Refine
Year of publication
Document Type
- Article (42)
- Book (1)
- Conference Proceeding (1)
Has Fulltext
- yes (44)
Is part of the Bibliography
- no (44) (remove)
Keywords
- coronavirus (4)
- exercise (4)
- Older adults (3)
- physical activity (3)
- Fascia (2)
- Foam rolling (2)
- Low back pain (2)
- Sports and exercise medicine (2)
- accelerometry (2)
- cognition (2)
Institute
A recent in-vivo experiment has shown that force can be transmitted between the gastrocnemius and the hamstring muscles due to a direct tissue continuity. However, it remains unclear if this mechanical interaction is affected by the stiffness of the structural connection. This study therefore aimed to investigate the impact of the knee angle on myofascial force transmission across the dorsal knee. A randomized, cross-over study was performed, including n = 56 healthy participants (25.36 ± 3.9 years, 25 females). On two separate days, they adopted a prone position on an isokinetic dynamometer (knee extended or 60° flexed). In each condition, the device moved the ankle three times from maximal plantarflexion to maximal dorsal extension. Muscle inactivity was ensured using EMG. High-resolution ultrasound videos of the semimembranosus (SM) and the gastrocnemius medialis (GM) soft tissue were recorded. Maximal horizontal tissue displacement, obtained using cross-correlation, was examined as a surrogate of force transmission. SM tissue displacement was higher at extended (4.83 ± 2.04 mm) than at flexed knees (3.81 ± 2.36 mm). Linear regression demonstrated significant associations between (1) SM and GM soft tissue displacement (extended: R2 = 0.18, p = 0.001; flexed: R2 = 0.17, p = 0.002) as well as (2) SM soft tissue displacement and ankle range of motion (extended: R2 = 0.103, p = 0.017; flexed: R2 = 0.095, p = 0.022). Our results further strengthen the evidence that local stretching induces a force transmission to neighboring muscles. Resulting remote exercise effects such as increased range of motion, seem to depend on the stiffness of the continuity.
Trial registration: DRKS (Deutsches Register Klinischer Studien), registration number DRKS00024420, first registered 08/02/2021, https://drks.de/search/de/trial/DRKS00024420.
Background/Objectives: Agility and cognitive abilities are typically assessed separately by different motor and cognitive tests. While many agility tests lack a reactive decision-making component, cognitive assessments are still mainly based on computer-based or paper-pencil tests with low ecological validity. This study is the first to validate the novel SKILLCOURT technology as an integrated assessment tool for agility and cognitive-motor performance.
Methods: Thirty-two healthy adults performed agility (Star Run), reactive agility (Random Star Run) and cognitive-motor (executive function test, 1-back decision making) performance assessments on the SKILLCOURT. Cognitive-motor tests included lower limb responses in a standing position to increase the ecological validity when compared to computer-based tests. Test results were compared to established motor and agility tests (countermovement jump, 10 m linear sprint, T-agility tests) as well as computer-based cognitive assessments (choice-reaction, Go-NoGo, task switching, memory span). Correlation and multiple regression analyses quantified the relation between SKILLCOURT performance and motor and cognitive outcomes.
Results: Star Run and Random Star Run tests were best predicted by linear sprint (r = 0.68, p < 0.001) and T-agility performance (r = 0.77, p < 0.001), respectively. The executive function test performance was well explained by computer-based assessments on choice reaction speed and cognitive flexibility (r = 0.64, p < 0.001). The 1-back test on the SKILLCOURT revealed moderate but significant correlations with the computer-based assessments (r = 0.47, p = 0.007).
Conclusion: The results support the validity of the SKILLCOURT technology for agility and cognitive assessments in more ecologically valid cognitive-motor tasks. This technology provides a promising alternative to existing performance assessment tools.
On the current psychotherapeutic situation for persons with pornography use disorder in Germany
(2023)
Background and aims: For the first time, the ICD-11 provides the diagnosis compulsive sexual behavior disorder (CSBD) that can be assigned for pornography use disorder (PUD). This study aimed to estimate the prevalence of PUD and associated consequences in Germany, to identify the psychotherapy demand among likely PUD (lPUD) cases and the treatment supply in different psychotherapeutic settings, to survey psychotherapists' level of expertise regarding PUD, and to identify predictors for psychotherapy demand.
