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Whole-body electromyostimulation has proven to be a highly effective alternative to conventional resistance-type exercise training. However, due to adverse effects in the past, very extensive contraindications have been put in place for the commercial, non-medical WB-EMS market. Considering recent positive innovations e.g., federal regulation, mandatory trainer education, revised guidelines, and new scientific studies on WB-EMS application, we believe that a careful revision of the very restrictive contraindications on WB-EMS is needed. This applies all the more because many cohorts with limited options for conventional exercise have so far been excluded. During a first meeting of an evidence-based consensus process, stakeholders from various backgrounds (e.g., research, education, application) set the priorities for revising the contraindications. We decided to focus on four categories of absolute contraindications: “Arteriosclerosis, arterial circulation disorders”, “Diabetes mellitus” (DM), “Tumor and cancer” (TC), “Neurologic diseases, neuronal disorders, epilepsy”. Based on scientific studies, quality criteria, safety aspects and benefit/risk assessment of the category, DM and TC were moved to the relative contraindication catalogue, while arteriosclerosis/arterial circulation disorders and neurologic diseases/neuronal disorders/epilepsy were still considered as absolute contraindications. While missing evidence suggests maintaining the status of neurologic diseases/neuronal disorders as an absolute contraindication, the risk/benefit-ratio does not support the application of WB-EMS in people with arteriosclerosis/arterial circulation diseases. Despite these very cautious modifications, countries with less restrictive structures for non-medical WB-EMS should consider our approach critically before implementing the present revisions. Considering further the largely increased amount of WB-EMS trials we advice regular updates of the present contraindication list.

ObjectivesFatigue can decrease knee stability and increase the injury risk. However, fatigue is rarely being applied throughout movement analysis. The aim of this study was to investigate if the knee stability throughout SLDLs differ between cyclic and acyclic sports, before and after fatigue in general, and between the dominant and non-dominant leg of soccer players.MethodsA total of 43 active male (n = 34) and female (n = 9) athletes (age: 26.5 ± 7.2) participated in this study with a pre-post-design. Subjects performed a single leg drop landing (SLDL) from a plyobox. For each leg, the two-dimensional frontal plane projection angle (FPPA) was analyzed. After pretesting the shuttle run test was performed until exhaustion, before repeating the measurements.ResultsANOVA with repeated measures was applied and identified no significance difference for the FPPA between cyclic and acyclic sports (F = 0.98, p = 0.33), a significant difference before and after fatigue (F = 12.49, p = 0.002) and no significant difference between the dominant and non dominant leg of soccer players (F = 4.35, p = 0.26).DiscussionFatigue seems to be able to have a significant influence on knee stability in the frontal axis. Therefore, fatigue should be included in motion analysis for injury prevention and return to play tests because during this physical state most injuries happen.

Abstract The role of the gravitomagnetic field in the rotation of galaxies is clarified. Larmor’s theorem simplifies the analysis of different galactic equilibrium solutions. In particular, the self-consistent solution, which takes into account both the equivalent Larmor gravitomagnetic field and fluid convection, recovers previous results that reproduce galactic rotation curves without recourse to dark matter.

In the global higher education sector, government accountability initiatives are increasingly focused on degree-level competencies that may be expected from university graduates. The purpose of this paper was to examine the extent to which SoTL reflects this increased interest in student learning across the degree program. Articles (N=136) published in three international SoTL journals, over the past three years, were systematically reviewed using a framework that concentrated on the extent to which they reflected a focus of (a) teaching-emphasis versus learning-emphasis and (b) unit-level (subject, course) versus degree-/program-level. Our analysis indicated that the majority of SoTL publications (47%) were focused at the level of a single unit with an emphasis on teaching practice; in contrast, only a small minority of SoTL publications (9%) were focused at the level of the overall degree with an emphasis on learning processes. Drawing on our review, we highlight SoTL publications that exemplify the inquiry into student learning at the level of the degree program and offer questions to guide future SoTL inquiries.

