ausbildung geriatrischer Syndrome gemindert werden.
Background
Artificial intelligence (AI) is one of the most promising areas in medicine with many possibilities for improving health and wellness. Already today, diagnostic decision support systems may help patients to estimate the severity of their complaints. This fictional case study aimed to test the diagnostic potential of an AI algorithm for common sports injuries and pathologies.
Methods
Based on a literature review and clinical expert experience, five fictional “common” cases of acute, and subacute injuries or chronic sport-related pathologies were created: Concussion, ankle sprain, muscle pain, chronic knee instability (after ACL rupture) and tennis elbow. The symptoms of these cases were entered into a freely available chatbot-guided AI app and its diagnoses were compared to the pre-defined injuries and pathologies.
Results
A mean of 25–36 questions were asked by the app per patient, with optional explanations of certain questions or illustrative photos on demand. It was stressed, that the symptom analysis would not replace a doctor’s consultation. A 23-yr-old male patient case with a mild concussion was correctly diagnosed. An ankle sprain of a 27-yr-old female without ligament or bony lesions was also detected and an ER visit was suggested. Muscle pain in the thigh of a 19-yr-old male was correctly diagnosed. In the case of a 26-yr-old male with chronic ACL instability, the algorithm did not sufficiently cover the chronic aspect of the pathology, but the given recommendation of seeing a doctor would have helped the patient. Finally, the condition of the chronic epicondylitis in a 41-yr-old male was correctly detected.
Conclusions
All chosen injuries and pathologies were either correctly diagnosed or at least tagged with the right advice of when it is urgent for seeking a medical specialist. However, the quality of AI-based results could presumably depend on the data-driven experience of these programs as well as on the understanding of their users. Further studies should compare existing AI programs and their diagnostic accuracy for medical injuries and pathologies.
The scapula plays a significant role in efficient shoulder movement. Thus, alterations from typical scapular motion during upper limb movements are thought to be associated with shoulder pathologies. However, a clear understanding of the relationship is not yet obtained.. Scapular alterations may only represent physiological variability as their occurrence can appear equally as frequent in individuals with and without shoulder disorders. Evaluation of scapular motion during increased load might be a beneficial approach to detect clinically relevant alterations. However, functional motion adaptations in response to maximum effort upper extremity loading has not been established yet. Therefore, the overall purpose of this research project was to give further insight in physiological adaptations of scapular kinematics and their underlying scapular muscle activity in response to high demanding shoulder movements in healthy asymptomatic individuals. Prior to the investigation of the effect of various load situation, the reproducibility of scapular kinematics and scapular muscle activity were evaluated under maximum effort arm movements. Healthy asymptomatic adults performed unloaded and maximal loaded concentric and eccentric isokinetic shoulder flexion and extension movements in the scapular plane while scapular kinematics and scapular muscle activity were simultaneously assessed. A 3D motion capture system (infra-red cameras & reflective markers) was utilized to track scapular and humerus motion in relation to the thorax. 3D scapular position angles were given for arm raising and lowering between humerus positions of 20° and 120° flexion. To further characterize the scapular pattern, the scapular motion extent and scapulohumeral rhythm (ratio of scapular and humerus motion extent) were determined. Muscle activity of the upper and lower trapezius and the serratus anterior were assessed with surface electromyography. Amplitudes were calculated for the whole ROM and four equidistant movement phases. Reliability was characterized by overall moderate to good reproducibility across the load conditions. Irrespective of applied load, scapular kinematics followed a motion pattern of continuous upward rotation, posterior tilt and external rotation during arm elevation and a continuous downward rotation, anterior tilt and internal rotation during arm lowering. However, kinematics were altered between maximal loaded and unloaded conditions showing increased upward rotation, reduced posterior tilt and external rotation. Further, the scapulohumeral rhythm was decreased and scapular motion extent increased under maximal loaded movements. Muscle activity during maximum effort were of greater magnitude and differed in their pattern in comparison to the continuous increase and decrease of activity during unloaded shoulder flexion and extension. Relationships between scapular kinematics and their underlying scapular muscle activity could only be identified for a few isolated combinations, whereas the majority showed no associations. Scapular kinematics and scapular muscle activity pattern alter according to the applied load. Alterations between the load conditions comply in magnitude and partially in direction with differences seen between symptomatic and asymptomatic individuals. Even though long-term effects of identified adaptations in response to maximum load are so far unclear, deviations from typical scapular motion or muscle activation should not per se be seen as indicators of shoulder impairment. However, evaluation of alterations in scapular motion and activation in response to maximum effort may have the potential to identify individuals that are unable to cope with increased upper limb demands. Findings further challenge the understanding of scapular motion and stabilization by the trapezius and serratus anterior muscles, as clear relationships between the underlying scapular muscle activity and scapular kinematics were neither observed during unloaded nor maximal loaded shoulder movements.
Extracellular vesicles: potential mediators of psychosocial stress contribution to osteoporosis?
(2021)
Osteoporosis is characterized by low bone mass and damage to the bone tissue’s microarchitecture, leading to increased fracture risk. Several studies have provided evidence for associations between psychosocial stress and osteoporosis through various pathways, including the hypothalamic-pituitary-adrenocortical axis, the sympathetic nervous system, and other endocrine factors. As psychosocial stress provokes oxidative cellular stress with consequences for mitochondrial function and cell signaling (e.g., gene expression, inflammation), it is of interest whether extracellular vesicles (EVs) may be a relevant biomarker in this context or act by transporting substances. EVs are intercellular communicators, transfer substances encapsulated in them, modify the phenotype and function of target cells, mediate cell-cell communication, and, therefore, have critical applications in disease progression and clinical diagnosis and therapy. This review summarizes the characteristics of EVs, their role in stress and osteoporosis, and their benefit as biological markers. We demonstrate that EVs are potential mediators of psychosocial stress and osteoporosis and may be beneficial in innovative research settings.
With the 2012 EU guidelines on dual careers (DC), DC research gained increasing awareness in Europe focussing particularly on student-athletes' motivation. The Student Athletes' Motivation toward Sports and Academics Questionnaire (SAMSAQ), arguably the most prominent instrument in this research area, has been used in various cross-cultural studies assessing DC motivation. The present investigation contributes to the cross-cultural discourse aiming to (1) adapt the SAMSAQ for the German context and adolescent secondary school student-athletes, and (2) evaluate the German pre-version. A sample of 208 student-athletes (52.4% females, mean age = 17.4 years, 49.5% at squad level) at three German Elite Sport Schools participated in the study. The investigation was split into two parts. First, the SAMSAQ was adapted to the German context and tested. In the second part, the first pre-version was revised. A series of exploratory factor analyses were applied to verify the factor structure of both German SAMSAQ pre-versions. Eight different factor models based on item removal were compared. Neither model demonstrated good results for the replication of previous findings or a meaningful solution in terms of content. Reasons for the deviations between the original and target SAMSAQ factor structures can be found in the different target groups and the culturally different approaches to career assistant programmes as well as in the theoretical background of the instrument. Since neither model was identified as acceptable, the findings indicate that a new instrument needs to be developed for assessing student-athletes' DC motivation along their pathways in different cross-cultural contexts.