Methods: Four studies were conducted: 1. Online study in the general population (n = 2070; m = 48.9%, f = 50.8%, d = 0.2%), 2. Survey among practicing psychotherapists (n = 983), 3. Survey of psychotherapists in psychotherapeutic outpatient clinics (n = 185), 4. Interviews with psychotherapeutic inpatient clinics (n = 28).
Results: The estimated prevalence of lPUD in the online study was 4.7% and men were 6.3 times more often affected than women. Compared to individuals without PUD, individuals with lPUD more often indicated negative consequences in performance-related areas. Among lPUD cases, 51.2% of men and 64.3% of women were interested in a specialized PUD treatment. Psychotherapists reported 1.2%–2.9% of lPUD cases among their patients. 43.2%–61.5% of psychotherapists stated to be poorly informed about PUD. Only 7% of psychotherapeutic inpatient clinics provided specific treatments to patients with PUD. While, among other factors, negative consequences attributed to lPUD were predictive for psychotherapy demand, weekly pornography consumption, subjective well-being, and religious attachment were not.
Discussion and conclusions: Although PUD occurs quite often in Germany, availability of mental health care services for PUD is poor. Specific PUD treatments are urgently needed.
Fitness and exercise may counteract the detrimental metabolic and mood adaptations during prolonged sitting. This study distinguishes the immediate effects of a single bout vs. work-load and intensity-matched repeated exercise breaks on subjective well-being, blood glucose, and insulin response (analyzed as area under the curve) during sedentary time; and assesses the influence of fitness and caloric intake on metabolic alterations during sedentariness. Eighteen women underwent cardiopulmonary exercise testing and three 4 h sitting interventions: two exercise interventions (70% VO2max, 30 min, cycle ergometer: (1) cycling prior to sitting; (2) sitting interrupted by 5 × 6 min cycling), and one control condition (sitting). Participants consumed one meal with ad libitum quantity (caloric intake), but standardized macronutrient proportion. Exercise breaks (4057 ± 2079 μU/mL·min) reduced insulin values compared to a single bout of exercise (5346 ± 5000 μU/mL·min) and the control condition (6037 ± 3571 μU/mL·min) (p ≤ 0.05). ANCOVA revealed moderating effects of caloric intake (519 ± 211 kilocalories) (p ≤ 0.01), but no effects of cardiorespiratory fitness (41.3 ± 4.2 mL/kg/min). Breaks also led to lower depression, but higher arousal compared to a no exercise control (p ≤ 0.05). Both exercise trials led to decreased agitation (p ≤ 0.05). Exercise prior to sitting led to greater peace of mind during sedentary behavior (p ≤ 0.05). Just being fit or exercising prior to sedentary behavior are not feasible to cope with acute detrimental metabolic changes during sedentary behavior. Exercise breaks reduce the insulin response to a meal. Despite their vigorous intensity, breaks are perceived as positive stimulus. Detrimental metabolic changes during sedentary time could also be minimized by limiting caloric intake.
Background: Knee osteoarthritis is associated with higher kinetic friction in the knee joint, hence increased acoustic emissions during motion. Decreases in compressive load and improvements in movement quality might reduce this friction and, thus, sound amplitude. We investigated if an exercise treatment acutely affects knee joint sounds during different activities of daily life.
Methods: Eighteen participants with knee osteoarthritis (aged 51.8 ± 7.3 years; 14 females) were included in this randomized crossover trial. A neuromuscular exercise intervention and a placebo laser needle acupuncture treatment were performed. Before and after both interventions, knee joint sounds were measured during three different activities of daily living (standing up/sitting down, walking, descending stairs) by means of vibroarthrography. The mean amplitude (dB) and the median power frequency (MPF, Hz) were assessed at the medial tibial plateau and the patella. Differences in knee acoustic emissions between placebo and exercise interventions were calculated by analyses of covariance.