Strukturen, Architektur und Genese der Stauchmoräne Peski/ Belorussland werden beschrieben und mit der Stauchmoräne Jasmund/Rügen verglichen. In beiden Stauchmoränen sind Oberkreide- und Pleistozänfolgen, bei Peski zusätzlich tertiäre Sande, glazigen gefaltet und verschuppt worden. Die Falten und Schuppen gleichen sich in beiden Stauchzonen in den Formen und Ausmaßen weitgehend. In ihrer Architektur unterscheiden sich beide Großstrukturen jedoch prinzipiell voneinander: Bei Peski ist eine bogenförmige Stauchzone an der Stirn eines ausgedehnten Eislobus entstanden; auf Jasmund ist der Eisstrom, der der Ostseesenke gefolgt war, durch ein höher liegendes Areal zweigeteilt worden und hat dieses samt den ersten Stauchwällen zunächst umflossen. Hier ist die Stauchung von den Flanken zweier Eiszungen ausgegangen. Der Interpretation als einer spitzwinkligen Kerbstauchung wird die Vorstellung einer in der Anlage schlingenförmig gerafften Stauchung gegenübergestellt, die später vom Eis überprägt worden ist. Die Lagebeziehungen beider Stauchmoränen zu den Bruchstrukturen im präquartären Untergrund der Region und zu deren neotektonischen Mobilität werden diskutiert. Die glazigene Stauchung bei Peski wird dem Sosch-(Warthe-)eis zugeschrieben, die auf Jasmund der Weichselvereisung. Beide Stauchungen sind nach dem Höhepunkt einer Vereisung, nach der maximalen Eisausbreitung, erfolgt. Diese rückläufigen Kälteperioden boten besonders günstige Voraussetzungen für Einwirkungen des Inlandeises auf den Untergrund.

Copyright of German Journal of Sports Medicine / Deutsche Zeitschrift fur Sportmedizin is the property of Verein zur Forderung der Sportmedizin Hannover e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract This paper analyzes, within the extended gravitoelectromagnetic (GEM) formulation, the equilibrium of a large scale gravitational system formed by rotating dust. The force balance equation gives the rotation velocity in terms of the GEM fields. Boundary conditions for the fields are introduced using Helmholtz’s decomposition and the virtual casing principle. Hydro-gravitomagnetic Cauchy invariance is implemented to relate the fluid and gravitomagnetic field vorticities. An energy conservation equation gives the rotation velocity in terms of the gravitational field and respective boundary values. A detailed solution is calculated for the case of rotating oblate spheroids. The equilibrium is in the form of a sheared rotational vortex, without introducing dark matter. The results are consistent with the Tully–Fisher relation and the Virginia Trimble correlations.

Abstract Historically, the existence of dark matter has been postulated to resolve discrepancies between astrophysical observations and accepted theories of gravity. In particular, the measured rotation curve of galaxies provided much experimental support to the dark matter concept. However, most theories used to explain the rotation curve have been restricted to the Newtonian potential framework, disregarding the general relativistic corrections associated with mass currents. In this paper it is shown that the gravitomagnetic field produced by the currents modifies the galactic rotation curve, notably at large distances. The coupling between the Newtonian potential and the gravitomagnetic flux function results in a nonlinear differential equation that relates the rotation velocity to the mass density. The solution of this equation reproduces the galactic rotation curve without recourse to obscure dark matter components, as exemplified by three characteristic cases. A bi-dimensional model is developed that allows to estimate the total mass, the central mass density, and the overall shape of the galaxies, while fitting the measured luminosity and rotation curves. The effects attributed to dark matter can be simply explained by the gravitomagnetic field produced by the mass currents.

Weak posture is a widely recognized problem affecting individuals of all ages, that can lead to back pain, which is a significant socio-economic burden in civil societies. Posture assessment enables the early detection of postural deficiencies, thus enabling proactive interventions. Therefore, it is an important tool for promoting public health, not only in childhood and adolescence. This article provides posture data of 1,149 subjects aged 10 to 69 years measured by stereophotogrammetry. In addition to subject anthropometrics, raw sagittal posture parameters as well as calculated flèche cervicale (FC), flèche lombaire (FL), and kyphosis index (KI) and the respective values normalized to the trunk height (FC%, FL%, KI%) are provided. Further, based on the measurements and a visual inspection, biomedical experts made a classification of the presence of hyperkyphosis of the thoracic spine or hyperlordosis of the lumbar spine. In a second step, these assessments were algorithmically checked for label quality due to possible errors of the raters. Critical cases were reassessed by experts. In addition to the original ratings, these corrected labels are also reported. The data offers potential for data driven objective posture assessment and the development of diagnostic supportive machine learning applications., (© 2024 The Author(s).)

