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Objective:
Depression and coronary heart disease (CHD) are highly comorbid conditions. Brain-derived neurotrophic factor (BDNF) plays an important role in cardiovascular processes. Depressed patients typically show decreased BDNF concentrations. We analysed the relationship between BDNF and depression in a sample of patients with CHD and additionally distinguished between cognitive-affective and somatic depression symptoms. We also investigated whether BDNF was associated with somatic comorbidity burden, acute coronary syndrome (ACS) or congestive heart failure (CHF).
Methods:
The following variables were assessed for 225 hospitalised patients with CHD: BDNF concentrations, depression [Patient Health Questionnaire-9 (PHQ-9)], somatic comorbidity (Charlson Comorbidity Index), CHF, ACS, platelet count, smoking status and antidepressant treatment.
Results:
Regression models revealed that BDNF was not associated with severity of depression. Although depressed patients (PHQ-9 score >7) had significantly lower BDNF concentrations compared to non-depressed patients (p = 0.04), this was not statistically significant after controlling for confounders (p = 0.15). Cognitive-affective symptoms and somatic comorbidity burden each closely missed a statistically significant association with BDNF concentrations (p = 0.08, p = 0.06, respectively). BDNF was reduced in patients with CHF (p = 0.02). There was no covariate-adjusted, significant association between BDNF and ACS.
Conclusion:
Serum BDNF concentrations are associated with cardiovascular dysfunction. Somatic comorbidities should be considered when investigating the relationship between depression and BDNF.
Real options are widely applied in strategic and operational decision-making, allowing for managerial flexibility in uncertaincontexts. Increased scholarly interest has led to an extensive but fragmented research landscape. We aim to measure andsystematize the research field quantitatively. To achieve this goal, we conduct bibliometric performance analyses and bibliographiccoupling analyses with an in-depth content review. The results of the performance analyses show an increasing interest in realoptions since the beginning of the 2000s and identify the most influential journals and authors. The science mappings reveal sixand seven research clusters over the last two decades. Based on an in-depth analysis of their themes, we develop a researchframework comprising antecedents, application areas, internal and external contingencies, and uncertainty resolution throughreal option valuation or reasoning. We identify several gaps in that framework, which we propose to tackle in future research.
We are glad to introduce the Second Journal Club of Volume Five, Second Issue. This edition is focused on relevant studies published in the last few years in the field of resistance training, chosen by our Editorial Board members and their colleagues. We hope to stimulate your curiosity in this field and to share with you the passion for the sport, seen also from the scientific point of view. The Editorial Board members wish you an inspiring lecture.
Background Recent shoulder injury prevention programs have utilized resistance exercises combined with different forms of instability, with the goal of eliciting functional adaptations and thereby reducing the risk of injury. However, it is still unknown how an unstable weight mass (UWM) affects the muscular activity of the shoulder stabilizers. Aim of the study was to assess neuromuscular activity of dynamic shoulder stabilizers under four conditions of stable and UWM during three shoulder exercises. It was hypothesized that a combined condition of weight with UWM would elicit greater activation due to the increased stabilization demand. Methods Sixteen participants (7 m/9 f) were included in this cross-sectional study and prepared with an EMG-setup for the: Mm. upper/lower trapezius (U.TA/L.TA), lateral deltoid (DE), latissimus dorsi (LD), serratus anterior (SA) and pectoralis major (PE). A maximal voluntary isometric contraction test (MVIC; 5 s.) was performed on an isokinetic dynamometer. Next, internal/external rotation (In/Ex), abduction/adduction (Ab/Ad) and diagonal flexion/extension (F/E) exercises (5 reps.) were performed with four custom-made-pipes representing different exercise conditions. First, the empty-pipe (P; 0.5 kg) and then, randomly ordered, water-filled-pipe (PW; 1 kg), weight-pipe (PG; 4.5 kg) and weight + water-filled-pipe (PWG; 4.5 kg), while EMG was recorded. Raw root-mean-square values (RMS) were normalized to MVIC (%MVIC). Differences between conditions for RMS%MVIC, scapular stabilizer (SR: U.TA/L.TA; U.TA/SA) and contraction (CR: concentric/eccentric) ratios were analyzed (paired t-test; p <= 0.05; Bonferroni adjusted alpha = 0.008). Results PWG showed significantly greater muscle activity for all exercises and all muscles except for PE compared to P and PW. Condition PG elicited muscular activity comparable to PWG (p > 0.008) with significantly lower activation of L.TA and SA in the In/Ex rotation. The SR ratio was significantly higher in PWG compared to P and PW. No significant differences were found for the CR ratio in all exercises and for all muscles. Conclusion Higher weight generated greater muscle activation whereas an UWM raised the neuromuscular activity, increasing the stabilization demands. Especially in the In/Ex rotation, an UWM increased the RMS%MVIC and SR ratio. This might improve training effects in shoulder prevention and rehabilitation programs.
Der tänzerische Kreativitätstest stellt ein valides Instrumentarium dar, welches auf tanzspezifischen Aufgaben basiert und für die differenzierte und standardisierte Erfassung der tänzerischen Kreativität bei Kindern im Alter von 8 bis 12 Jahren konzipiert ist. Mit dem tänzerischen Kreativitätstest können nicht nur Fragestellungen zum Stand sowie zur Entwicklung tänzerisch-kreativer Fähigkeiten im Kindesalter bearbeitet werden, sondern er liefert auch wertvolle Informationen für die Optimierung von Trainings-, Förder- und Vermittlungsmaßnahmen. Erfasst werden folgende tänzerisch-kreativen Fähigkeiten: 1) Vielfalt und Originalität in der Fortbewegung und in Körperpositionen sowie 2) Ideenreichtum, Vielfalt und Originalität in der Gestaltung von Bewegungspatterns und -kompositionen. Dieser Test lässt sich mit größeren Gruppen und minimalem materiellen Aufwand durchführen, ist zeitlich unbeschränkt und ermöglicht es, unterschiedliche Leistungsniveaus zu identifizieren. Der tänzerische Kreativitätstest bietet Forschenden und Lehrkräften eine wertvolle Möglichkeit, die tänzerisch-kreativen Fähigkeiten von Kindern zu analysieren und zu fördern.
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.
Background: Physical fitness is a key aspect of children’s ability to perform activities of daily living, engage in leisure activities, and is associated with important health characteristics. As such, it shows multi-directional associations with weight status as well as executive functions, and varies according to a variety of moderating factors, such as the child’s gender, age, geographical location, and socioeconomic conditions and context. The assessment and monitoring of children’s physical fitness has gained attention in recent decades, as has the question of how to promote physical fitness through the implementation of a variety of programs and interventions. However, these programs and interventions rarely focus on children with deficits in their physical fitness. Due to their deficits, these children are at the highest risk of suffering health impairments compared to their more average fit peers. In efforts to promote physical fitness, schools could offer promising and viable approaches to interventions, as they provide access to large youth populations while providing useful infrastructure. Evidence suggests that school-based physical fitness interventions, particularly those that include supplementary physical education, are useful for promoting and improving physical fitness in children with normal fitness. However, there is little evidence on whether these interventions have similar or even greater effects on children with deficits in their physical fitness. Furthermore, the question arises whether these measures help to sustainably improve the development/trajectories of physical fitness in these children.
The present thesis aims to elucidate the following four objectives: (1) to evaluate the effects of a 14 week intervention with 2 x 45 minutes per week additional remedial physical education on physical fitness and executive function in children with deficits in their physical fitness; (2) to assess moderating effects of body height and body mass on physical fitness components in children with physical fitness deficits; (3) to assess moderating effects of age and skeletal growth on physical fitness in children with physical fitness deficits; and (4) to analyse moderating effects of different physical fitness components on executive function in children with physical fitness deficits.
Methods: Using physical fitness data from the EMOTIKON study, 76 third graders with physical fitness deficits were identified in 11 schools in Brandenburg state that met the requirements for implementing a remedial physical education intervention (i.e., employing specially trained physical education teachers). The fitness intervention was implemented in a cross-over design and schools were randomly assigned to either an intervention-control or control-intervention group. The remedial physical education intervention consisted of a 14 week, 2 x 45 minutes per week remedial physical education curriculum supplemented by a physical exercise homework program. Assessments were conducted at the beginning and end of each intervention and control period, and further assessments were conducted at the beginning and end of each school year until the end of sixth grade. Physical fitness as the primary outcome was assessed using fitness tests implemented in the EMOTIKON study (i.e., lower body muscular strength (standing long jump), speed (20 m sprint), cardiorespiratory fitness (6 min run), agility (star run), upper body muscular strength (ball push test), and balance (one leg balance)). Executive functions as a secondary outcome were assessed using attention and psychomotor processing speed (digit symbol substitution test), mental flexibility and fine motor skills (trail making test), and inhibitory control (Simon task). Anthropometric measures such as body height, body mass, maturity offset, and body composition parameters, as well as socioeconomic information were recorded as potential moderators.
Results: (1) The evaluation of possible effects of the remedial physical education intervention on physical fitness and executive functions of children with deficits in their physical fitness did not reveal any detectable intervention-related improvements in physical fitness or executive functions. The implemented analysis strategies also showed moderating effects of body mass index (BMI) on performance in 6 min run, star run, and standing long jump, with children with a lower BMI performing better, moderating effects of proximity to Berlin on performance in the 6 min run and standing long jump, better performances being found in children living closer to Berlin, and overall gendered differences in executive function test performance, with boys performing better compared to girls. (2) Analysing moderating effects of body height and body mass on physical fitness performance, better overall physical fitness performance was found for taller children. For body mass, a negative effect was found on performance in the 6 min run (linear), standing long jump (linear), and 20 m sprint (quadratic), with better performance associated with lighter children, and a positive effect of body mass on performance in the ball push test, with heavier children performing better. In addition, the analysis revealed significant interactions between body height and body mass on performance in 6 min run and 20 m sprint, with higher body mass being associated with performance improvements in larger children, while higher body mass was associated with performance declines in smaller children. In addition, the analysis revealed overall age-related improvements in physical fitness and was able to show that children with better overall physical fitness also elicit greater age-related improvements. (3) In the analysis of moderating effects of age and maturity offset on physical fitness performances, two unrotated principal components of z-transformed age and maturity offset values were calculated (i.e., relative growth = (age + maturity offset)/2; growth delay = (age - maturity offset)) to avoid colinearity. Analysing these constructs revealed positive effects of relative growth on performances in star run, 20 m sprint, and standing long jump, with children of higher relative growth performing better. For growth delay, positive effects were found on performances in 6 min run and 20 m sprint, with children having larger growth delays showing better performances. Further, the model revealed gendered differences in 6 min run and 20 m sprint performances with girls performing better than boys. (4) Analysing the effects of physical fitness tests on executive function revealed a positive effect of star run and one leg balance performance and a negative effect of 6 min run performance on reaction speed in the Simon task. However, these effects were not detectable when individual differences were accounted for. Then these effects showed overall positive effects, with better performances being associated with faster reaction speeds. In addition, the analysis revealed a positive correlation between overall reaction speed and effects of the 6 min run, suggesting that children with greater effects of 6 min run had faster overall reaction speeds. Negative correlations were found between star run effects and age effects on Simon task reaction speed, meaning that children with larger star run effects had smaller age effects, and between 6 min run effects and star run effects on Simon task reaction speed, meaning that children with larger 6 min run effects tended to have smaller star run effects on Simon task reaction speed and vice versa.