Results: Controlled for participant's age, knee demanding activity level and osteoarthritis stage, the conditions significantly differed in their impact on the MPF (mean(± SD) pre-post-differences standing up: placebo: 9.55(± 29.15) Hz/ exercise: 13.01(± 56.06) Hz, F = 4.9, p < 0.05) and the amplitude (standing up: placebo:0.75(± 1.43) dB/ exercise: 0.51(± 4.68) dB, F = 5.0, p < 0.05; sitting down: placebo: 0.07(± 1.21) dB/ exercise: -0.16(± .36) dB, F = 4.7, p < 0.05) at the tibia. There were no differences in the MPF and amplitude during walking and descending stairs (p > 0.05). At the patella, we found significant differences in the MPF during walking (placebo 0.08(± 1.42) Hz/ exercise: 15.76(± 64.25) Hz, F = 4.8, p < .05) and in the amplitude during descending stairs (placebo: 0.02 (± 2.72) dB/ exercise: -0.73(± 2.84) dB, F = 4.9, p < 0.05). There were no differences in standing up/ sitting down for both parameters, nor in descending stairs for the MPF and walking for the amplitude (p > 0.05).
Conclusion: The MPF pre-post differences of the exercise intervention were higher compared to the MPF pre-post differences of the placebo treatment. The amplitude pre-post differences were lower in the exercise intervention. In particular, the sound amplitude might be an indicator for therapy effects in persons with knee osteoarthritis.
Trial registration: The study was retrospectively registered in the German Clinical Trials Register (DRKS00022936, date of registry: 26/08/2020).
Background: Physical activity and sleep quality are both major factors for improving one's health. Knowledge on the interactions of sleep quality and the amount of physical activity may be helpful for implementing multimodal health interventions in older adults. Methods: This preliminary cross-sectional study is based on 64 participants [82.1 ± 6.4 years (MD ± SD); 22 male: 42 female]. The amount of physical activity was assessed by means of an accelerometer (MyWellness Key). Self-reported sleep parameters were obtained using the Pittsburgh Sleep Quality Index. The Barthel Index was used for physical disability rating. Bivariate correlations (Spearman's Rho) were used to explore relationships between the amount of physical activity and sleep quality. To analyse differences between categorial subgroups univariate ANOVAs were applied; in cases of significance, these were followed by Tukey-HSD post-hoc analyses. Results: No linear association between physical activity and sleep quality was found (r = 0.119; p > 0.05). In subgroup analyses (n = 41, Barthel Index ≥90 pts, free of pre-existing conditions), physical activity levels differed significantly between groups of different sleep duration (≥7 h; ≥6 to <7 h; ≥5 to <6 h; <5h; p = 0.037). Conclusion: There is no general association between higher activity levels and better sleep quality in the investigated cohort. However, a sleep duration of ≥5 to <6 h, corresponding to 7.6 h bed rest time, was associated with a higher level of physical activity.
Purpose: Physical activity is associated with altered levels of circulating microRNAs (ci-miRNAs). Changes in miRNA expression have great potential to modulate biological pathways of skeletal muscle hypertrophy and metabolism. This study was designed to determine whether the profile of ci-miRNAs is altered after different approaches of endurance exercise. Methods: Eighteen healthy volunteers (aged 24 ± 3 years) participated this three-arm, randomized-balanced crossover study. Each arm was a single bout of treadmill-based acute endurance exercise at (1) 100% of the individual anaerobic threshold (IANS), (2) at 80% of the IANS and (3) at 80% of the IANS with blood flow restriction (BFR). Load-associated outcomes (fatigue, feeling, heart rate, and exhaustion) as well as acute effects (circulating miRNA patterns and lactate) were determined. Results: All training interventions increased the lactate concentration (LC) and heart rate (HR) (p < 0.001). The high-intensity intervention (HI) resulted in a higher LC than both lower intensity protocols (p < 0.001). The low-intensity blood flow restriction (LI-BFR) protocol led to a higher HR and higher LC than the low-intensity (LI) protocol without BFR (p = 0.037 and p = 0.003). The level of miR-142-5p and miR-197-3p were up-regulated in both interventions without BFR (p < 0.05). After LI exercise, the expression of miR-342-3p was up-regulated (p = 0.038). In LI-BFR, the level of miR-342-3p and miR-424-5p was confirmed to be up-regulated (p < 0.05). Three miRNAs and LC show a significant negative correlation (miR-99a-5p, p = 0.011, r = − 0.343/miR-199a-3p, p = 0.045, r = − 0.274/miR-125b-5p, p = 0.026, r = − 0.302). Two partial correlations (intervention partialized) showed a systematic impact of the type of exercise (LI-BFR vs. HI) (miR-99a-59: r = − 0.280/miR-199a-3p: r = − 0.293). Conclusion: MiRNA expression patterns differ according to type of activity. We concluded that not only the intensity of the exercise (LC) is decisive for the release of circulating miRNAs—as essential is the type of training and the oxygen supply.