Whole-body electromyostimulation has proven to be a highly effective alternative to conventional resistance-type exercise training. However, due to adverse effects in the past, very extensive contraindications have been put in place for the commercial, non-medical WB-EMS market. Considering recent positive innovations e.g., federal regulation, mandatory trainer education, revised guidelines, and new scientific studies on WB-EMS application, we believe that a careful revision of the very restrictive contraindications on WB-EMS is needed. This applies all the more because many cohorts with limited options for conventional exercise have so far been excluded. During a first meeting of an evidence-based consensus process, stakeholders from various backgrounds (e.g., research, education, application) set the priorities for revising the contraindications. We decided to focus on four categories of absolute contraindications: "Arteriosclerosis, arterial circulation disorders", "Diabetes mellitus" (DM), "Tumor and cancer" (TC), "Neurologic diseases, neuronal disorders, epilepsy". Based on scientific studies, quality criteria, safety aspects and benefit/risk assessment of the category, DM and TC were moved to the relative contraindication catalogue, while arteriosclerosis/arterial circulation disorders and neurologic diseases/neuronal disorders/epilepsy were still considered as absolute contraindications. While missing evidence suggests maintaining the status of neurologic diseases/neuronal disorders as an absolute contraindication, the risk/benefit-ratio does not support the application of WB-EMS in people with arteriosclerosis/arterial circulation diseases. Despite these very cautious modifications, countries with less restrictive structures for non-medical WB-EMS should consider our approach critically before implementing the present revisions. Considering further the largely increased amount of WB-EMS trials we advice regular updates of the present contraindication list., Competing Interests: The authors declare the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 von Stengel, Fröhlich, Ludwig, Eifler, Berger, Kleinöder, Micke, Wegener, Zinner, Mooren, Teschler, Filipovic, Müller, England, Vatter, Authenrieth, Kohl and Kemmler.)

[Purpose] The aim of this study was to examine whether the forward tilt of the sacrum, which can be measured using an inclinometer, correlates with pelvic tilt and is therefore suitable for therapeutic use as part of a postural assessment for treatment planning or for preventive screening. [Participants and Methods] In 121 athletes (22 females, 99 males), we measured the forward tilt of the sacrum in habitual stance using a digital inclinometer attached to the skin at the level of the posterior superior spinae. At the same time, the forward tilt of the pelvis was determined using videography. For this purpose, we determined the angle between two marker spheres placed on the posterior and anterior superior spinae and the horizontal using sagittal posture photographs. [Results] Taking age as a control variable, we found a significant correlation of moderate strength between pelvic tilt and sacral tilt in men. In women, there was a significant correlation with a strong effect. [Conclusion] The measurement of sacral tilt using an inclinometer positioned on the skin between the posterior superior spinae correlates statistically significantly with pelvic tilt and is therefore suitable as an easy-to-use diagnostic tool for therapeutic use in treatment planning and evaluation., Competing Interests: The authors declared no conflict of interest., (2024©by the Society of Physical Therapy Science. Published by IPEC Inc.)

The correction of postural weaknesses through the better positioning of the pelvis is an important approach in sports therapy and physiotherapy. The pelvic position in the sagittal plane is largely dependent on the muscular balance of the ventral and dorsal muscle groups. The aim of this exploratory study was to examine whether healthy persons use similar muscular activation patterns to correct their pelvic position or whether there are different motor strategies. The following muscles were recorded in 41 persons using surface electromyography (EMG): M. trapezius pars ascendens, M. erector spinae pars lumbalis, M. gluteus maximus, M. biceps femoris, M. rectus abdominis, and M. obliquus externus. The participants performed 10 voluntary pelvic movements (retroversion of the pelvis). The anterior pelvic tilt was measured videographically via marker points on the anterior and posterior superior iliac spine. The EMG data were further processed and normalized to the maximum voluntary contraction. A linear regression analysis was conducted to assess the relationship between changes in the pelvic tilt and muscle activities. Subsequently, a Ward clustering analysis was applied to detect potential muscle activation patterns. The differences between the clusters and the pelvic tilt were examined using ANOVA. Cluster analysis revealed the presence of four clusters with different muscle activation patterns in which the abdominal muscles and dorsal muscle groups were differently involved. However, the gluteus maximus muscle was involved in every activation pattern. It also had the strongest correlation with the changes in pelvic tilt. Different individual muscle patterns are used by different persons to correct pelvic posture, with the gluteus maximus muscle apparently playing the most important role. This can be important for therapy, as different muscle strategies should be trained depending on the individually preferred motor patterns.