Conclusions: (1) The lack of detectable intervention-related effects could have been caused by an insufficient intervention period, by the implementation of comprehensive and thus non- specific exercises, or by both. Accordingly, longer intervention periods and/or more specific exercises may have been more beneficial and could have led to detectable improvements in physical fitness and/or executive function. However, it remains unclear whether these interventions can benefit children with deficits in physical fitness, as it is possible that their deficits are not caused by a mere lack of exercise, but rather depend on the socioeconomic conditions of the children and their families and areas. Therefore, further research is needed to assess the moderation of physical fitness in children with physical fitness deficits and, in particular, the links between children’s environment and their physical fitness trajectories. (2) Findings from this work suggest that using BMI as a composite of body height and body mass may not be able to capture the variation associated with these parameters and their interactions. In particular, because of their multidirectional associations, further research would help elucidate how BMI and its subcomponents influence physical fitness and how they vary between children with and without physical fitness deficits. (3) The assessment of growth- related changes indicated negative effects associated with the growth spurt approaching age of peak height velocity, and furthermore showed significant differences in these effects between children. Thus, these effects and possible interindividual differences should be considered in the assessment of the development of physical fitness in children. (4) Furthermore, this work has shown that the associations between physical fitness and executive functions vary between children and may be moderated by children’s socioeconomic conditions and the structure of their daily activities. Further research is needed to explore these associations using approaches that account for individual variance.
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.
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.
In animals and humans, behavior can be influenced by irrelevant stimuli, a phenomenon called Pavlovian-to-instrumental transfer (PIT). In subjects with substance use disorder, PIT is even enhanced with functional activation in the nucleus accumbens (NAcc) and amygdala. While we observed enhanced behavioral and neural PIT effects in alcohol-dependent subjects, we here aimed to determine whether behavioral PIT is enhanced in young men with high-risk compared to low-risk drinking and subsequently related functional activation in an a-priori region of interest encompassing the NAcc and amygdala and related to polygenic risk for alcohol consumption. A representative sample of 18-year old men (n = 1937) was contacted: 445 were screened, 209 assessed: resulting in 191 valid behavioral, 139 imaging and 157 genetic datasets. None of the subjects fulfilled criteria for alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders-IV-TextRevision (DSM-IV-TR). We measured how instrumental responding for rewards was influenced by background Pavlovian conditioned stimuli predicting action-independent rewards and losses. Behavioral PIT was enhanced in high-compared to low-risk drinkers (b = 0.09, SE = 0.03, z = 2.7, p < 0.009). Across all subjects, we observed PIT-related neural blood oxygen level-dependent (BOLD) signal in the right amygdala (t = 3.25, p(SVC) = 0.04, x = 26, y = -6, z = -12), but not in NAcc. The strength of the behavioral PIT effect was positively correlated with polygenic risk for alcohol consumption (r(s) = 0.17, p = 0.032). We conclude that behavioral PIT and polygenic risk for alcohol consumption might be a biomarker for a subclinical phenotype of risky alcohol consumption, even if no drug-related stimulus is present. The association between behavioral PIT effects and the amygdala might point to habitual processes related to out PIT task. In non-dependent young social drinkers, the amygdala rather than the NAcc is activated during PIT; possible different involvement in association with disease trajectory should be investigated in future studies.
Background: Habitual walking speed predicts many clinical conditions later in life, but it declines with age. However, which particular exercise intervention can minimize the age-related gait speed loss is unclear.
Purpose: Our objective was to determine the effects of strength, power, coordination, and multimodal exercise training on healthy old adults' habitual and fast gait speed.
Methods: We performed a computerized systematic literature search in PubMed and Web of Knowledge from January 1984 up to December 2014. Search terms included 'Resistance training', 'power training', 'coordination training', 'multimodal training', and 'gait speed (outcome term). Inclusion criteria were articles available in full text, publication period over past 30 years, human species, journal articles, clinical trials, randomized controlled trials, English as publication language, and subject age C65 years. The methodological quality of all eligible intervention studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. We computed weighted average standardized mean differences of the intervention-induced adaptations in gait speed using a random-effects model and tested for overall and individual intervention effects relative to no-exercise controls.
Results: A total of 42 studies (mean PEDro score of 5.0 +/- 1.2) were included in the analyses (2495 healthy old adults; age 74.2 years [64.4-82.7]; body mass 69.9 +/- 4.9 kg, height 1.64 +/- 0.05 m, body mass index 26.4 +/- 1.9 kg/m(2), and gait speed 1.22 +/- 0.18 m/s). The search identified only one power training study, therefore the subsequent analyses focused only on the effects of resistance, coordination, and multimodal training on gait speed. The three types of intervention improved gait speed in the three experimental groups combined (n = 1297) by 0.10 m/s (+/- 0.12) or 8.4 % (+/- 9.7), with a large effect size (ES) of 0.84. Resistance (24 studies; n = 613; 0.11 m/s; 9.3 %; ES: 0.84), coordination (eight studies, n = 198; 0.09 m/s; 7.6 %; ES: 0.76), and multimodal training (19 studies; n = 486; 0.09 m/s; 8.4 %, ES: 0.86) increased gait speed statistically and similarly.
Conclusions: Commonly used exercise interventions can functionally and clinically increase habitual and fast gait speed and help slow the loss of gait speed or delay its onset.
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.
The Adaptive Force (AF) reflects the neuromuscular capacity to adapt to external loads during holding muscle actions and is similar to motions in real life and sports. The maximal isometric AF (AFisomax) was considered to be the most relevant parameter and was assumed to have major importance regarding injury mechanisms and the development of musculoskeletal pain. The aim of this study was to investigate the behavior of different torque parameters over the course of 30 repeated maximal AF trials. In addition, maximal holding vs. maximal pushing isometric muscle actions were compared. A side consideration was the behavior of torques in the course of repeated AF actions when comparing strength and endurance athletes. The elbow flexors of n = 12 males (six strength/six endurance athletes, non-professionals) were measured 30 times (120 s rest) using a pneumatic device. Maximal voluntary isometric contraction (MVIC) was measured pre and post. MVIC, AFisomax, and AFmax (maximal torque of one AF measurement) were evaluated regarding different considerations and statistical tests. AFmax and AFisomax declined in the course of 30 trials [slope regression (mean ± standard deviation): AFmax = −0.323 ± 0.263; AFisomax = −0.45 ± 0.45]. The decline from start to end amounted to −12.8% ± 8.3% (p < 0.001) for AFmax and −25.41% ± 26.40% (p < 0.001) for AFisomax. AF parameters declined more in strength vs. endurance athletes. Thereby, strength athletes showed a rather stable decline for AFmax and a plateau formation for AFisomax after 15 trials. In contrast, endurance athletes reduced their AFmax, especially after the first five trials, and remained on a rather similar level for AFisomax. The maximum of AFisomax of all 30 trials amounted 67.67% ± 13.60% of MVIC (p < 0.001, n = 12), supporting the hypothesis of two types of isometric muscle action (holding vs. pushing). The findings provided the first data on the behavior of torque parameters after repeated isometric–eccentric actions and revealed further insights into neuromuscular control strategies. Additionally, they highlight the importance of investigating AF parameters in athletes based on the different behaviors compared to MVIC. This is assumed to be especially relevant regarding injury mechanisms.
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.
Exercise or not?
(2023)
Objective: Individuals’ decisions to engage in exercise are often the result of in-the-moment choices between exercise and a competing behavioral alternative. The purpose of this study was to investigate processes that occur in-the-moment (i.e., situated processes) when individuals are faced with the choice between exercise and a behavioral alternative during a computerized task. These were analyzed against the background of interindividual differences in individuals’ automatic valuation and controlled evaluation of exercise.
Method: In a behavioral alternatives task 101 participants were asked whether they would rather choose an exercise option or a behavioral alternative in 25 trials. Participants’ gaze behavior (first gaze and fixations) was recorded using eye-tracking. An exercise-specific affect misattribution procedure (AMP) was used to assess participants’ automatic valuation of exercise before the task. After the task, self-reported feelings towards exercise (controlled evaluation) and usual weekly exercise volume were assessed. Mixed effects models with random effects for subjects and trials were used for data analysis.
Results: Choosing exercise was positively correlated with individuals’ automatic valuation (r = 0.20, p = 0.05), controlled evaluation (r = 0.58, p < 0.001), and their weekly exercise volume (r = 0.43, p < 0.001). Participants showed no bias in their initial gaze or number of fixations towards the exercise or the non-exercise alternative. However, participants were 1.30 times more likely to fixate on the chosen alternative first and more frequently, but this gaze behavior was not related to individuals’ automatic valuation, controlled evaluation, or weekly exercise volume.
Conclusion: The results suggest that situated processes arising from defined behavioral alternatives may be independent of individuals’ general preferences. Despite one’s best general intention to exercise more, the choice of a non-exercise alternative behavior may seem more appealing in-the-moment and eventually be chosen. New psychological theories of health behavior change should therefore better consider the role of potentially conflicting alternatives when it comes to initiating physical activity or exercise.
Muscle quality defined as the ratio of muscle strength to muscle mass disregards underlying factors which influence muscle strength. The aim of this review was to investigate the relationship of phase angle (PhA), echo intensity (EI), muscular adipose tissue (MAT), muscle fiber type, fascicle pennation angle (θf), fascicle length (lf), muscle oxidative capacity, insulin sensitivity (IS), neuromuscular activation, and motor unit to muscle strength. PubMed search was performed in 2021. The inclusion criteria were: (i) original research, (ii) human participants, (iii) adults (≥18 years). Exclusion criteria were: (i) no full-text, (ii) non-English or -German language, (iii) pathologies. Forty-one studies were identified. Nine studies found a weak–moderate negative (range r: [−0.26]–[−0.656], p < 0.05) correlation between muscle strength and EI. Four studies found a weak–moderate positive correlation (range r: 0.177–0.696, p < 0.05) between muscle strength and PhA. Two studies found a moderate-strong negative correlation (range r: [−0.446]–[−0.87], p < 0.05) between muscle strength and MAT. Two studies found a weak-strong positive correlation (range r: 0.28–0.907, p < 0.05) between θf and muscle strength. Muscle oxidative capacity was found to be a predictor of muscle strength. This review highlights that the current definition of muscle quality should be expanded upon as to encompass all possible factors of muscle quality.
The relevance of physical fitness for children’s and adolescents’ health is indisputable and it is crucial to regularly assess and evaluate children’s and adolescents’ individual physical fitness development to detect potential negative health consequences in time. Physical fitness tests are easy-to-administer, reliable, and valid which is why they should be widely used to provide information on performance development and health status of children and adolescents. When talking about development of physical fitness, two perspectives can be distinguished. One perspective is how the physical fitness status of children and adolescents changed / developed over the past decades (i.e., secular trends). The other perspective covers the analyses how physical fitness develops with increasing age due to growth and maturation processes. Although, the development of children’s and adolescents’ physical fitness has been extensively described and analyzed in the literature, still some questions remain to be uncovered that will be addressed in the present doctoral thesis.