Background: The promotion of healthy aging is one of the major challenges for healthcare systems in current times. The present study investigates the effects of a standardized physical activity intervention for older adults on cognitive capacity, self-reported health, fear of falls, balance, leg strength and gait under consideration of movement biography, sleep duration, and current activity behavior. Methods: This single-blinded, randomized controlled trial included 49 community-dwelling older adults (36 women; 82.9 ± 4.5 years of age (Mean [M] ± SD); intervention group = 25; control group = 24). Movement biography, sleep duration, cognitive capacity, self-reported health status, and fear of falls were assessed by means of questionnaires. Leg strength, gait, and current activity levels were captured using a pressure plate, accelerometers, and conducting the functional-reach and chair-rising-test. The multicomponent intervention took place twice a week for 45 min and lasted 16 weeks. Sub-cohorts of different sleep duration were formed to distinguish between intervention effects and benefits of healthy sleep durations. Change scores were evaluated in univariate analyses of covariances (ANCOVAs) between groups and sub-cohorts of different sleep duration in both groups. Changes in cognitive capacity, self-reported health, fear of falls, balance, leg strength, and gait were investigated using the respective baseline values, movement biography, and current activity levels as covariates. Analysis was by intention-to-treat (ITT). Results: We found sub-cohort differences in cognitive capacity change scores [F(3,48) = 5.498, p = 0.003, ηp2 = 0.287]. Effects on fear of falls [F(1,48) = 12.961, p = 0.001, ηp2 = 0.240] and balance change scores F(1,48) = 4.521, p = 0.040, ηp2 = (0.099) were modified by the level of current activity. Effects on gait cadence were modified by the movement biography [F(1,48) = 4.545; p = 0.039, ηp2 = 0.100]. Conclusions: Unlike for functional outcomes, our multicomponent intervention in combination with adequate sleep duration appears to provide combinable beneficial effects for cognitive capacity in older adults. Trainability of gait, fear of falls, and flexibility seems to be affected by movement biography and current physical activity levels. Trial registration: This study was registered at the DRKS (German Clinical Trials Register) on November 11, 2020 with the corresponding trial number: DRKS00020472.
During dynamic ultrasound assessments, unintended transducer movement over the skin needs to be prevented as it may bias the results. The present study investigated the validity of two methods quantifying transducer motion. An ultrasound transducer was moved on a pre-specified 3 cm distance over the semitendinosus muscle of eleven adults (35.8 ± 9.8 years), stopping briefly at intervals of 0.5 cm. Transducer motion was quantified (1) measuring the 2-D displacement of the shadow produced by reflective tape (RT) attached to the skin and (2) using a marker-based, three-dimensional movement analysis system (MAS). Differences between methods were detected with Wilcoxon tests; associations were checked by means of intraclass correlation coefficients (ICC 3.1) and Bland–Altman plots. Values for RT (r = 0.57, p < 0.001) and MAS (r = 0.19, p = 0.002) were significantly higher than true distances (TD). Strong correlations were found between RT and TD (ICC: 0.98, p < 0.001), MAS and TD (ICC: 0.95, p < 0.001), and MAS and RT (ICC: 0.97, p < 0.001). Bland–Altman plots showed narrow limits of agreement for both RT (−0.49 to 0.13 cm) and MAS (−0.49 to 0.34 cm) versus TD. RT and MAS are valid methods to quantify US transducer movement. In view of its low costs and complexity, RT can particularly be recommended for application in research and clinical practice. View Full-Text
Keywords: ultrasound; reflective tape; transducer movement
Background: Excessive unilateral joint loads may lead to overuse disorders. Bilateral training in archery is only performed as a supportive coordination training and as a variation of typical exercise. However, a series of studies demonstrated a crossover transfer of training-induced motor skills to the contralateral side, especially in case of mainly unilateral skills. We compared the cervical spine and shoulder kinematics of unilateral and bilateral training archers.