Objectives: Fatigue can decrease knee stability and increase the injury risk. However, fatigue is rarely being applied throughout movement analysis. The aim of this study was to investigate if the knee stability throughout SLDLs differ between cyclic and acyclic sports, before and after fatigue in general, and between the dominant and non-dominant leg of soccer players., Methods: A total of 43 active male ( n  = 34) and female ( n  = 9) athletes (age: 26.5 ± 7.2) participated in this study with a pre-post-design. Subjects performed a single leg drop landing (SLDL) from a plyobox. For each leg, the two-dimensional frontal plane projection angle (FPPA) was analyzed. After pretesting the shuttle run test was performed until exhaustion, before repeating the measurements., Results: ANOVA with repeated measures was applied and identified no significance difference for the FPPA between cyclic and acyclic sports ( F  = 0.98, p  = 0.33), a significant difference before and after fatigue ( F  = 12.49, p  = 0.002) and no significant difference between the dominant and non dominant leg of soccer players ( F  = 4.35, p  = 0.26)., Discussion: Fatigue seems to be able to have a significant influence on knee stability in the frontal axis. Therefore, fatigue should be included in motion analysis for injury prevention and return to play tests because during this physical state most injuries happen., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Becker, Simon, Dindorf, Dully, Bartaguiz, Schmitz, Kothe, Fröhlich and Ludwig.)

Primary ciliary dyskinesia (PCD) represents a group of diseases characterized by impaired movement of cilia and subsequent health problems in diverse organ systems, notably the respiratory tract. Almost 50 candidate genes for PCD are known in humans. In this study, we investigated an Australian Shepherd dog with a history of recurrent respiratory infections and nasal discharge. A transmission electron microscopy investigation led to the diagnosis of PCD with central pair defect, in which the normal 9:2 arrangement of respiratory cilia was altered and reduced to a 9:0 arrangement. Whole genome sequencing data from the affected dog was obtained and searched for variants in PCD candidate genes that were not present in 918 control genomes from different breeds. This revealed a homozygous single base pair exchange at a splice site of STK36, XM_038585732.1:c.2868-1G>A. The mutant allele was absent from 281 additionally genotyped Australian Shepherd dogs. RT-PCR confirmed aberrant splicing in the affected dog with the skipping of exon 20 and the insertion of a cryptic exon, which is predicted to lead to a premature stop codon and truncation of 36% of the STK36 wild-type open reading frame, XP_038441660.1:(p.Met957Profs*11). STK36 variants were previously reported to cause PCD in humans and mice. The knowledge from other species together with the absence of the mutant allele in more than 1000 control dogs suggests STK36:c.2868-1G>A as the most likely candidate variant for PCD in the investigated case., (© 2023 The Authors. Animal Genetics published by John Wiley & Sons Ltd on behalf of Stichting International Foundation for Animal Genetics.)

Postural deficits such as hyperlordosis (hollow back) or hyperkyphosis (hunchback) are relevant health issues. Diagnoses depend on the experience of the examiner and are, therefore, often subjective and prone to errors. Machine learning (ML) methods in combination with explainable artificial intelligence (XAI) tools have proven useful for providing an objective, data-based orientation. However, only a few works have considered posture parameters, leaving the potential for more human-friendly XAI interpretations still untouched. Therefore, the present work proposes an objective, data-driven ML system for medical decision support that enables especially human-friendly interpretations using counterfactual explanations (CFs). The posture data for 1151 subjects were recorded by means of stereophotogrammetry. An expert-based classification of the subjects regarding the presence of hyperlordosis or hyperkyphosis was initially performed. Using a Gaussian progress classifier, the models were trained and interpreted using CFs. The label errors were flagged and re-evaluated using confident learning. Very good classification performances for both hyperlordosis and hyperkyphosis were found, whereby the re-evaluation and correction of the test labels led to a significant improvement (M PRAUC = 0.97). A statistical evaluation showed that the CFs seemed to be plausible, in general. In the context of personalized medicine, the present study's approach could be of importance for reducing diagnostic errors and thereby improving the individual adaptation of therapeutic measures. Likewise, it could be a basis for the development of apps for preventive posture assessment.