Previous systematic reviews and meta-analyses have examined secular trends in children’s and adolescents’ physical fitness. However, considering that those analyses are by now 15 years old and that updates are available only to limited components of physical fitness, it is time to re-analyze the literature and examine secular trends for selected components of physical fitness (i.e., cardiorespiratory endurance, muscle strength, proxies of muscle power, and speed). Fur-thermore, the available studies on children’s development of physical fitness as well as the ef-fects of moderating variables such as age and sex have been investigated within a long-term ontogenetic perspective. However, the effects of age and sex in the transition from pre-puberty to puberty in the ninth year of life using a short-term ontogenetic perspective and the effect of timing of school enrollment on children’s development of physical fitness have not been clearly identified. Therefore, the present doctoral thesis seeks to complement the knowledge of children’s and adolescents’ physical fitness development by updating secular trend analysis in selected components of physical fitness, by examining short-term ontogenetic cross-sectional developmental differences in children`s physical fitness, and by comparing physical fitness of older- and younger-than-keyage children versus keyage-children. These findings provide valuable information about children’s and adolescents’ physical fitness development to help prevent potential deficits in physical fitness as early as possible and consequently ensure a holistic development and a lifelong healthy life.
Initially, a systematic review to provide an ‘update’ on secular trends in selected components of physical fitness (i.e., cardiorespiratory endurance, relative muscle strength, proxies of muscle power, speed) in children and adolescents aged 6 to 18 years was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guidelines. To examine short-term ontogenetic cross-sectional developmental differences and to compare physical fitness of older- and younger-than-keyage children versus keyage-children physical fitness data of 108,295 keyage-children (i.e., aged 8.00 to 8.99 years), 2,586 younger-than-keyage children (i.e., aged 7.00 to 7.99 years), and 26,540 older-than-keyage children (i.e., aged 9.00 to 9.99 years) from the third grade were analyzed. Physical fitness was assessed through the EMOTIKON test battery measuring cardiorespiratory endurance (i.e., 6-min-run test), coordina-tion (i.e., star-run test), speed (i.e., 20-m linear sprint test), and proxies of lower (i.e., standing long jump test) and upper limbs (i.e., ball-push test) muscle power. Statistical inference was based on Linear Mixed Models.
Findings from the systematic review revealed a large initial improvement and an equally large subsequent decline between 1986 and 2010 as well as a stabilization between 2010 and 2015 in cardiorespiratory endurance, a general trend towards a small improvement in relative muscle strength from 1972 to 2015, an overall small negative quadratic trend for proxies of muscle power from 1972 to 2015, and a small-to-medium improvement in speed from 2002 to 2015. Findings from the cross-sectional studies showed that even in a single prepubertal year of life (i.e., ninth year) physical fitness performance develops linearly with increasing chronological age, boys showed better performances than girls in all physical fitness components, and the components varied in the size of sex and age effects. Furthermore, findings revealed that older-than-keyage children showed poorer performance in physical fitness compared to keyage-children, older-than-keyage girls showed better performances than older-than-keyage boys, and younger-than-keyage children outperformed keyage-children.
Due to the varying secular trends in physical fitness, it is recommended to promote initiatives for physical activity and physical fitness for children and adolescents to prevent adverse effects on health and well-being. More precisely, public health initiatives should specifically consider exercising cardiorespiratory endurance and muscle strength because both components showed strong positive associations with markers of health. Furthermore, the findings implied that physical education teachers, coaches, or researchers can utilize a proportional adjustment to individually interpret physical fitness of prepubertal school-aged children. Special attention should be given to the promotion of physical fitness of older-than-keyage children because they showed poorer performance in physical fitness than keyage-children. Therefore, it is necessary to specifically consider this group and provide additional health and fitness programs to reduce their deficits in physical fitness experienced during prior years to guarantee a holistic development.
Stress and pain
(2022)
Introduction: Low back pain (LBP) leads to considerable impairment of quality of life worldwide and is often accompanied by psychosomatic symptoms.
Objectives: First, to assess the association between stress and chronic low back pain (CLBP) and its simultaneous appearance with fatigue and depression as a symptom triad. Second, to identify the most predictive stress-related pattern set for CLBP for a 1-year diagnosis.
Methods: In a 1-year observational study with four measurement points, a total of 140 volunteers (aged 18–45 years with intermittent pain) were recruited. The primary outcomes were pain [characteristic pain intensity (CPI), subjective pain disability (DISS)], fatigue, and depressive mood. Stress was assessed as chronic stress, perceived stress, effort reward imbalance, life events, and physiological markers [allostatic load index (ALI), hair cortisol concentration (HCC)]. Multiple linear regression models and selection procedures for model shrinkage and variable selection (least absolute shrinkage and selection operator) were applied. Prediction accuracy was calculated by root mean squared error (RMSE) and receiver-operating characteristic curves.
Results: There were 110 participants completed the baseline assessments (28.2 7.5 years, 38.1% female), including HCC, and a further of 46 participants agreed to ALI laboratory measurements. Different stress types were associated with LBP, CLBP, fatigue, and depressive mood and its joint occurrence as a symptom triad at baseline; mainly social-related stress types were of relevance. Work-related stress, such as “excessive demands at work”[b = 0.51 (95%CI -0.23, 1.25), p = 0.18] played a role for upcoming chronic pain disability. “Social overload” [b = 0.45 (95%CI -0.06, 0.96), p = 0.080] and “over-commitment at work” [b = 0.28 (95%CI -0.39, 0.95), p = 0.42] were associated with an upcoming depressive mood within 1-year. Finally, seven psychometric (CPI: RMSE = 12.63; DISS: RMSE = 9.81) and five biomarkers (CPI: RMSE = 12.21; DISS: RMSE = 8.94) could be derived as the most predictive pattern set for a 1-year prediction of CLBP. The biomarker set showed an apparent area under the curve of 0.88 for CPI and 0.99 for DISS.
Conclusion: Stress disrupts allostasis and favors the development of chronic pain, fatigue, and depression and the emergence of a “hypocortisolemic symptom triad,” whereby the social-related stressors play a significant role. For translational medicine, a predictive pattern set could be derived which enables to diagnose the individuals at higher risk for the upcoming pain disorders and can be used in practice.
Long COVID patients show symptoms, such as fatigue, muscle weakness and pain. Adequate diagnostics are still lacking. Investigating muscle function might be a beneficial approach. The holding capacity (maximal isometric Adaptive Force; AFisomax) was previously suggested to be especially sensitive for impairments. This longitudinal, non-clinical study aimed to investigate the AF in long COVID patients and their recovery process. AF parameters of elbow and hip flexors were assessed in 17 patients at three time points (pre: long COVID state, post: immediately after first treatment, end: recovery) by an objectified manual muscle test. The tester applied an increasing force on the limb of the patient, who had to resist isometrically for as long as possible. The intensity of 13 common symptoms were queried. At pre, patients started to lengthen their muscles at ~50% of the maximal AF (AFmax), which was then reached during eccentric motion, indicating unstable adaptation. At post and end, AFisomax increased significantly to ~99% and 100% of AFmax, respectively, reflecting stable adaptation. AFmax was statistically similar for all three time points. Symptom intensity decreased significantly from pre to end. The findings revealed a substantially impaired maximal holding capacity in long COVID patients, which returned to normal function with substantial health improvement. AFisomax might be a suitable sensitive functional parameter to assess long COVID patients and to support therapy process
The link between emotions and motor function has been known for decades but is still not clarified. The Adaptive Force (AF) describes the neuromuscular capability to adapt to increasing forces and was suggested to be especially vulnerable to interfering inputs. This study investigated the influence of pleasant an unpleasant food imagery on the manually assessed AF of elbow and hip flexors objectified by a handheld device in 12 healthy women. The maximal isometric AF was significantly reduced during unpleasant vs. pleasant imagery and baseline (p < 0.001, dz = 0.98–1.61). During unpleasant imagery, muscle lengthening started at 59.00 ± 22.50% of maximal AF, in contrast to baseline and pleasant imagery, during which the isometric position could be maintained mostly during the entire force increase up to ~97.90 ± 5.00% of maximal AF. Healthy participants showed an immediately impaired holding function triggered by unpleasant imagery, presumably related to negative emotions. Hence, AF seems to be suitable to test instantaneously the effect of emotions on motor function. Since musculoskeletal complaints can result from muscular instability, the findings provide insights into the understanding of the causal chain of linked musculoskeletal pain and mental stress. A case example (current stress vs. positive imagery) suggests that the approach presented in this study might have future implications for psychomotor diagnostics and therapeutics.
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.
Isometric muscle function
(2022)
The cumulative dissertation consists of four original articles. These considered isometric muscle ac-tions in healthy humans from a basic physiological view (oxygen and blood supply) as well as possibilities of their distinction. It includes a novel approach to measure a specific form of isometric hold-ing function which has not been considered in motor science so far. This function is characterized by an adaptation to varying external forces with particular importance in daily activities and sports.
The first part of the research program analyzed how the biceps brachii muscle is supplied with oxygen and blood by adapting to a moderate constant load until task failure (publication 1). In this regard, regulative mechanisms were investigated in relation to the issue of presumably compressed capillaries due to high intramuscular pressures (publication 2).
Furthermore, it was examined if oxygenation and time to task failure (TTF) differs compared to an-other isometric muscle function (publication 3). This function is mainly of diagnostic interest by measuring the maximal voluntary isometric contraction (MVIC) as a gold standard. For that, a person pulls on or pushes against an insurmountable resistance. However, the underlying pulling or pushing form of isometric muscle action (PIMA) differs compared to the holding one (HIMA).
HIMAs have mainly been examined by using constant loads. In order to quantify the adaptability to varying external forces, a new approach was necessary and considered in the second part of the research program. A device was constructed based on a previously developed pneumatic measurement system. The device should have been able to measure the Adaptive Force (AF) of elbow ex-tensor muscles. The AF determines the adaptability to increasing external forces under isometric (AFiso) and eccentric (AFecc) conditions. At first, it was questioned if these parameters can be relia-bly assessed by use of the new device (publication 4). Subsequently, the main research question was investigated: Is the maximal AFiso a specific and independent variable of muscle function in comparison to the MVIC? Furthermore, both research parts contained a sub-question of how results can be influenced.
Parameters of local oxygen saturation (SvO2) and capillary blood filling (rHb) were non-invasively recorded by a spectrophotometer during maximal and submaximal HIMAs and PIMAs.
These were the main findings: Under load, SvO2 and rHb always adjusted into a steady state after an initial decrease. Nevertheless, their behavior could roughly be categorized into two types. In type I, both parameters behaved nearly parallel to each other. In contrast, their progression over time was partly inverse in type II. The inverse behavior probably depends on the level of deoxygenation since rHb increased reliably at a suggested threshold of about 59% SvO2. This triggered mechanism and the found homeostatic steady states seem to be in conflict with the concept of mechanically compressed capillaries and consequently with a restricted blood flow. Anatomical configuration of blood vessels might provide one hypothetical explanation of how blood flow might be maintained. HIMA and PIMA did not differ regarding oxygenation and allocation to the described types. The TTF tended to be longer during PIMA.
As a sub-question, oxygenation and TTF were compared between (HIMA) and intermittent voluntary muscle twitches during a weight holding task. TTF but not oxygenation differed significantly
(Twitch > HIMA). A changed neuromuscular control might serve as a speculative explanation of how the results can be explained. This is supported by the finding that the TTF did not correlate significantly with the extent of deoxygenation irrespective of the performed task (HIMA, PIMA or Twitch).
Other neuromuscular aspects of muscle function were considered in second part of the re-search program. The new device mentioned above detected different force capacities within four trials at two days each. Among AF measurements, the functional counterpart of a concentric muscle action merging into an isometric one was analyzed in comparison to the MVIC.
