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Die Gesundheit unserer Jugend ist seit je ein gesellschaftspolitisches Primat und verdient die grösstmögliche Beachtung. Ein Teilbereich, nämlich Bewegung und Sport, ist in der Schweiz auch aus diesem Grund verfassungsmässig geregelt. Sämtliche Volksschulen müssen bis ins neunte Schuljahr pro Woche drei Lektionen Bewegung und Sport anbieten.. Als einziges Schulfach geniesst Bewegung und Sport diesen bundesgesetzlichen Support im sonst streng föderalistisch organisierten Bildungssystem der Schweiz. Trotz diesen drei verordneten Sportlektionen ist die physische Leistungsfähigkeit unserer Jugend einhergehend mit gesundheitlichen Parametern seit 1985 rückläufig und seit ein paar Jahren auf tiefem Niveau stagnierend. Zudem berichten Lehrpersonen über sinkende Konzentrationsfähigkeit in den letzten Jahren. Um eine flächendeckende Verbesserung der Situation zu bewirken, bietet sich die Schule als zentraler Ort der Einflussnahme an. Dies gilt im Besonderen für den Bereich Bewegung und Sport. Im Jahr 2005 wurde das Programm einer täglichen Bewegungs- und Sportstunde an der Primarschule in Luzern/Schweiz gestartet. Nach einem kontinuierlichen Ausbau kamen ab 2011 etwas über 1300 Kinder von der ersten bis zur sechsten Klasse in den Genuss dieser täglichen Bewegungslektion. Die wissenschaftlichen Untersuchungen in den drei gesellschaftlich hoch relevanten Bereichen der Konzentrationsfähigkeit, des Übergewichts und der Gleichgewichtsfähigkeit ergaben positive Resultate. So konnte die Konzentrationsfähigkeit – die Basis für erfolgreiches Lernen – signifikant gesteigert werden und teilweise signifikant war die Verbesserung des statischen Gleichgewichts. Ein positiver Trend zeigte sich auch bei der Senkung des Body-Mass-Indexes bei Knaben. Dies konnte bei den Mädchen nicht nachgewiesen werden. Auch wenn nicht alle Hypothesen vollumfänglich bestätigt werden konnten, gilt es festzuhalten, dass das Projekt der täglichen Sport- und Bewegungsstunde die Erwartungen in allen drei Messbereichen erfüllt hat und die Verbesserungen hinsichtlich der Konzentrationsfähigkeit, des Übergewichts und der Gleichgewichtsfähigkeit mehrheitlich ausgewiesen werden können. Es lohnt sich also, die tägliche Sport- und Bewegungsstunde an der Primarschule einzuführen und den Präventionsgedanken auch Taten folgen zu lassen.
Food Neophilie
(2023)
Trotz der eindeutigen Vorteile einer ausgewogenen Ernährung halten sich viele Menschen weltweit nicht an entsprechende Ernährungsrichtlinien. Um angemessene Strategien zur Unterstützung einer gesundheitsfördernden Ernährung zu entwickeln, ist ein Verständnis der zugrunde liegenden Faktoren unerlässlich. Insbesondere die Gruppe der älteren Erwachsenen stellt dabei eine wichtige Zielgruppe für ernährungsbezogene Präventions- und Interventionsansätze dar. Einer der vielen Faktoren, die als Determinanten einer gesundheitsfördernden Ernährung diskutiert werden, ist die Food Neophilie, also die Bereitschaft, neue und unbekannte Lebensmittel auszuprobieren. Aktuelle Forschungsergebnisse legen nahe, dass die Food Neophilie positiv mit einer gesundheitsfördernden Ernährung in Verbindung steht, allerdings ist die bisherige Forschung in diesem Bereich äußerst begrenzt. Das Ziel der Dissertation war es, das Konstrukt der Food Neophilie sowie seine Beziehung zu gesundheitsförderndem Ernährungsverhalten im höheren Erwachsenenalter grundlegend zu erforschen, um das Potenzial der Food Neophilie für die Gesundheitsförderung älterer Erwachsener besser zu verstehen. Dabei wurde im Rahmen der ersten Publikation zunächst untersucht, wie sich das Konstrukt der Food Neophilie reliabel und valide erfassen lässt, um weiterführende Untersuchungen der Food Neophilie zu ermöglichen. Die psychometrische Validierung der deutschen Version der Variety Seeking Tendency Scale (VARSEEK) basierte auf zwei unabhängigen Stichproben mit insgesamt N = 1000 Teilnehmenden und bestätigte, dass es sich bei der Skala um ein reliables und valides Messinstrument zur Erfassung der Food Neophilie handelt. Darauf aufbauend wurde im Rahmen der zweiten Publikation die Beziehung der Food Neophilie und der Ernährungsqualität über die Zeit hinweg analysiert. Die prospektive Untersuchung von N = 960 Teilnehmenden des höheren Erwachsenenalters (M = 63.4 Jahre) anhand einer Cross-Lagged-Panel-Analyse ergab hohe zeitliche Stabilitäten der Food Neophilie und der Ernährungsqualität über