Methemoglobinemia is an acquired or inherited condition resulting from oxidative stress or dysfunction of the NADH-cytochrome b5 reductase or associated pathways. This study describes the clinical, pathophysiological, and molecular genetic features of a cat with hereditary methemoglobinemia. Whole genome sequencing and mRNA transcript analyses were performed in affected and control cats. Co-oximetry, ektacytometry, Ellman's assay for reduced glutathione concentrations, and CYB5R activity were assessed. A young adult European domestic shorthair cat decompensated at induction of anesthesia and was found to have persistent methemoglobinemia of 39 ± 8% (reference range < 3%) of total hemoglobin which could be reversed upon intravenous methylene blue injection. The erythrocytic CYB5R activity was 20 ± 6% of normal. Genetic analyses revealed a single homozygous base exchange at the beginning of intron 3 of the CYB5R3 gene, c.226+5G>A. Subsequent mRNA studies confirmed a splice defect and demonstrated expression of two mutant CYB5R3 transcripts. Erythrocytic glutathione levels were twice that of controls. Mild microcytosis, echinocytes, and multiple Ca 2+ -filled vesicles were found in the affected cat. Erythrocytes were unstable at high osmolarities although highly deformable as follows from the changes in elongation index and maximal-tolerated osmolarity. Clinicopathological presentation of this cat was similar to other cats with CYB5R3 deficiency. We found that methemoglobinemia is associated with an increase in red blood cell fragility and deformability, glutathione overload, and morphological alterations typical for stress erythropoiesis.

Whole-Body Electromyostimulation (WB-EMS) is a training technology that enables simultaneous stimulation of all the main muscle groups with a specific impulse intensity for each electrode. The corresponding time-efficiency and joint-friendliness of WB-EMS may be particularly attractive for people unable or unmotivated to conduct (intense) conventional training protocols. However, due to the enormous metabolic and musculoskeletal impact of WB-EMS, particular attention must be paid to the application of this technology. In the past, several scientific and newspaper articles reported severe adverse effects of WB-EMS. To increase the safety of commercial non-medical WB-EMS application, recommendations "for safe and effective whole-body electromyostimulation" were launched in 2016. However, new developments and trends require an update of these recommendations to incorporate more international expertise with demonstrated experience in the application of WB-EMS. The new version of these consensus-based recommendations has been structured into 1) "general aspects of WB-EMS", 2) "preparation for training", recommendations for the 3) "WB-EMS application" itself and 4) "safety aspects during and after training". Key topics particularly addressed are 1) consistent and close supervision of WB-EMS application, 2) mandatory qualification of WB-EMS trainers, 3) anamnesis and corresponding consideration of contraindications prior to WB-EMS, 4) the participant's proper preparation for the session, 5) careful preparation of the WB-EMS novice, 6) appropriate regeneration periods between WB-EMS sessions and 7) continuous interaction between trainer and participant at a close physical distance. In summary, we are convinced that the present guideline will contribute to greater safety and effectiveness in the area of non-medical commercial WB-EMS application., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kemmler, Fröhlich, Ludwig, Eifler, von Stengel, Willert, Teschler, Weissenfels, Kleinöder, Micke, Wirtz, Zinner, Filipovic, Wegener, Berger, Evangelista, D’Ottavio, Sara, Lerman, Perez de Arrilucea Le Floc’h, Carle-Calo, Guitierrez and Amaro-Gahete.)

Poor posture is a well-known problem in all age groups and can lead to back pain, which in turn can result in high socio-economic costs. Regular assessment of posture can therefore help to identify postural deficits at an early stage in order to take preventive measures and can therefore be an important tool for promoting public health. We measured the posture of 1127 symptom-free subjects aged 10 to 69 years using stereophotogrammetry and determined the sagittal posture parameters flèche cervicale (FC), flèche lombaire (FL), and kyphosis index (KI) as well as the values standardized to the trunk height (FC%, FL%, KI%). FC, FC%, KI, and KI% showed an increase with age in men but not in women, and a difference between the sexes. FL remained largely constant with age, although FL% had significantly greater values in women than men. Postural parameters correlated only moderately or weakly with body mass index. Reference values were determined for different age groups and for both sexes. Since the parameters analyzed can also be determined by simple and non-instrumental methods in medical office, they are suitable for performing preventive checks in daily medical or therapeutic practice.