Based on the results, it can be assumed that a prior concentric muscle action does not influence the MVIC. However, the results were inconsistent and possibly influenced by systematic errors. In con-trast, maximal variables of the AF (AFisomax and AFeccmax) could be measured in a reliable way which is indicated by a high test-retest reliability. Despite substantial correlations between force variables, the AFisomax differed significantly from MVIC and AFmax, which was identical with AFeccmax in almost all cases. Moreover, AFisomax revealed the highest variability between trials.
These results indicate that maximal force capacities should be assessed separately. The adaptive holding capacity of a muscle can be lower compared to a commonly determined MVIC. This is of relevance since muscles frequently need to respond adequately to external forces. If their response does not correspond to the external impact, the muscle is forced to lengthen. In this scenario, joints are not completely stabilized and an injury may occur. This outlined issue should be addressed in future research in the field of sport and health sciences.
At last, the dissertation presents another possibility to quantify the AFisomax by use of a handheld device applied in combination with a manual muscle test. This assessment delivers a more practical way for clinical purposes.
The post-antiretroviral therapy era has transformed HIV into a chronic disease and non-HIV comorbidities (i.e., cardiovascular and mental diseases) are more prevalent in PLWH. The source of these non-HIV comorbidities aside from traditional risk factor include HIV infection, inflammation, distorted immune activation, burden of chronic diseases, and unhealthy lifestyle like sedentarism. Exercise is known for its beneficial effects in mental and physical health; reasons why exercise is recommended to prevent and treat difference cardiovascular and mental diseases in the general population. This cumulative thesis aimed to comprehend the relation exercise has to non-HIV comorbidities in German PLWH. Four studies were conducted to 1) understand exercise effects in cardiorespiratory fitness and muscle strength on PLWH through a systematic review and meta-analyses and 2) determine the likelihood of German PLWH developing non-HIV comorbidities, in a cross-sectional study. Meta-analytic examination indicates PLWH cardiorespiratory fitness (VO2max SMD = 0.61 ml·kg·min-1, 95% CI: 0.35-0.88, z = 4.47, p < 0.001, I2 = 50%) and strength (of remark lowerbody strength by 16.8 kg, 95% CI: 13–20.6, p< 0.001) improves after an exercise intervention in comparison to a control group. Cross-sectional data suggest exercise has a positive effect on German PLWH mental health (less anxiety and depressive symptoms) and protects against the development of anxiety (PR: 0.57, 95%IC: 0.36 – 0.91, p = 0.01) and depression (PR: 0.62, 95%IC: 0.41 – 0.94, p = 0.01). Likewise, exercise duration is related to a lower likelihood of reporting heart arrhythmias (PR: 0.20, 95%IC: 0.10 – 0.60, p < 0.01) and exercise frequency to a lower likelihood of reporting diabetes mellitus (PR: 0.40, 95%IC: 0.10 – 1, p < 0.01) in German PLWH. A preliminary recommendation for German PLWH who want to engage in exercise can be to exercise ≥ 1 time per week, at an intensity of 5 METs per session or > 103 MET·min·day-1, with a duration ≥ 150 minutes per week. Nevertheless, further research is needed to comprehend exercise dose response and protective effect for cardiovascular diseases, anxiety, and depression in German PLWH.
Developmental Gains in Physical Fitness Components of Keyage and Older-than-Keyage Third-Graders
(2022)
Children who were enrolled according to legal enrollment dates (i.e., keyage third-graders aged eight to nine years) exhibit a positive linear physical fitness development (Fühner et al., 2021). However, children who were enrolled with a delay of one year or who repeated a grade (i.e., older-than-keyage children [OTK] aged nine to ten years in third grade) appear to exhibit a poorer physical fitness relative to what could be expected given their chronological age (Fühner et al., 2022). However, because Fühner et al. (2022) compared the performance of OTK children to predicted test scores that were extrapolated based on the data of keyage children, the observed physical fitness of these children could either indicate a delayed physical-fitness development or some physiological or psychological changes occurring during the tenth year of life. We investigate four hypotheses about this effect. (H1) OTK children are biologically younger than keyage children. A formula transforming OTK’s chronological age into a proxy for their biological age brings some of the observed cross-sectional age-related development in line with the predicted age-related development based on the data of keyage children, but large negative group differences remain. Hypotheses 2 to 4 were tested with a longitudinal assessment. (H2) Physiological changes due to biological maturation or psychological factors cause a stagnation of physical fitness development in the tenth year of life. H2 predicts a decline of performance from third to fourth grade also for keyage children. (H3) OTK children exhibit an age-related (temporary) developmental delay in the tenth year of life, but later catch up to the performance of age-matched keyage children. H3 predicts a larger developmental gain for OTK than for keyage children from third to fourth grade. (H4) OTK children exhibit a sustained physical fitness deficit and do not catch up over time. H4 predicts a positive development for keyage and OTK children, with no greater development for OTK compared to keyage children. The longitudinal study was based on a subset of children from the EMOTIKON project (www.uni-potsdam.de/emotikon). The physical fitness (cardiorespiratory endurance [6-minute-run test], coordination [star-run test], speed [20-m sprint test], lower [standing long jump test] and upper [ball push test] limbs muscle power, and balance [one-legged stance test]) of 1,274 children (1,030 keyage and 244 OTK children) from 32 different schools was tested in third grade and retested one year later in fourth grade. Results: (a) Both keyage and OTK children exhibit a positive longitudinal development from third to fourth grade in all six physical fitness components. (b) There is no evidence for a different longitudinal development of keyage and OTK children. (c) Keyage children (approximately 9.5 years in fourth grade) outperform age-matched OTK children (approximately 9.5 years in third grade) in all six physical fitness components. The results show that the physical fitness of OTK children is indeed impaired and are in support of a sustained difference in physical fitness between the groups of keyage and OTK children (H4).
Throughout the years 2020 and 2021, schools were temporarily closed to slow the spread of SarsCoV-2. For some periods, children were locked out of sports in schools (physical education lessons, school sports working groups) and organized sports in sports clubs which often resulted in physical inactivity. Did these restrictions affect children’s physical fitness? The EMOTIKON project (www.uni-potsdam.de/emotikon) annually assesses the physical fitness (cardiorespiratory endurance [6-minute-run test], coordination [star-run test], speed [20-m sprint test], lower [standing long jump test] and upper [ball push test] limbs muscle power, and balance [one-legged stance test]) of all third graders in the Federal State of Brandenburg, Germany. Participation is mandatory for all public primary schools. In the falls from 2016 to 2021, 83,476 keyage children (i.e., school enrollment according to the legal key date, between eight and nine years in third grade) from 512 schools were assessed with the EMOTIKON test battery. We tested the Covid pandemic effect on a composite score of the four highly correlated physical fitness tests assessing cardiorespiratory endurance, coordination, speed and powerLOW and on another composite score of the three running tests (cardiorespiratory endurance, coordination, speed), as well as separately on all six physical fitness components. Secular trends for each of the physical fitness components and differences between schools and children were taken into account in linear mixed models. We found a negative Covid pandemic effect on the two composite physical fitness scores, as well as on cardiorespiratory endurance, coordination, and speed. We found a positive Covid pandemic effect on powerLOW. Coordination was associated with the largest negative Covid pandemic effect, also passing the threshold of smallest meaningful change (SMC, i.e., 0.2 Cohen’s d) when accumulated across two years. Given the educational context, Covid pandemic effects were also compared relative to the expected age-related development of the physical fitness components between eight and nine years. The Covid pandemic-related developmental costs/gains ranged from three to seven months relative to a longitudinal age effect, and from five to 17 months relative to a cross-sectional age effect. We propose that a longitudinal assessment yields a more reliable estimate of the developmental (age-related) gain than a cross-sectional one. Therefore, we consider the smaller Covid pandemic-related developmental costs/gains to be more credible. Interestingly, on the school level, „fitter” schools (relatively higher Grand Mean) exhibited larger negative Covid pandemic effects than schools with a lower physical fitness score. Negative Covid pandemic effects for the three run tasks were also found by Bähr et al. (2022), who tested the physical fitness of 16,496 Thuringian third-graders from 292 schools with the same six physical fitness tests used in EMOTIKON. Our results may be used to prioritize health-related interventions.
Das Hauptziel der Bachelorarbeit stellt eine theoretische Auseinandersetzung mit dem Thema Wassergewöhnung im eigenen Zuhause dar. Ausgehend von dieser Ausführung erstellt die Autorin als Theorie-Praxis-Transfer eine Handreichung für Erziehungsberechtigte mit den relevantesten Informationen ihrer Qualifikationsarbeit in komprimierter Form. Damit die Erziehungsberechtigten ihren Kindern proaktiv zur Seite stehen können, soll die Handreichung adressat*innengerecht und prägnant sein, ohne den Erziehungsberechtigten essenzielle Details vorzuenthalten. Die Erziehungsberechtigten erhalten eine Handreichung, welche die bedeutendsten Informationen rund um die Wassergewöhnung zu Hause enthält. Sie erfahren unter anderem etwas über die höchstmögliche Aufenthaltsdauer der Kinder im Wasser und die optimale Temperatur des Badewassers. Außerdem erhalten sie wichtige Informationen rund um die Körperreaktionen, welche durch oder im Wasser auftreten können. Das sind bspw. der Lidschlussreflex oder der Kältereiz. Sie werden über essenzielle Sicherheitsaspekte informiert und erhalten eine kompakte Darstellung über Verhaltensregeln, den sogenannten do’s and dont‘s. Die Übungen/Spiele werden nach den aktuellen Vorgaben der DGUV (2019) für die Inhalte der Wassergewöhnung ausgewählt und nach den heimischen Voraussetzungen strukturiert sein. In der Handreichung werden zudem auch Übungen/Spiele zu finden sein, bei welchen keine Eigenschaften oder Wirkungen des Wassers kennengelernt werden. Atem- und Tauchübungen werden in der Handreichung ebenso beschrieben. Die Angst vor dem Wasser stellt, sobald sie sich manifestiert, bekanntlich das größte Hindernis der Nichtschwimmer*innen dar (DGUV, 2019). Darum möchte die Autorin mit der Aufklärung über diese Angst in ihrer Qualifikationsarbeit und der Handreichung bewirken, dass die Erziehungsberechtigten in der Lage sind, den Kindern das Angstgefühl gegenüber dem Wasser zu nehmen oder ihre Angstfreiheit beizubehalten und um daran anschließend den Kindern Freude an der Bewegung im Wasser zu ermöglichen. „Je mehr Freude die Kinder im Kleinkindalter am Baden haben, je weniger Angst sie mit dem Medium verbinden, umso schneller erlernen sie später das Schwimmen“ (DGUV, 2016, S. 6).