einen Zeitraum von drei Jahren. Es zeigte sich zudem ein positiver querschnittlicher Zusammenhang zwischen der Food Neophilie und der Ernährungsqualität, jedoch wurde die Food Neophilie nicht als signifikante Determinante der Ernährungsqualität über die Zeit hinweg identifiziert. In der dritten Publikation wurden schließlich nicht nur die individuellen Auswirkungen der Food Neophilie auf die Ernährungsqualität betrachtet, sondern auch potenzielle dynamische Wechselwirkungen innerhalb von Partnerschaften einbezogen. Hierzu erfolgte mittels eines Actor-Partner-Interdependence-Modells eine Differenzierung potenzieller intra- und interpersoneller Einflüsse der Food Neophilie auf die Ernährungsqualität. Im Rahmen der dyadischen Analyse zeigte sich bei N = 390 heterosexuellen Paaren im höheren Erwachsenenalter (M = 64.0 Jahre) ein Dominanzmuster: Während die Food Neophilie der Frauen positiv mit ihrer eigenen Ernährungsqualität und der ihrer Partner zusammenhing, war die Food Neophilie der Männer nicht mit der Ernährungsqualität des Paares assoziiert. Insgesamt leistet die vorliegende Dissertation einen wertvollen Beitrag zum umfassenden Verständnis der Food Neophilie sowie ihrer Rolle im Kontext der Ernährungsgesundheit älterer Erwachsener. Trotz fehlender Vorhersagekraft über die Zeit hinweg deutet der positive Zusammenhang zwischen Food Neophilie und Ernährungsqualität darauf hin, dass die Fokussierung auf eine positive und neugierige Einstellung gegenüber Lebensmitteln eine innovative Perspektive für Präventions- und Interventionsansätze zur Unterstützung einer gesundheitsfördernden Ernährung älterer Erwachsener bieten könnte.
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.
Since 1998, elite athletes’ sport injuries have been monitored in single sport event, which leads to the development of first comprehensive injury surveillance system in multi-sport Olympic Games in 2008. However, injury and illness occurred in training phases have not been systematically studied due to its multi-facets, potentially interactive risk related factors. The present thesis aim to address issues of feasibility of establishing a validated measure for injury/illness, training environment and psychosocial risk factors by creating the evaluation tool namely risk of injury questionnaire (Risk-IQ) for elite athletes, which based on IOC consensus statement 2009 recommended content of preparticipation evaluation(PPE) and periodic health exam (PHE).
A total of 335 top level athletes and a total of 88 medical care providers from Germany and Taiwan participated in tow “cross-sectional plus longitudinal” Risk-IQ and MCPQ surveys respectively. Four categories of injury/illness related risk factors questions were asked in Risk-IQ for athletes while injury risk and psychological related questions were asked in MCPQ for MCP cohorts. Answers were quantified scales wise/subscales wise before analyzed with other factors/scales. In addition, adapted variables such as sport format were introduced for difference task of analysis.
Validated with 2-wyas translation and test-retest reliabilities, the Risk-IQ was proved to be in good standard which were further confirmed by analyzed results from official surveys in both Germany and Taiwan. The result of Risk-IQ revealed that elite athletes’ accumulated total injuries, in general, were multi-factor dependent; influencing factors including but not limited to background experiences, medical history, PHE and PPE medical resources as well as stress from life events. Injuries of different body parts were sport format and location specific. Additionally, medical support of PPE and PHE indicated significant difference between German and Taiwan.
The result of the present thesis confirmed that it is feasible to construct a comprehensive evalua-tion instrument for heterogeneous elite athletes cohorts’ risk factor analysis for injury/illness oc-curred during their non-competition periods. In average and with many moderators involved, Ger-man elite athletes have superior medical care support yet suffered more severe injuries than Tai-wanese counterparts. Opinions of injury related psychological issues reflected differently on vari-ous MCP groups irrespective of different nationalities. In general, influencing factors and interac-tions existed among relevant factors in both studies which implied further investigation with multiple regression analysis is needed for better understanding.