Methods: In this cross-sectional study, 25 (5 females, 48 ± 14 years) bilaterally training and 50 age-, sex- and level-matched (1:2; 47.3 ± 13.9 years) unilaterally training competitive archers were included. Cervical range of motion (RoM, all planes) and glenohumeral rotation were assessed with an ultrasound-based 3D motion analysis system. Upward rotation of the scapula during abduction and elevation of the arm were measured by means of a digital inclinometer and active shoulder mobility by means of an electronic caliper. All outcomes were compared between groups (unilaterally vs. bilaterally) and sides (pull-hand- vs. bow-hand-side).
Results: Unilateral and bilateral archers showed no between group and no side-to-side-differences in either of the movement direction of the cervical spine. The unilateral archers had higher pull-arm-side total glenohumeral rotation than the bilateral archers (mean, 95% CI), (148°, 144–152° vs. 140°, 135°-145°). In particular, internal rotation (61°, 58–65° vs. 56°, 51–61°) and more upward rotation of the scapula at 45 degrees (12°, 11–14° vs. 8°, 6–10°), 90 degrees (34°, 31–36° vs. 28°, 24–32°), 135 degrees (56°, 53–59° vs. 49°, 46–53°), and maximal (68°, 65–70° vs. 62°, 59–65°) arm abduction differed. The bow- and pull-arm of the unilateral, but not of the bilateral archers, differed in the active mobility of the shoulder (22 cm, 20–24 cm vs. 18 cm, 16–20 cm).
Conclusions: Unilaterally training archers display no unphysiologic movement behaviour of the cervical spine, but show distinct shoulder asymmetris in the bow- and pull-arm-side when compared to bilateral archers in glenohumeral rotation, scapula rotation during arm abduction, and active mobility of the shoulder. These asymmetries in may exceed physiological performance-enhancing degrees. Bilateral training may seems appropriate in archery to prevent asymmetries.
Background and aims: One reason for the controversial discussion of whether the dual task (DT) walking paradigm has an added value for diagnosis in clinical conditions might be the use of different gait measurement systems. Therefore, the purpose was 1) to detect DT effects of central gait parameters obtained from five different gait analysis devices in young and old adults, 2) to assess the consistency of the measurement systems, and 3) to determine if the absolut and proportional DT costs (DTC) are greater than the system-measurement error under ST. Methods: Twelve old (72.2 ± 7.9y) and 14 young adults (28.3 ± 6.2y) walked a 14.7-m distance under ST and DT at a self-selected gait velocity. Interrater reliability, precision of the measurement and sensitivity to change were calculated under ST and DT. Results: An age effect was observed in almost all gait parameters for the ST condition. For DT only differences for stride length (p < .029, ɳ2p = .239) as well as single and double limb support (p = .036, ɳ2p = .227; p = .034, ɳ2p = .218) remained. The measurement systems showed a lower absolute agreement compared to consistency across all systems. Conclusions: When reporting DT effects, the real changes in performance and random measurement errors should always be accounted for. These findings have strong implications for interpreting DT effects.
Governments have restricted public life during the COVID-19 pandemic, inter alia closing sports facilities and gyms. As regular exercise is essential for health, this study examined the effect of pandemic-related confinements on physical activity (PA) levels. A multinational survey was performed in 14 countries. Times spent in moderate-to-vigorous physical activity (MVPA) as well as in vigorous physical activity only (VPA) were assessed using the Nordic Physical Activity Questionnaire (short form). Data were obtained for leisure and occupational PA pre- and during restrictions. Compliance with PA guidelines was calculated based on the recommendations of the World Health Organization (WHO). In total, n = 13,503 respondents (39 ± 15 years, 59% females) were surveyed. Compared to pre-restrictions, overall self-reported PA declined by 41% (MVPA) and 42.2% (VPA). Reductions were higher for occupational vs. leisure time, young and old vs. middle-aged persons, previously more active vs. less active individuals, but similar between men and women. Compared to pre-pandemic, compliance with WHO guidelines decreased from 80.9% (95% CI: 80.3–81.7) to 62.5% (95% CI: 61.6–63.3). Results suggest PA levels have substantially decreased globally during the COVID-19 pandemic. Key stakeholders should consider strategies to mitigate loss in PA in order to preserve health during the pandemic.