Die theoretischen Grundlagen der Handreichungen stellen die zentralen Aspekte und Ziele der Wassergewöhnung dar. Diese werden der, im Rahmen Schule, bedeutsamen Publikation der Deutschen Gesetzlichen Unfallversicherung aus dem Jahr 2019 entnommen. Hierbei handelt es sich um die Wahrnehmung der spezifischen Voraussetzungen des Wassers sowie deren Annäherung und Gewöhnung. Die Kinder erfahren die Eigenschaften Dichte, Druck und Temperatur des Elements und den Einfluss des Wassers auf den Körper. Das sind Wasserwiderstand, Auftrieb und die Wasserkraft. So werden die Übungen, in denen die Kinder das Wasser kennenlernen, beziehungsweise zum ersten Mal intensiv in Berührung mit diesem kommen, zu Beginn erwähnt. Anschließend folgen Übungen, überwiegend in Spielformen, bei denen die Freude geweckt werden soll. Als letzte Phase folgen Übungen, bei welchen der spezifische Umgang mit dem Wassers vonnöten ist. Diese Struktur ist an den ersten drei Phasen nach Baumeisters (1984) Methodik zur Wassergewöhnung orientiert. So wird zudem das methodische Prinzip vom Einfachen zum Komplexen als theoretische Grundlage verwendet. Legahn (2007) beschreibt einige Lernmodelle, die je nach Alter und Entwicklungsstand bei der Wassergewöhnung angewendet werden können. In der Handreichung wird die Autorin auf diese zurückgreifen und passende Lerntechniken ausführen. Beispiele hierfür sind unter anderem das Lernen am Modell (Nachahmung von Personen, Tieren oder Puppen) oder das Aktive Lernen (ein spielerischer Bewegungsaufbau verbessert die Fertigkeiten). Die benötigten Materialien werden in der Handreichung unter der Überschrift der Übungen/Spiele ausgeführt und dienen als erste Information. Neben der Überschrift werden die möglichen Eigenschaften und Wirkungen des Wassers, welche in dieser spezifischen Übung kennengelernt werden, benannt. Das sind beispielsweise Druck und Auftrieb für Wasserdruck und Wasserauftrieb. Darunter wird die jeweilige Übung beschrieben. Als Visualisierung erstellt die Autorin selbstständig gezeichnete Bilder. Unterhalb dieser Bilder befindet sich oft auch eine passende Spielvariante, um mit dieser Übung noch zusätzlich Freude zu wecken. Ebenso werden auch mehrmals passende Übungsformen oder Tipps erwähnt.
Inter-brain synchronization is primarily investigated during social interactions but had not been examined during coupled muscle action between two persons until now. It was previously shown that mechanical muscle oscillations can develop coherent behavior between two isometrically interacting persons. This case study investigated if inter-brain synchronization appears thereby, and if differences of inter- and intrapersonal muscle and brain coherence exist regarding two different types of isometric muscle action. Electroencephalography (EEG) and mechanomyography/mechanotendography (MMG/MTG) of right elbow extensors were recorded during six fatiguing trials of two coupled isometrically interacting participants (70% MVIC). One partner performed holding and one pushing isometric muscle action (HIMA/PIMA; tasks changed). The wavelet coherence of all signals (EEG, MMG/MTG, force, ACC) were analyzed intra- and interpersonally. The five longest coherence patches in 8–15 Hz and their weighted frequency were compared between real vs. random pairs and between HIMA vs. PIMA. Real vs. random pairs showed significantly higher coherence for intra-muscle, intra-brain, and inter-muscle-brain activity (p < 0.001 to 0.019). Inter-brain coherence was significantly higher for real vs. random pairs for EEG of right and central areas and for sub-regions of EEG left (p = 0.002 to 0.025). Interpersonal muscle-brain synchronization was significantly higher than intrapersonal one, whereby it was significantly higher for HIMA vs. PIMA. These preliminary findings indicate that inter-brain synchronization can arise during muscular interaction. It is hypothesized both partners merge into one oscillating neuromuscular system. The results reinforce the hypothesis that HIMA is characterized by more complex control strategies than PIMA. The pilot study suggests investigating the topic further to verify these results on a larger sample size. Findings could contribute to the basic understanding of motor control and is relevant for functional diagnostics such as the manual muscle test which is applied in several disciplines, e.g., neurology, physiotherapy.
Background: In terms of physiological and biomechanical characteristics, over-pronation of the feet has been associated with distinct muscle recruitment patterns and ground reaction forces during running.
Objective: The aim of this study was to evaluate the effects of running on sand vs. stable ground on ground-reaction-forces (GRFs) and electromyographic (EMG) activity of lower limb muscles in individuals with over-pronated feet (OPF) compared with healthy controls.
Methods: Thirty-three OPF individuals and 33 controls ran at preferred speed and in randomized-order over level-ground and sand. A force-plate was embedded in an 18-m runway to collect GRFs. Muscle activities were recorded using an EMG-system. Data were adjusted for surface-related differences in running speed.
Results: Running on sand resulted in lower speed compared with stable ground running (p < 0.001; d = 0.83). Results demonstrated that running on sand produced higher tibialis anterior activity (p = 0.024; d = 0.28). Also, findings indicated larger loading rates (p = 0.004; d = 0.72) and greater vastus medialis (p < 0.001; d = 0.89) and rectus femoris (p = 0.001; d = 0.61) activities in OPF individuals. Controls but not OPF showed significantly lower gluteus-medius activity (p = 0.022; d = 0.63) when running on sand.
Conclusion: Running on sand resulted in lower running speed and higher tibialis anterior activity during the loading phase. This may indicate alterations in neuromuscular demands in the distal part of the lower limbs when running on sand. In OPF individuals, higher loading rates together with greater quadriceps activity may constitute a proximal compensatory mechanism for distal surface instability.
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.
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
The metabolic syndrome (MetS) is a risk cluster for a number of secondary diseases. The implementation of prevention programs requires early detection of individuals at risk. However, access to health care providers is limited in structurally weak regions. Brandenburg, a rural federal state in Germany, has an especially high MetS prevalence and disease burden. This study aims to validate and test the feasibility of a setup for mobile diagnostics of MetS and its secondary diseases, to evaluate the MetS prevalence and its association with moderating factors in Brandenburg and to identify new ways of early prevention, while establishing a “Mobile Brandenburg Cohort” to reveal new causes and risk factors for MetS.
Methods
In a pilot study, setups for mobile diagnostics of MetS and secondary diseases will be developed and validated. A van will be equipped as an examination room using point-of-care blood analyzers and by mobilizing standard methods. In study part A, these mobile diagnostic units will be placed at different locations in Brandenburg to locally recruit 5000 participants aged 40-70 years. They will be examined for MetS and advice on nutrition and physical activity will be provided. Questionnaires will be used to evaluate sociodemographics, stress perception, and physical activity. In study part B, participants with MetS, but without known secondary diseases, will receive a detailed mobile medical examination, including MetS diagnostics, medical history, clinical examinations, and instrumental diagnostics for internal, cardiovascular, musculoskeletal, and cognitive disorders. Participants will receive advice on nutrition and an exercise program will be demonstrated on site. People unable to participate in these mobile examinations will be interviewed by telephone. If necessary, participants will be referred to general practitioners for further diagnosis.
Discussion
The mobile diagnostics approach enables early detection of individuals at risk, and their targeted referral to local health care providers. Evaluation of the MetS prevalence, its relation to risk-increasing factors, and the “Mobile Brandenburg Cohort” create a unique database for further longitudinal studies on the implementation of home-based prevention programs to reduce mortality, especially in rural regions.
Trial registration
German Clinical Trials Register, DRKS00022764; registered 07 October 2020—retrospectively registered.
Development of chronic pain after a low back pain episode is associated with increased pain sensitivity, altered pain processing mechanisms and the influence of psychosocial factors. Although there is some evidence that multimodal therapy (such as behavioral or motor control therapy) may be an important therapeutic strategy, its long-term effect on pain reduction and psychosocial load is still unclear. Prospective longitudinal designs providing information about the extent of such possible long-term effects are missing. This study aims to investigate the long-term effects of a homebased uni- and multidisciplinary motor control exercise program on low back pain intensity, disability and psychosocial variables. 14 months after completion of a multicenter study comparing uni- and multidisciplinary exercise interventions, a sample of one study center (n = 154) was assessed once more. Participants filled in questionnaires regarding their low back pain symptoms (characteristic pain intensity and related disability), stress and vital exhaustion (short version of the Maastricht Vital Exhaustion Questionnaire), anxiety and depression experiences (the Hospital and Anxiety Depression Scale), and pain-related cognitions (the Fear Avoidance Beliefs Questionnaire). Repeated measures mixed ANCOVAs were calculated to determine the long-term effects of the interventions on characteristic pain intensity and disability as well as on the psychosocial variables. Fifty four percent of the sub-sample responded to the questionnaires (n = 84). Longitudinal analyses revealed a significant long-term effect of the exercise intervention on pain disability. The multidisciplinary group missed statistical significance yet showed a medium sized long-term effect. The groups did not differ in their changes of the psychosocial variables of interest. There was evidence of long-term effects of the interventions on pain-related disability, but there was no effect on the other variables of interest. This may be partially explained by participant's low comorbidities at baseline. Results are important regarding costless homebased alternatives for back pain patients and prevention tasks. Furthermore, this study closes the gap of missing long-term effect analysis in this field.
Purpose: The aim of this study was to compare the effects of moderate intensity, low volume (MILV) vs. low intensity, high volume (LIHV) strength training on sport-specific performance, measures of muscular fitness, and skeletal muscle mass in young kayakers and canoeists.
Methods: Semi-elite young kayakers and canoeists (N = 40, 13 ± 0.8 years, 11 girls) performed either MILV (70–80% 1-RM, 6–12 repetitions per set) or LIHV (30–40% 1-RM, 60–120 repetitions per set) strength training for one season. Linear mixed-effects models were used to compare effects of training condition on changes over time in 250 and 2,000 m time trials, handgrip strength, underhand shot throw, average bench pull power over 2 min, and skeletal muscle mass. Both between- and within-subject designs were used for analysis. An alpha of 0.05 was used to determine statistical significance.
Results: Between- and within-subject analyses showed that monthly changes were greater in LIHV vs. MILV for the 2,000 m time trial (between: 9.16 s, SE = 2.70, p < 0.01; within: 2,000 m: 13.90 s, SE = 5.02, p = 0.01) and bench pull average power (between: 0.021 W⋅kg–1, SE = 0.008, p = 0.02; within: 0.010 W⋅kg–1, SE = 0.009, p > 0.05). Training conditions did not affect other outcomes.
Conclusion: Young sprint kayakers and canoeists benefit from LIHV more than MILV strength training in terms of 2,000 m performance and muscular endurance (i.e., 2 min bench pull power).
Background: The prevalence of diabetes worldwide is predicted to increase from 2.8% in 2000 to 4.4% in 2030. Diabetic neuropathy (DN) is associated with damage to nerve glial cells, their axons, and endothelial cells leading to impaired function and mobility.
Objective: We aimed to examine the effects of an endurance-dominated exercise program on maximum oxygen consumption (VO2max), ground reaction forces, and muscle activities during walking in patients with moderate DN.
Methods: Sixty male and female individuals aged 45–65 years with DN were randomly assigned to an intervention (IG, n = 30) or a waiting control (CON, n = 30) group. The research protocol of this study was registered with the Local Clinical Trial Organization (IRCT20200201046326N1). IG conducted an endurance-dominated exercise program including exercises on a bike ergometer and gait therapy. The progressive intervention program lasted 12 weeks with three sessions per week, each 40–55 min. CON received the same treatment as IG after the post-tests. Pre- and post-training, VO2max was tested during a graded exercise test using spiroergometry. In addition, ground reaction forces and lower limbs muscle activities were recorded while walking at a constant speed of ∼1 m/s.