The objectification of acute fatigue (during isometric muscle contraction) and cumulative fatigue (due to multiple intermittent isometric muscle contractions) plays an important role in sport climbing. The data of 42 participants were used in the study. Climbing performance was operationalized using maximal climbing-specific holding time (CSHT) by performing dead hangs. The test started with an initial measurement of handgrip strength (HGS) followed by three intermittent measurements of CSHT and HGS. During the test, finger flexor muscle oxygen saturation (SmO 2 ) was measured using a near-infrared spectroscopy wearable biosensor. Significant reductions in CSHT and HGS could be found ( p < 0.001), which indicates that the consecutive maximal isometric holding introduces cumulative fatigue. The reduction in CSHT did not correlate with a reduction in HGS over multiple consecutive maximal dead hangs ( p > 0.35). Furthermore, there were no significant differences in initial SmO 2 level, SmO 2 level at termination, SmO 2 recovery, and mean negative slope of the SmO 2 saturation reduction between the different measurements ( p > 0.24). Significant differences were found between pre-, termination-, and recovery- (10 s after termination) SmO 2 levels ( p < 0.001). Therefore, monitoring acute fatigue using athletes' termination SmO 2 saturation seems promising. By contrast, the measurement of HGS and muscle oxygen metabolism seems inappropriate for monitoring cumulative fatigue during intermittent isometric climbing-specific muscle contractions.

Disproportionate dwarfism phenotypes represent a heterogeneous subset of skeletal dysplasias and have been described in many species including humans and dogs. In this study, we investigated Vizsla dogs that were affected by disproportionate dwarfism that we propose to designate as skeletal dysplasia 3 (SD3). The most striking skeletal changes comprised a marked shortening and deformation of the humerus and femur. An extended pedigree with six affected dogs suggested autosomal recessive inheritance. Combined linkage and homozygosity mapping localized a potential genetic defect to a ~4 Mb interval on chromosome 33. We sequenced the genome of an affected dog, and comparison with 926 control genomes revealed a single, private protein-changing variant in the critical interval, PCYT1A :XM&#95;038583131.1:c.673T>C, predicted to cause an exchange of a highly conserved amino acid, XP&#95;038439059.1:p.(Y225H). We observed perfect co-segregation of the genotypes with the phenotype in the studied family. When genotyping additional Vizslas, we encountered a single dog with disproportionate dwarfism that did not carry the mutant PCYT1A allele, which we hypothesize was due to heterogeneity. In the remaining 130 dogs, we observed perfect genotype-phenotype association, and none of the unaffected dogs were homozygous for the mutant PCYT1A allele. PCYT1A loss-of-function variants cause spondylometaphyseal dysplasia with cone-rod dystrophy (SMD-CRD) in humans. The skeletal changes in Vizslas were comparable to human patients. So far, no ocular phenotype has been recognized in dwarf Vizslas. We propose the PCYT1A missense variant as a candidate causative variant for SD3. Our data facilitate genetic testing of Vizslas to prevent the unintentional breeding of further affected puppies.

Handgrip strength (HGS) appears to be an indicator of climbing performance. The transferability of HGS measurements obtained using a hand dynamometer and factors that influence the maximal climbing-specific holding time (CSHT) are largely unclear. Forty-eight healthy subjects (27 female, 21 male; age: 22.46 ± 3.17 years; height: 172.76 ± 8.91 cm; weight: 69.07 ± 12.41 kg; body fat: 20.05% ± 7.95%) underwent a maximal pull-up test prior to the experiment and completed a self-assessment using a Likert scale questionnaire. HGS was measured using a hand dynamometer, whereas CSHT was measured using a fingerboard. Multiple linear regressions showed that weight, maximal number of pull-ups, HGS normalized by subject weight, and length of the middle finger had a significant effect on the maximal CSHT (non-dominant hand: R 2 corr = 0.63; dominant hand: R 2 corr = 0.55). Deeper exploration using a machine learning model including all available data showed a predictive performance with R 2 = 0.51 and identified another relevant parameter for the regression model. These results call into question the use of hand dynamometers and highlight the performance-related importance of body weight in climbing practice. The results provide initial indications that finger length may be used as a sub-factor in talent scouting.