Most countries affected by the COVID-19 pandemic have repeatedly restricted public life to control the contagion. However, the health impact of confinement measures is hitherto unclear. We performed a multinational survey investigating changes in mental and physical well-being (MWB/PWB) during the first wave of the pandemic. A total of 14,975 individuals from 14 countries provided valid responses. Compared to pre-restrictions, MWB, as measured by the WHO-5 questionnaire, decreased considerably during restrictions (68.1 ± 16.9 to 51.9 ± 21.0 points). Whereas 14.2% of the participants met the cutoff for depression screening pre-restrictions, this share tripled to 45.2% during restrictions. Factors associated with clinically relevant decreases in MWB were female sex (odds ratio/OR = 1.20, 95% CI: 1.11–1.29), high physical activity levels pre-restrictions (OR = 1.29, 95% CI 1.16–1.42), decreased vigorous physical activity during restrictions (OR = 1.14, 95% CI: 1.05–1.23), and working (partially) outside the home vs. working remotely (OR = 1.29, 95% CI: 1.16–1.44/OR = 1.35, 95% CI: 1.23–1.47). Reductions, although smaller, were also seen for PWB. Scores in the SF-36 bodily pain subscale decreased from 85.8 ± 18.7% pre-restrictions to 81.3 ± 21.9% during restrictions. Clinically relevant decrements of PWB were associated with female sex (OR = 1.62, 95% CI: 1.50–1.75), high levels of public life restrictions (OR = 1.26, 95% CI: 1.18–1.36), and young age (OR = 1.10, 95% CI: 1.03–1.19). Study findings suggest lockdowns instituted during the COVID-19 pandemic may have had substantial adverse public health effects. The development of interventions mitigating losses in MWB and PWB is, thus, paramount when preparing for forthcoming waves of COVID-19 or future public life restrictions.
Background: Associations between age, concerns or history of falling, and various gait parameters are evident. Limited research, however, exists on how such variables moderate the age-related decline in gait characteristics. The purpose of the present study was to investigate the moderating effects of concerns of falling (formerly referred to as fear of falling), history of falls & diseases, and sociodemographic characteristics on changes in gait characteristics with increasing age in the elderly. Methods: In this individual participant level data re-analysis, data from 198 participants (n = 125 females) from 60 to 94 years of age were analysed (mean 73.9, standard deviation 7.7 years). Dependent variables were major spatiotemporal gait characteristics, assessed using a capacitive force measurement platform (zebris FDM-T). Age (independent variable) and the moderating variables concerns of falling (FES-I), gender/sex, history of falls and fall-related medical records, number of drugs daily taken, and body mass index were used in the statistical analysis. Hierarchical linear mixed moderation models (multilevel analysis) with stepwise (forward) modelling were performed. Results: Decreases of gait speed (estimate = −.03, equals a decrease of 0.03 m/s per year of ageing), absolute (− 1.4) and gait speed-normalized (−.52) stride length, step width (−.08), as well as increases in speed normalized cadence (.65) and gait speed variability (.15) are all age-related (each p < .05). Overall and specific situation-related concerns of falling (estimates: −.0012 to −.07) were significant moderators. History of potentially gait- and/or falls-affecting diseases accelerated the age-related decline in gait speed (−.002) and its variability (.03). History of falls was, although non-significant, a relevant moderator (in view of increasing the model fit) for cadence (.058) and gait speed (−.0027). Sociodemographics and anthropometrics showed further moderating effects (sex moderated the ageing effect on stride length, .08; height moderated the effect on the normalised stride length, .26; BMI moderated the effects on step width, .003). Conclusion: Age-related decline in spatiotemporal gait characteristics is moderated by concerns of falling, (non-significantly) by history of falls, significantly by history of diseases, and sociodemographic characteristics in 60–94 years old adults. Knowing the interactive contributions to gait impairments could be helpful for tailoring interventions for the prevention of falls. Trial registration: Re-analysis of [21–24].
Objectives: The aim of this study was to compare the effects of acupuncture and medical training therapy alone and in combination with those of usual care on the pain sensation of patients with frequent episodic and chronic tension-type headache.
Design: This was a prospective single-centre randomised controlled trial with four balanced treatment arms. The allocation was carried out by pre-generated randomisation lists in the ratio 1:1:1:1 with different permutation block sizes.
Setting: The study was undertaken in the outpatient clinic of Rehabilitation Medicine of the Hannover Medical School.