Results: No statistically significant baseline between group differences was observed for all analyzed variables. Significant group-by-time interactions were found for VO2max (p < 0.001; d = 1.22). The post-hoc test revealed a significant increase in IG (p < 0.001; d = 1.88) but not CON. Significant group-by-time interactions were observed for peak lateral and vertical ground reaction forces during heel contact and peak vertical ground reaction force during push-off (p = 0.001–0.037; d = 0.56–1.53). For IG, post-hoc analyses showed decreases in peak lateral (p < 0.001; d = 1.33) and vertical (p = 0.004; d = 0.55) ground reaction forces during heel contact and increases in peak vertical ground reaction force during push-off (p < 0.001; d = 0.92). In terms of muscle activity, significant group-by-time interactions were found for vastus lateralis and gluteus medius during the loading phase and for vastus medialis during the mid-stance phase, and gastrocnemius medialis during the push-off phase (p = 0.001–0.044; d = 0.54–0.81). Post-hoc tests indicated significant intervention-related increases in vastus lateralis (p = 0.001; d = 1.08) and gluteus medius (p = 0.008; d = 0.67) during the loading phase and vastus medialis activity during mid-stance (p = 0.001; d = 0.86). In addition, post-hoc tests showed decreases in gastrocnemius medialis during the push-off phase in IG only (p < 0.001; d = 1.28).
Conclusions: This study demonstrated that an endurance-dominated exercise program has the potential to improve VO2max and diabetes-related abnormal gait in patients with DN. The observed decreases in peak vertical ground reaction force during the heel contact of walking could be due to increased vastus lateralis and gluteus medius activities during the loading phase. Accordingly, we recommend to implement endurance-dominated exercise programs in type 2 diabetic patients because it is feasible, safe and effective by improving aerobic capacity and gait characteristics.
Background: Change-of-direction (CoD) is a necessary physical ability of a field sport and may vary in youth players according to their maturation status.
Objectives: The aim of this study is: to compare the effectiveness of a 6-week CoD training intervention on dynamic balance (CS-YBT), horizontal jump (5JT), speed (10 and 30-m linear sprint times), CoD with (15 m-CoD + B) and without (15 m-CoD) the ball, in youth male soccer players at different levels of maturity [pre- and post-peak height velocity (PHV)].
Materials and Methods: Thirty elite male youth soccer players aged 10–17 years from the Tunisian first division participated in this study. The players were divided into pre- (G1, n = 15) and post-PHV (G2, n = 15) groups. Both groups completed a similar 6-week training program with two sessions per week of four CoD exercises. All players completed the following tests before and after intervention: CS-YBT; 5 JT; 10, 30, and 15 m-CoD; and 15 m-CoD + B, and data were analyzed using ANCOVA.
Results: All 30 players completed the study according to the study design and methodology. Adherence rate was 100% across all groups, and no training or test-related injuries were reported. Pre-PHV and post-PHV groups showed significant amelioration post-intervention for all dependent variables (after test > before test; p < 0.01, d = 0.09–1.51). ANOVA revealed a significant group × time interaction only for CS-YBT (F = 4.45; p < 0.04; η2 = 0.14), 5JT (F = 6.39; p < 0.02; η2 = 0.18), and 15 m-CoD (F = 7.88; p < 0.01; η2 = 0.22). CS-YBT, 5JT, and 15 m-CoD improved significantly in the post-PHV group (+ 4.56%, effect size = 1.51; + 4.51%, effect size = 1.05; and -3.08%, effect size = 0.51, respectively), more than the pre-PHV group (+ 2.77%, effect size = 0.85; + 2.91%, effect size = 0.54; and -1.56%, effect size = 0.20, respectively).
Conclusion: The CoD training program improved balance, horizontal jump, and CoD without the ball in male preadolescent and adolescent soccer players, and this improvement was greater in the post-PHV players. The maturity status of the athletes should be considered when programming CoD training for soccer players.
Das Therapiemanagement bei Lipödem stellt auf Grund unzureichenden Wissensstandes in entscheidenden Aspekten eine besondere Herausforderung dar. Da die Pathogenese der Erkrankung nicht hinreichend geklärt ist und bislang kein pathognomonisches Diagnostikkriterium definiert wurde, beklagen viele Betroffene einen langjährigen Leidensweg bis zur Einleitung von Therapiemaßnahmen. Durch Steigerung der Awareness der Erkrankung in den letzten Jahren konnten die Intervalle bis zur korrekten Diagnose erfreulicherweise erheblich verkürzt werden. Obwohl die Zuordnung der Beschwerden zu einer klar definierten Erkrankung für viele Patientinnen eine Erleichterung ist, stellt die Erkenntnis über begrenzte Therapiemöglichkeiten häufig eine neuerliche Belastung dar.
Als Konsequenz der ungeklärten Pathogenese konnte bis dato keine kausale Therapie für das Lipödem definiert werden. Zu Beginn waren die Möglichkeiten konservativer Behandlungsstrategien nur eingeschränkt in den Rahmen eines allgemeingültigen Konzeptes involviert und insbesondere Limitationen nicht klar definiert. Obwohl in diversen Bereichen der Therapie weiterhin keine ausreichende Evidenz besteht, konnten durch eine systematische Aufarbeitung die grundsätzlichen Behandlungsoptionen in Relation zueinander gesetzt werden. Betroffene Patientinnen, sowie die verschiedenen in die Behandlung integrierte medizinische Disziplinen verfügen somit über einen grundsätzlichen Handlungsalgorithmus, deren Empfehlungen über einfache Rezeptierung von Lymphdrainage und Kompressionsbekleidung hinausgehen. Durch kritische Reflexion der geltenden Dogmata wurde ein interdisziplinärer Leitfaden vorgeschlagen, der auf nachvollziehbare Weise im Sinne eines Stufenschemas alle wesentlichen Therapiesäulen in einen allgemeingültigen Behandlungsplan einbindet.
Im vielschichten Management der Erkrankung verbleibt die operative Behandlung, die Liposuktion, allerdings häufig als „ultima ratio“ nach ausbleibender Linderung unter konservativen Therapiemaßnahmen. Die wesentliche Zielstellung der vorliegenden Arbeit konzentriert sich demnach auf die Optimierung des operativen Vorgehens in der Durchführung von Liposuktionen bei Patientinnen mit Lipödem und zeigt sowohl Grenzen der Indikationsstellung, als auch Potenzial des Behandlungserfolges im Langzeitverlauf auf. Langzeitergebnisse zeigen, dass die Liposuktion als sicherer Eingriff mit dem Potenzial einer nachhaltigen Symptomreduktion für Lipödem-Patientinnen angesehen werden kann. Betont werden soll zudem die Notwendigkeit der Verzahnung operativer Maßnahmen mit konservativen Therapien und somit die Integration der Liposuktion als sinnvolle Behandlungsalternative in ein klar umrissenes Therapiekonzept.
Methodisch greift die Arbeit auf insgesamt 10 Publikationen zurück. Die hier postulierte mehrzeitige Megaliposuktion zur Therapie des Lipödems, mit summierten Gesamtaspirationsvolumina über alle Eingriffe von bis zu 66.000 ml, konnte als evidenzbasiertes Therapieverfahren bestätigt und validiert werden. Die beschriebenen niedrigen Komplikationsraten sind unter Anderem Resultat einer differenzierten, individualisierten perioperativen Strategie. Neben der Berücksichtigung grundsätzlicher methodischer Prinzipien existieren allerdings vielfältige Variationen, deren Implikationen auf Komplikationsraten jeweils differenziert zu betrachten sind. Es existiert zwar kein Konsensus für ein allgemeingültiges Standardverfahren der Liposuktion, allerdings konnten zahlreiche Elemente im perioperativen Management definiert werden, die unabhängig von der verwendeten Operationstechnik einen potenziellen positiven Einfluss auf das Outcome haben. Obwohl die Liposuktion bei Lipödem somit zusammenfassend mittlerweile als sicheres Verfahren gelten kann, sind einige Aspekte weiterhin nicht abschließend geklärt. Hierbei stehen vor allem das Volumenmanagement und die standardisierte Festlegung des maximalen Aspirationsvolumens im Fokus.
Die Analyse verschiedener Kovariablen auf die Linderung Lipödem-assoziierter Symptome nach Liposuktion zeigt, dass Alter, Body-Mass-Index (BMI) und präoperatives Stadium der Erkrankung einen signifikanten Einfluss auf das postoperative Ergebnis haben und in der Planung des mehrzeitigen operativen Vorgehens berücksichtigt werden müssen. BMI- oder körpergewichtsabhängige Zielgrößen der Absaugvolumina waren als Prognosefaktor für das postoperative Outcome dagegen nicht relevant. Inwieweit dies möglicherweise an der Überschreitung des „notwendigen“ Volumengrenzwerts für adäquate Symptomlinderung durch reguläre Durchführung von Megaliposuktionen liegen könnte, oder ob dieser Parameter tatsächlich keinen Einfluss auf das Ergebnis nach Operation besitzt, konnte nicht abschließend geklärt werden.
Weiterhin konnte ein positiver Nutzen auf assoziierte Begleiterkrankungen bei Lipödem nachgewiesen werden. Das Spektrum der Behandlungsmethoden kann durch reguläre Integration der Liposuktion in das Therapieschema somit um eine nachhaltige Alternative sinnvoll ergänzt werden. Im Unterschied zur alleinigen konservativen Therapie kann hierdurch ein wesentlicher Schritt weg von der alleinigen symptomatischen Therapie gemacht werden. Zudem die vielfältige Symptomatik der diversen assoziierten Komorbiditäten zu berücksichtigen. Als Konsequenz und für die Notwendigkeit eines ganzheitlichen, interdisziplinären Therapieansatzes wäre der Terminus „Lipödem-Syndrom“ möglicherweise treffender und wird zur Diskussion gestellt.
Für ein gesondertes Patientenklientel wurden zudem basale Grundsätze im perioperativen Vorgehen differenziert aufgearbeitet. Lipödem-Patientinnen mit begleitendem von-Willebrand-Syndrom stellen im Hinblick auf Blutungskomplikationen eine außerordentliche Herausforderung dar. Die vorliegenden evidenzbasierten Empfehlungen zum Therapiemanagement dieser Patientinnen bei Eingriffen ähnlicher Risikoklassifizierung wurden systematisch aufgearbeitet und in Bezug zu den speziellen Anforderungen bei Megaliposuktionen gebracht. Das dabei erarbeitete Therapieschema wird die präoperative Detektion von Koagulopathien im Allgemeinen, sowie die perioperative Komplikationsrate bei von-Willebrand-Patientinnen im Speziellen zukünftig erheblich verbessern.
Zusammenfassend konnte somit ein allgemeingültiger Algorithmus für die moderne und langfristig erfolgreiche Therapie von Lipödem-Patientinnen mit besonderem Fokus auf die Megaliposuktion erarbeitet werden. Bei adäquatem perioperativem Management und Berücksichtigung der großen Volumenverschiebungen kann der Eingriff komplikationsarm und sicher durchgeführt werden. Nicht abschließend geklärt ist derzeit die Pathophysiologie der Erkrankung wobei eine immunologische Genese sowie die primäre Pathologie des Lymphgefäßsystems bzw. der Fett(vorläufer)zellen als Erklärungmodelle favorisiert werden. Die Entwicklung diagnostischer Biomarker sollte dabei verfolgt werden.