Background: The worldwide prevalence of diabetes has been increasing in recent years, with a projected prevalence of 700 million patients by 2045, leading to economic burdens on societies. Type 2 diabetes mellitus (T2DM), representing more than 95% of all diabetes cases, is a multifactorial metabolic disorder characterized by insulin resistance leading to an imbalance between insulin requirements and supply. Overweight and obesity are the main risk factors for developing type 2 diabetes mellitus. The lifestyle modification of following a healthy diet and physical activity are the primary successful treatment and prevention methods for type 2 diabetes mellitus. Problems may exist with patients not achieving recommended levels of physical activity. Electrical muscle stimulation (EMS) is an increasingly popular training method and has become in the focus of research in recent years. It involves the external application of an electric field to muscles, which can lead to muscle contraction. Positive effects of EMS training have been found in healthy individuals as well as in various patient groups. New EMS devices offer a wide range of mobile applications for whole-body electrical muscle stimulation (WB-EMS) training, e.g., the intensification of dynamic low-intensity endurance exercises through WB-EMS. This dissertation project aims to investigate whether WB-EMS is suitable for intensifying low-intensive dynamic exercises such as walking and Nordic walking.
Methods: Two independent studies were conducted. The first study aimed to investigate the reliability of exercise parameters during the 10-meter Incremental Shuttle Walk Test (10MISWT) using superimposed WB-EMS (research question 1, sub-question a) and the difference in exercise intensity compared to conventional walking (CON-W, research question 1, sub-question b). The second study aimed to compare differences in exercise parameters between superimposed WB-EMS (WB-EMS-W) and conventional walking (CON-W), as well as between superimposed WB-EMS (WB-EMS-NW) and conventional Nordic walking (CON-NW) on a treadmill (research question 2). Both studies took place in participant groups of healthy, moderately active men aged 35-70 years. During all measurements, the Easy Motion Skin® WB-EMS low frequency stimulation device with adjustable intensities for eight muscle groups was used. The current intensity was individually adjusted for each participant at each trial to ensure safety, avoiding pain and muscle cramps. In study 1, thirteen individuals were included for each sub question. A randomized cross-over design with three measurement appointments used was to avoid confounding factors such as delayed onset muscle soreness. The 10MISWT was performed until the participants no longer met the criteria of the test and recording five outcome measures: peak oxygen uptake (VO2peak), relative VO2peak (rel.VO2peak), maximum walk distance (MWD), blood lactate concentration, and the rate of perceived exertion (RPE).
Eleven participants were included in study 2. A randomized cross-over design in a study with four measurement appointments was used to avoid confounding factors. A treadmill test protocol at constant velocity (6.5 m/s) was developed to compare exercise intensities. Oxygen uptake (VO2), relative VO2 (rel.VO2) blood lactate, and the RPE were used as outcome variables. Test-retest reliability between measurements was determined using a compilation of absolute and relative measures of reliability. Outcome measures in study 2 were studied using multifactorial analyses of variances.
Results: Reliability analysis showed good reliability for VO2peak, rel.VO2peak, MWD and RPE with no statistically significant difference for WB-EMS-W during 10WISWT. However, differences compared to conventional walking in outcome variables were not found. The analysis of the treadmill tests showed significant effects for the factors CON/WB-EMS and W/NW for the outcome variables VO2, rel.VO2 and lactate, with both factors leading to higher results. However, the difference in VO2 and relative VO2 is within the range of biological variability of ± 12%. The factor combination EMS∗W/NW is statistically non-significant for all three variables. WB-EMS resulted in the higher RPE values, RPE differences for W/NW and EMS∗W/NW were not significant.
Discussion: The present project found good reliability for measuring VO2peak, rel. VO2peak, MWD and RPE during 10MISWT during WB-EMS-W, confirming prior research of the test. The test appears technically limited rather than physiologically in healthy, moderately active men. However, it is unsuitable for investigating differences in exercise intensities using WB-EMS-W compared to CON-W due to different perceptions of current intensity between exercise and rest. A treadmill test with constant walking speed was conducted to adjust individual maximum tolerable current intensity for the second part of the project. The treadmill test showed a significant increase in metabolic demands during WB-EMS-W and WB-EMS-NW by an increased VO2 and blood lactate concentration. However, the clinical relevance of these findings remains debatable. The study also found that WB-EMS superimposed exercises are perceived as more strenuous than conventional exercise. While in parts comparable studies lead to higher results for VO2, our results are in line with those of other studies using the same frequency. Due to the minor clinical relevance the use of WB-EMS as exercise intensification tool during walking and Nordic walking is limited. High device cost should be considered. Habituation to WB-EMS could increase current intensity tolerance and VO2 and make it a meaningful method in the treatment of T2DM. Recent figures show that WB-EMS is used in obese people to achieve health and weight goals. The supposed benefit should be further investigated scientifically.