Participants and interventions: Ninety-six adult patients with tension-type headache were included and randomised into usual care (n = 24), acupuncture (n = 24), medical training (n = 24), and combination of acupuncture and medical training (n = 24). One patient was excluded from analysis because of withdrawing her/his consent, leaving 95 patients for intention to treat analysis. Each therapy arm consisted of 6 weeks of treatment with 12 interventions. Follow-up was at 3 and 6 months.
Main outcome measures: Pain intensity (average, maximum and minimum), frequency of headache, responder rate (50% frequency reduction), duration of headache and use of headache medication.
Clinical results: The combination of acupuncture and medical training therapy significantly reduced mean pain intensity compared to usual care (mean = −38%, standard deviation = 25%, p = 0.012). Comparable reductions were observed for maximal pain intensity (−25%, standard deviation = 20%, 0.014) and for minimal pain intensity (−35%, standard deviation = 31%, 0.03). In contrast, neither acupuncture nor medical training therapy differed significantly from usual care. No between-group differences were found in headache frequency, mean duration of headache episodes, and pain medication intake. At 3 months, the majority of all patients showed a reduction of at least 50% in headache frequency. At 6 months, significantly higher responder rates were found in all intervention groups compared to usual care.
Conclusions: In contrast to monotherapy, only the combination of acupuncture and medical training therapy was significantly superior in reduction of pain intensity compared to usual care.
Failed jump landings represent a key mechanism of musculoskeletal trauma. It has been speculated that cognitive dual-task loading during the flight phase may moderate the injury risk. This study aimed to explore whether increased visual distraction can compromise landing biomechanics. Twenty-one healthy, physically active participants (15 females, 25.8 ± 0.4 years) completed a series of 30 counter-movement jumps (CMJ) onto a capacitive pressure platform. In addition to safely landing on one leg, they were required to memorize either one, two or three jersey numbers shown during the flight phase (randomly selected and equally balanced over all jumps). Outcomes included the number of recall errors as well as landing errors and three variables of landing kinetics (time to stabilization/TTS, peak ground reaction force/pGRF, length of the centre of pressure trace/COPT). Differences between the conditions were calculated using the Friedman test and the post hoc Bonferroni-Holm corrected Wilcoxon test. Regardless of the condition, landing errors remained unchanged (p = .46). In contrast, increased visual distraction resulted in a higher number of recall errors (chi² = 13.3, p = .001). Higher cognitive loading, furthermore, appeared to negatively impact mediolateral COPT (p < .05). Time to stabilization (p = .84) and pGRF (p = .78) were unaffected. A simple visual distraction in a controlled experimental setting is sufficient to adversely affect landing stability and task-related short-term memory during CMJ. The ability to precisely perceive the environment during movement under time constraints may, hence, represent a new injury risk factor and should be investigated in a prospective trial.
Current evidence indicates that acute aerobic exercise might increase domain-specific cognitive performance. However, only a small number of studies deduced the impact on lower and higher cognitive functions systematically or analyzed dose–response relationships and the underlying mechanisms. This study aimed to expose the dose–response relationships by investigating the influence of exercise duration on subjective and objective arousal, cognitive attention and visual recognition memory tasks. Nineteen participants (eight female; 25.69 ± 3.11 years) were included in a randomized, three-armed intervention study in a cross-over design. The participants completed three different interventions consisting of either 15, 30 or 45 min of cycling at 60–70% VO2max. Arousal and cognitive measurements were taken before and immediately after (<2 min) exercise. All three interventions led to significant but comparable effects on self-perceived arousal, heart rate (HR) and rating of perceived exertion (RPE) (p < 0.05). Analysis of variance (ANOVA) indicated significant effects of exercise duration on visual recognition memory accuracy. Reaction times for higher and lower cognitive tasks did not change after exercise. Fifteen minutes of aerobic exercise was feasible to induce beneficial changes in self-perceived arousal. Processing speed of visual recognition memory and attention remained unaltered. Exercise exceeding fifteen minutes seemed to negatively impact visual recognition memory accuracy.