The survey of the prevalence of chronic ankle instability in elite Taiwanese basketball athletes
(2021)
BACKGROUND: Ankle sprains are common in basketball. It could develop into Chronic Ankle Instability (CAI) causing decreased quality of life, functional performance, early osteoarthritis, and increased risk of other injuries. To develop a strategy of CAI prevention, localized epidemiology data and a valid/reliable tool are essential. However, the epidemiological data of CAI is not conclusive from previous studies and the prevalence of CAI in Taiwanese basketball athletes are not clear. In addition, a valid and reliable tool among the Taiwan-Chinese version to evaluate ankle instability is missing.
PURPOSE: The aims were to have an overview of the prevalence of CAI in sports population using a systematic review, to develop a valid and reliable cross-cultural adapted Cumberland Ankle Instability Tool Questionnaire (CAIT) in Taiwan-Chinese (CAIT-TW), and to survey the prevalence of CAI in elite basketball athletes in Taiwan using CAIT-TW.
METHODS: Firstly, a systematic search was conducted. Research articles applying CAI related questionnaires in order to survey the prevalence of CAI were included in the review. Second, the English version of CAIT was translated and cross-culturally adapted into the CAIT-TW. The construct validity, test-retest reliability, internal consistency, and cutoff score of CAIT-TW were evaluated in an athletic population (N=135). Finally, the cross-sectional data of CAI prevalence in 388 elite Taiwanese basketball athletes were presented. Demographics, presence of CAI, and difference of prevalence between gender, different competitive levels and play positions were evaluated.
RESULTS: The prevalence of CAI was 25%, ranging between 7% and 53%. The prevalence of CAI among participants with a history of ankle sprains was 46%, ranging between 9% and 76%. In addition, the cross-cultural adapted CAIT-TW showed a moderate to strong construct validity, an excellent test-retest reliability, a good internal consistency, and a cutoff score of 21.5 for the Taiwanese athletic population. Finally, 26% of Taiwanese basketball athletes had unilateral CAI while 50% of them had bilateral CAI. In addition, women athletes in the investigated cohort had a higher prevalence of CAI than men. There was no difference in prevalence between competitive levels and among play positions.
CONCLUSION: The systematic review shows that the prevalence of CAI has a wide range among included studies. This could be due to the different exclusion criteria, age, sports discipline, or other factors among the included studies. For future studies, standardized criteria to investigate the epidemiology of CAI are required. The CAI epidemiological study should be prospective. Factors affecting the prevalence of CAI ability should be investigated and described. The translated CAIT-TW is a valid and reliable tool to differentiate between stable and unstable ankles in athletes and may further apply for research or daily practice in Taiwan. In the Taiwanese basketball population, CAI is highly prevalent. This might relate to the research method, preexisting ankle instability, and training-related issues. Women showed a higher prevalence of CAI than men. When applying the preventive measure, gender should be taken into consideration.
Background and objectives: The intricate interdependencies between the musculoskeletal and neural systems build the foundation for postural control in humans, which is a prerequisite for successful performance of daily and sports-specific activities. Balance training (BT) is a well-established training method to improve postural control and its components (i.e., static/dynamic steady-state, reactive, proactive balance). The effects of BT have been studied in adult and youth populations, but were systematically and comprehensively assessed only in young and old adults. Additionally, when taking a closer look at established recommendations for BT modalities (e.g., training period, frequency, volume), standardized means to assess and control the progressive increase in exercise intensity are missing. Considering that postural control is primarily neuronally driven, intensity is not easy to quantify. In this context, a measure of balance task difficulty (BTD) appears to be an auspicious alternative as a training modality to monitor BT and control training progression. However, it remains unclear how a systematic increase in BTD affects balance performance and neurophysiological outcomes. Therefore, the primary objectives of the present thesis were to systematically and comprehensively assess the effects of BT on balance performance in healthy youth and establish dose-response relationships for an adolescent population. Additionally, this thesis aimed to investigate the effects of a graded increase in BTD on balance performance (i.e., postural sway) and neurophysiological outcomes (i.e, leg muscle activity, leg muscle coactivation, cortical activity) in adolescents.
Methods: Initially, a systematic review and meta-analysis on the effects of BT on balance performance in youth was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guidelines. Following this complementary analysis, thirteen healthy adolescents (3 female/ 10 male) aged 16-17 years were enrolled for two cross-sectional studies. The participants executed bipedal balance tasks on a multidirectional balance board that allowed six gradually increasing levels of BTD by narrowing the balance boards’ base of support. During task performance, two pressure sensitive mats fixed on the balance board recorded postural sway. Leg muscle activity and leg muscle coactivation were assessed via electromyography while electroencephalography was used to monitor cortical activity.
Results: Findings from the systematic review and meta-analysis indicated moderate-to-large effects of BT on static and dynamic balance performance in youth (static: weighted mean standardized mean differences [SMDwm] = 0.71; dynamic: SMDwm = 1.03). In adolescents, training-induced effects were moderate and large for static (SMDwm = 0.61) and dynamic (SMDwm = 0.86) balance performance, respectively. Independently (i.e. modality-specific) calculated dose-response relationships identified a training period of 12 weeks, a frequency of two training sessions per week, a total of 24-36 sessions, a duration of 4-15 minutes, and a total duration of 31-60 minutes as the training modalities with the largest effect on overall balance performance in adolescents. However, the implemented meta-regression indicated that none of these training modalities (R² = 0%) could predict the observed performance-increasing effects of BT.
Results from the first cross-sectional study revealed that a gradually increasing level of BTD caused increases in postural sway (p < 0.001; d = 6.36), higher leg muscle activity (p < 0.001; 2.19 < d < 4.88), and higher leg muscle coactivation (p < 0.001; 1.32 < d < 1.41). Increases in postural sway and leg muscle activity were mainly observed during low and high levels of task difficulty during continuous performance of the respective balance task. Results from the second cross-sectional study indicated frequency-specific increases/decreases in cortical activity of different brain areas (p < 0.005; 0.92 < d < 1.80) as a function of BTD. Higher cortical activity within the theta frequency band in the frontal and central right brain areas was observed with increasing postural demands. Concomitantly, activity in the alpha-2 frequency band was attenuated in parietal brain areas.
Conclusion: BT is an effective method to increase static and dynamic balance performance and, thus, improve postural control in healthy youth populations. However, none of the reported training modalities (i.e., training period, frequency, volume) could explain the effects on balance performance. Furthermore, a gradually increasing level of task difficulty resulted in increases in postural sway, leg muscle activity, and coactivation. Frequency and brain area-specific increases/decreases in cortical activity emphasize the involvement of frontoparietal brain areas in regulatory processes of postural control dependent on BTD. Overall, it appears that increasing BTD can be easily accomplished by narrowing the base of support. Since valid methods to assess and quantify BT intensity do not exist, increasing BTD appears to be a very useful candidate to implement and monitor progression in BT programs in healthy adolescents.
The mechanotendography (MTG) is a method for analyzing the mechanical oscillations of tendons during muscular actions. The aim of this investigation was to evaluate the technical reliability of a piezo-based measurement system used for MTG. The reliability measurements were performed by using audio samples played by a subwoofer. The thereby generated pressure waves were recorded by a piezo-based measurement system. An audio of 40 Hz sine oscillations and four different formerly in vivo recorded MTG-signals were converted into audio files and were used as test signals. Five trials with each audio were performed and one audio was used for repetition trials on another day. The signals’ correlation was estimated by Spearman (MCC) and intraclass correlation coefficients (ICC(3,1)), Cronbach’s alpha (CA) and by mean distances (MD). All parameters were compared between repetition and randomized matched signals. The repetition trials show high correlations (MCC: 0.86 ± 0.13, ICC: 0.89 ± 0.12, CA: 0.98 ± 0.03), low MD (0.03 ± 0.03V) and differ significantly from the randomized matched signals (MCC: 0.15 ± 0.10, ICC: 0.17 ± 0.09, CA: 0.37 ± 0.16, MD: 0.19 ± 0.01V) (p = 0.001 – 0.043). This speaks for an excellent reliability of the measurement system. Presuming the skin above superficial tendons oscillates adequately, we estimate this tool as valid for the application in musculoskeletal system.
Bisher ist die Ursache für die Entstehung der meisten Skoliosen noch ungeklärt und damit eine kausale Behandlung der Betroffenen unmöglich. Die vorliegende Arbeit geht davon aus, dass der Auslöser für die sogenannte idiopathische Skoliose eine funktionelle Störung von Muskeln ist, die sich in einer verminderten relativen Haltekraft äußert. Durch gezielte willkürliche Muskelanspannungen könnte es möglich sein, kompensatorisch auf die Deformität einzuwirken, um damit ein Fortschreiten zu verhindern bzw. sogar eine Regression hervorzurufen. Insbesondere Patientengruppen mit einem hohen Progressionsrisiko, wie Jugendliche im Wachstumsalter, könnten davon profitieren.
Ein Muskeltraining kann mit unterschiedlichsten Hilfsmitteln und Methoden erfolgen. Eine Möglichkeit bietet auch das Klettern. Im Kern wird daher ein Trainingskonzept zum Therapeutischen Klettern bei Jugendlichen mit Skoliose vorgestellt. Dabei beruft sich der Autor auf das Potsdamer Modell. Dieses Modell erlaubt es, gezielte Kraftübungen systematisiert an der Kletterwand in Absprunghöhe umzusetzen. Materielle Sicherungsmaßnahmen sind dadurch nicht erforderlich und eventuell notwendige Korrekturen bzw. Hilfestellungen können direkt erfolgen. Hauptinhalt eines Trainings nach dem vorgestellten Konzept sind spielerische Bewegungserfahrung innerhalb der Sportart Klettern und ein Systembouldertraining.
In einem beigefügten Übungskatalog werden für letzteres Möglichkeiten der praktischen Umsetzun-gen gegeben. Die Übungen fokussieren sich auf die Aktivierung und das Training wirbelkörperdero-tierender Muskeln. Im Hauptteil einer Trainingseinheit können sie dann in Kombination mit der Kor-rektur der Seitverbiegung und des sagittalen Profils (3D Autokorrektur) unter Aufsicht eines geschul-ten Therapeuten durchgeführt werden. Die Arbeit erhebt den Anspruch, einem Leser vom Fach, die Auswahl der Übungen und die darin enthaltene individuelle Anpassung an den Patienten aus funktionell-anatomischer Sicht zu begründen.
In naher Zukunft wird das Konzept in einer randomisiert kontrollierten Studie untersucht. Alle notwendigen Vorbereitungen wurden im Rahmen dieser Arbeit getroffen.
Background: Chronic ankle instability, developing from ankle sprain, is one of the most common sports injuries. Besides it being an ankle issue, chronic ankle instability can also cause additional injuries. Investigating the epidemiology of chronic ankle instability is an essential step to develop an adequate injury prevention strategy. However, the epidemiology of chronic ankle instability remains unknown. Therefore, the purpose of this study was to investigate the epidemiology of chronic ankle instability through valid and reliable self-reported tools in active populations.
Methods: An electronic search was performed on PubMed and Web of Science in July 2020. The inclusion criteria for articles were peer-reviewed, published between 2006 and 2020, using one of the valid and reliable tools to evaluate ankle instability, determining chronic ankle instability based on the criteria of the International Ankle
Consortium, and including the outcome of epidemiology of chronic ankle instability. The risk of bias of the included studies was evaluated with an adapted tool for the sports injury review method.
Results: After removing duplicated studies, 593 articles were screened for eligibility. Twenty full-texts were screened and finally nine studies were included, assessing 3804 participants in total. The participants were between 15 and 32 years old and represented soldiers, students, athletes and active individuals with a history of ankle sprain. The prevalence of chronic ankle instability was 25%, ranging between 7 and 53%. The prevalence of chronic ankle instability within participants with a history of ankle sprains was 46%, ranging between 9 and 76%. Five included studies identified chronic ankle instability based on the standard criteria, and four studies applied adapted exclusion criteria to conduct the study. Five out of nine included studies showed a low risk of bias.
Conclusions: The prevalence of chronic ankle instability shows a wide range. This could be due to the different exclusion criteria, age, sports discipline, or other factors among the included studies. For future studies, standardized criteria to investigate the epidemiology of chronic ankle instability are required. The epidemiology of
CAI should be prospective. Factors affecting the prevalence of chronic ankle instability should be investigated and clearly described.
There is ample evidence that youth resistance training (RT) is safe, joyful, and effective for different markers of performance (e.g., muscle strength, power, linear sprint speed) and health (e.g., injury prevention). Accordingly, the first aim of this narrative review is to present and discuss the relevance of muscle strength for youth physical development. The second purpose is to report evidence on the effectiveness of RT on muscular fitness (muscle strength, power, muscle endurance), on movement skill performance and injury prevention in youth. There is evidence that RT is effective in enhancing measures of muscle fitness in children and adolescents, irrespective of sex. Additionally, numerous studies indicate that RT has positive effects on fundamental movement skills (e.g., jumping, running, throwing) in youth regardless of age, maturity, training status, and sex. Further, irrespective of age, sex, and training status, regular exposure to RT (e.g., plyometric training) decreases the risk of sustaining injuries in youth. This implies that RT should be a meaningful element of youths’ exercise programming. This has been acknowledged by global (e.g., World Health Organization) and national (e.g., National Strength and Conditioning Association) health- and performance-related organizations which is why they recommended to perform RT as an integral part of weekly exercise programs to promote muscular strength, fundamental movement skills, and to resist injuries in youth.
This meta-analysis aimed to assess the effects of plyometric jump training (PJT) on volleyball players’ vertical jump height (VJH), comparing changes with those observed in a matched control group. A literature search in the databases of PubMed, MEDLINE, Web of Science, and SCOPUS was conducted. Only randomized-controlled trials and studies that included a pre-to-post intervention assessment of VJH were included. They involved only healthy volleyball players with no restrictions on age or sex. Data were independently extracted from the included studies by two authors. The Physiotherapy Evidence Database scale was used to assess the risk of bias, and methodological quality, of eligible studies included in the review. From 7,081 records, 14 studies were meta-analysed. A moderate Cohen’s d effect size (ES = 0.82, p <0.001) was observed for VJH, with moderate heterogeneity (I2 = 34.4%, p = 0.09) and no publication bias (Egger’s test, p = 0.59). Analyses of moderator variables revealed no significant differences for PJT program duration (≤8 vs. >8 weeks, ES = 0.79 vs. 0.87, respectively), frequency (≤2 vs. >2 sessions/week, ES = 0.83 vs. 0.78, respectively), total number of sessions (≤16 vs. >16 sessions, ES = 0.73 vs. 0.92, respectively), sex (female vs. male, ES = 1.3 vs. 0.5, respectively), age (≥19 vs. <19 years of age, ES = 0.89 vs. 0.70, respectively), and volume (>2,000 vs. <2,000 jumps, ES = 0.76 vs. 0.79, respectively). In conclusion, PJT appears to be effective in inducing improvements in volleyball players’ VJH. Improvements in VJH may be achieved by both male and female volleyball players, in different age groups, with programs of relatively low volume and frequency. Though PJT seems to be safe for volleyball players, it is recommended that an individualized approach, according to player position, is adopted with some players (e.g. libero) less prepared to sustain PJT loads.
One of the major risk factors for global death and disability is alcohol, tobacco, and illicit drug use. While there is increasing knowledge with respect to individual factors promoting the initiation and maintenance of substance use disorders (SUDs), disease trajectories involved in losing and regaining control over drug intake (ReCoDe) are still not well described. Our newly formed German Collaborative Research Centre (CRC) on ReCoDe has an interdisciplinary approach funded by the German Research Foundation (DFG) with a 12-year perspective. The main goals of our research consortium are (i) to identify triggers and modifying factors that longitudinally modulate the trajectories of losing and regaining control over drug consumption in real life, (ii) to study underlying behavioral, cognitive, and neurobiological mechanisms, and (iii) to implicate mechanism-based interventions. These goals will be achieved by: (i) using mobile health (m-health) tools to longitudinally monitor the effects of triggers (drug cues, stressors, and priming doses) and modify factors (eg, age, gender, physical activity, and cognitive control) on drug consumption patterns in real-life conditions and in animal models of addiction; (ii) the identification and computational modeling of key mechanisms mediating the effects of such triggers and modifying factors on goal-directed, habitual, and compulsive aspects of behavior from human studies and animal models; and (iii) developing and testing interventions that specifically target the underlying mechanisms for regaining control over drug intake.
The mechanical muscular oscillations are rarely the objective of investigations regarding the identification of a biomarker for Parkinson’s disease (PD). Therefore, the aim of this study was to investigate whether or not this specific motor output differs between PD patients and controls. The novelty is that patients without tremor are investigated performing a unilateral isometric motor task. The force of armflexors and the forearm acceleration (ACC) were recorded as well as the mechanomyography of the biceps brachii (MMGbi), brachioradialis (MMGbra) and pectoralis major (MMGpect) muscles using a piezoelectric-sensor-based system during a unilateral motor task at 70% of the MVIC. The frequency, a power-frequency-ratio, the amplitude variation, the slope of amplitudes and their interlimb asymmetries were analysed. The results indicate that the oscillatory behavior of muscular output in PD without tremor deviates from controls in some parameters: Significant differences appeared for the power-frequency-ratio (p = 0.001, r = 0.43) and for the amplitude variation (p = 0.003, r = 0.34) of MMGpect. The interlimb asymmetries differed significantly concerning the power-frequency-ratio of MMGbi (p = 0.013, r = 0.42) and MMGbra (p = 0.048, r = 0.39) as well as regarding the mean frequency (p = 0.004, r = 0.48) and amplitude variation of MMGpect (p = 0.033, r = 0.37). The mean (M) and variation coefficient (CV) of slope of ACC differed significantly (M: p = 0.022, r = 0.33; CV: p = 0.004, r = 0.43). All other parameters showed no significant differences between PD and controls. It remains open, if this altered mechanical muscular output is reproducible and specific for PD.
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.
This study examined the concurrent validity of an inverse dynamic (force computed from barbell acceleration [reference method]) and a work-energy (force computed from work at the barbell [alternative method]) approach to measure the mean vertical barbell force during the snatch using kinematic data from video analysis. For this purpose, the acceleration phase of the snatch was analyzed in thirty male medal winners of the 2018 weightlifting World Championships (age: 25.2±3.1 years; body mass: 88.9±28.6 kg). Vertical barbell kinematics were measured using a custom-made 2D real-time video analysis software. Agreement between the two computational approaches was assessed using Bland-Altman analysis, Deming regression, and Pearson product-moment correlation. Further, principal component analysis in conjunction with multiple linear regression was used to assess whether individual differences related to the two approaches are due to the waveforms of the acceleration time-series data. Results indicated no mean difference (p > 0.05; d = −0.04) and an extremely large correlation (r = 0.99) between the two approaches. Despite the high agreement, the total error of individual differences was 8.2% (163.0 N). The individual differences can be explained by a multiple linear regression model (R2adj = 0.86) on principal component scores from the principal component analysis of vertical barbell acceleration time-series waveforms. Findings from this study indicate that the individual errors of force measures can be associated with the inverse dynamic approach. This approach uses vertical barbell acceleration data from video analysis that is prone to error. Therefore, it is recommended to use the work-energy approach to compute mean vertical barbell force as this approach did not rely on vertical barbell acceleration.
In sports and movement sciences isometric muscle function is usually measured by pushing against a stable resistance. However, subjectively one can hold or push isometrically. Several investigations suggest a distinction of those forms. The aim of this study was to investigate whether these two forms of isometric muscle action can be distinguished by objective parameters in an interpersonal setting. 20 subjects were grouped in 10 same sex pairs, in which one partner should perform the pushing isometric muscle action (PIMA) and the other partner executed the holding isometric muscle action (HIMA). The partners had contact at the distal forearms via an interface, which included a strain gauge and an acceleration sensor. The mechanical oscillations of the triceps brachii (MMGtri) muscle, its tendon (MTGtri) and the abdominal muscle (MMGobl) were recorded by a piezoelectric-sensor-based measurement system. Each partner performed three 15s (80% MVIC) and two fatiguing trials (90% MVIC) during PIMA and HIMA, respectively. Parameters to compare PIMA and HIMA were the mean frequency, the normalized mean amplitude, the amplitude variation, the power in the frequency range of 8 to 15 Hz, a special power-frequency ratio and the number of task failures during HIMA or PIMA (partner who quit the task). A “HIMA failure” occurred in 85% of trials (p < 0.001). No significant differences between PIMA and HIMA were found for the mean frequency and normalized amplitude. The MMGobl showed significantly higher values of amplitude variation (15s: p = 0.013; fatiguing: p = 0.007) and of power-frequency-ratio (15s: p = 0.040; fatiguing: p = 0.002) during HIMA and a higher power in the range of 8 to 15 Hz during PIMA (15s: p = 0.001; fatiguing: p = 0.011). MMGtri and MTGtri showed no significant differences. Based on the findings it is suggested that a holding and a pushing isometric muscle action can be distinguished objectively, whereby a more complex neural control is assumed for HIMA.
Background
Earlier studies have shown that balance training (BT) has the potential to induce performance enhancements in selected components of physical fitness (i.e., balance, muscle strength, power, speed). While there is ample evidence on the long-term effects of BT on components of physical fitness in youth, less is known on the short-term or acute effects of single BT sessions on selected measures of physical fitness.
Objective
To examine the acute effects of different balance exercise types on balance, change-of-direction (CoD) speed, and jump performance in youth female volleyball players.
Methods
Eleven female players aged 14 years participated in this study. Three types of balance exercises (i.e., anterior, posterolateral, rotational type) were conducted in randomized order. For each exercise, 3 sets including 5 repetitions were performed. Before and after the performance of the balance exercises, participants were tested for their static balance (center of pressure surface area [CoP SA] and velocity [CoP V]) on foam and firm surfaces, CoD speed (T-Half test), and vertical jump height (countermovement jump [CMJ] height). A 3 (condition: anterior, mediolateral, rotational balance exercise type) × 2 (time: pre, post) analysis of variance was computed with repeated measures on time.
Results
Findings showed no significant condition × time interactions for all outcome measures (p > 0.05). However, there were small main effects of time for CoP SA on firm and foam surfaces (both d = 0.38; all p < 0.05) with no effect for CoP V on both surface conditions (p > 0.05). For CoD speed, findings showed a large main effect of time (d = 0.91; p < 0.001). However, for CMJ height, no main effect of time was observed (p > 0.05).
Conclusions
Overall, our results indicated small-to-large changes in balance and CoD speed performances but not in CMJ height in youth female volleyball players, regardless of the balance exercise type. Accordingly, it is recommended to regularly integrate balance exercises before the performance of sport-specific training to optimize performance development in youth female volleyball players.