Background: This study investigated whether work ability is associated with the duration of unemployment, heart rate variability (HRV), and the level of physical activity. Methods: Thirty-four unemployed persons (mean 55.7 ± standard deviation 33.3 years, 22 female, 12 male, unemployed: range 1–22.5 years) participated in the cross-sectional study. The Work Ability Index (WAI) and International Physical Activity Questionnaire (IPAQ) were applied. Short-term (five minutes) resting HRV (Low Frequency (LF), High Frequency (HF), Total Power (TP)) was collected. Results: Work ability was positively associated with the HRV: LF (r = 0.383; p = 0.025), HF (r = 0.412; p = 0.015) and TP (r = 0.361; p = 0.036). The WAI showed a positive linear correlation with the amount of total physical activity (r = 0.461; p = 0.006) as well as with the amount of moderate to vigorous physical activity (r = 0.413; p = 0.015). No association between the WAI and the duration of unemployment occurred. Conclusions: the relation between self-perceived work ability, health-associated parameters, the HRV and the level of physical activity points out the relevance of health-care exercise and the need of stress-reducing interventions to improve perceived work ability. Our results point out the need for the further and more holistic development of healthcare for the unemployed.
Study design: Systematic review. Background and objectives: Preoperative neuromuscular function is predictive for knee function and return to sports (RTS) after reconstruction of the anterior cruciate ligament (ACL). The aim of this review was to examine the potential benefits of prehabilitation on pre-/postoperative objective, self-reported and RTS-specific outcomes. Methods: A systematic search was conducted within three databases. From the 1.071 studies screened, two randomized control trials (RCTs), two control trials (CTs) and two cohort studies (CS) met the inclusion criteria. Methodological quality rating adopted the PEDro- (RCT, CT) or Newcastle-Ottawa-Scale (CS). Results and conclusions: Methodological quality of the included studies was moderate (PEDro score: 6.5 ± 1.7; range 4 to 9). Two studies reported higher increases of the maximal quadriceps torque from baseline to pre-reconstruction: one study in the limb symmetry index (LSI), and one in both legs of the prehabilitation group compared to the controls. At 12-weeks post-reconstruction, one study (from two) indicated that the prehabilitation group had a lesser post-operative decline in the single-leg-hop for distance LSI (clinically meaningful). Similar findings were found in terms of quadriceps strength LSI (one study). At both pre-reconstruction (three studies) and two-year post-surgery (two studies), the prehabilitation groups reached significantly higher self-reported knee function (clinically meaningful) than the controls. RTS tended to be faster (one study). At two years post-surgery, RTS rates (one study) were higher in the prehabilitation groups. The results provide evidence for the relevance of prehabilitation prior to ACL-reconstruction to improve neuromuscular and self-reported knee function as well as RTS. More high quality confirmatory RCTs are warranted.
Low-to-moderate quality meta-analytic evidence shows that motor control stabilisation exercise (MCE) is an effective treatment of non-specific low back pain. A possible approach to overcome the weaknesses of traditional meta-analyses would be that of a prospective meta-analyses. The aim of the present analysis was to generate high-quality evidence to support the view that motor control stabilisation exercises (MCE) lead to a reduction in pain intensity and disability in non-specific low back pain patients when compared to a control group. In this prospective meta-analysis and sensitivity multilevel meta-regression within the MiSpEx-Network, 18 randomized controlled study arms were included. Participants with non-specific low back pain were allocated to an intervention (individualized MCE, 12 weeks) or a control group (no additive exercise intervention). From each study site/arm, outcomes at baseline, 3 weeks, 12 weeks, and 6 months were pooled. The outcomes were current pain (NRS or VAS, 11 points scale), characteristic pain intensity, and subjective disability. A random effects meta-analysis model for continuous outcomes to display standardized mean differences between intervention and control was performed, followed by sensitivity multilevel meta-regressions. Overall, 2391 patients were randomized; 1976 (3 weeks, short-term), 1740 (12 weeks, intermediate), and 1560 (6 months, sustainability) participants were included in the meta-analyses. In the short-term, intermediate and sustainability, moderate-to-high quality evidence indicated that MCE has a larger effect on current pain (SMD = −0.15, −0.15, −0.19), pain intensity (SMD = −0.19, −0.26, −0.26) and disability (SMD = −0.15, −0.27, −0.25) compared with no exercise intervention. Low-quality evidence suggested that those patients with comparably intermediate current pain and older patients may profit the most from MCE. Motor control stabilisation exercise is an effective treatment for non-specific low back pain. Sub-clinical intermediate pain and middle-aged patients may profit the most from this intervention.