(1) Background. The coronavirus pandemic had a serious impact on the everyday life of children and young people with sometimes drastic effects on daily physical activity time that could have led to posture imbalances. The aim of the study was to examine whether a six-week, feedback-supported online training programme could improve posture parameters in young soccer players. (2) Methods. Data of 170 adolescent soccer players (age 15.6 ± 1.6 years) were analyzed. A total of 86 soccer players of a youth academy participated in an online training program that included eight exercises twice per week for 45 min (Zoom group). The participants’ exercise execution could be monitored and corrected via smartphone or laptop camera. Before and after the training intervention, participants’ posture was assessed using photographic analysis. The changes of relevant posture parameters (perpendicular positions of ear, shoulder and hips, pelvic tilt, trunk tilt and sacral angle) were statistically tested by robust mixed ANOVA using trimmed means. Postural parameters were also assessed post hoc at 8-week intervals in a control group of 84 participants of the same age. (3) Results. We found a statistically significant interaction (p < 0.05) between time and group for trunk tilt, head and shoulder protrusion and for hip anteversion in the Zoom group. No changes were found for these parameters in the control group. For pelvic tilt no significant changes were found. (4) Conclusions. Feedback-based online training with two 45 min sessions per week can improve postural parameters in adolescent soccer players over a period of six weeks.

The present study aimed to assess the effects of asymmetric muscle fatigue on the skin surface temperature of abdominal and back muscles. The study was based on a pre-post/follow-up design with one group and included a total of 41 subjects (22 male, 19 female; age, 22.63 ± 3.91; weight, 71.89 ± 12.97 kg; height, 173.36 ± 9.95). All the participants were asked to perform side bends in sets of 20 repetitions on a Roman chair until complete exhaustion. The pre-, post- and follow-up test (24 h after) skin surface temperatures were recorded with infrared thermography. Subjective muscle soreness and muscle fatigue were analyzed using two questionnaires. The results of the post hoc tests showed that skin temperature was statistically significantly lower in the post-tests than in the pre- and follow-up tests, but no meaningful differences existed between the pre- and follow-up tests. Asymmetric side differences were found in the post-test for the upper and lower areas of the back. Differences were also noted for the front in both the upper and lower areas. No thermographic side asymmetries were found at the pre- or follow-up measurement for either the back or the front. Our results support the potential of using thermographic skin surface temperature to monitor exercise and recovery in athletes, as well as its use in rehabilitational exercise selection.

There is little scientific evidence regarding the cumulative effect of purposeful heading. The head-neck-torso alignment is considered to be of great importance when it comes to minimizing potential risks when heading. Therefore, this study determined the relationship between head-neck-torso alignment (cervical spine, head, thoracic spine) and the acceleration of the head, the relationship between head acceleration and maximum ball speed after head impact and differences between head accelerations throughout different heading approaches (standing, jumping, running). A total of 60 male soccer players (18.9 ± 4.0 years, 177.6 ± 14.9 cm, 73.1 ± 8.6 kg) participated in the study. Head accelerations were measured by a telemetric Noraxon DTS 3D Sensor, whereas angles for the head-neck-torso alignment and ball speed were analyzed with a Qualisys Track Manager program. No relationship at all was found for the standing, jumping and running approaches. Concerning the relationship between head acceleration and maximum ball speed after head impact only for the standing header a significant result was calculated (p = 0.024, R 2 = .085). A significant difference in head acceleration (p < .001) was identified between standing, jumping and running headers. To sum up, the relationship between head acceleration and head-neck-torso alignment is more complex than initially assumed and could not be proven in this study. Furthermore first data were generated to check whether the acceleration of the head is a predictor for the resulting maximum ball speed after head impact, but further investigations have to follow. Lastly, we confirmed the results that the head acceleration differs with the approach., (© 2021 Stephan Becker, Joshua Berger, Oliver Ludwig, Daniel Günther, Jens Kelm, Michael Fröhlich, published by Sciendo.)

Strength training in youth soccer has both a preventive and a sports-specific component. Whole-body electromyostimulation (WB-EMS) could represent an interesting time-saving add-on to classical strength exercises in performance-oriented soccer. The objective of this study was to find out whether a 10-week superimposed WB-EMS training might have a more positive impact on strength parameters in male youth elite soccer players than regular athletic strength exercises alone. A total of 30 male youth soccer players from a youth academy aged 15 to 17 years participated in the study. Before and after the intervention, the isometric extension and flexion forces of trunk and knee, and the hip abduction and adduction forces were tested. Twelve players (control group) absolved a conventional 20-minute strength training once a week for a period of ten weeks. Eighteen players absolved the same exercises but with superimposed WB-EMS. Blood creatine kinase concentration was measured for training control. ANOVAs, Friedman tests and post hoc t-tests were calculated (p = 0.05) to examine the strength development during the training period between the groups. While we could not find significant strength increases in the leg, hip and trunk muscles in the control group (<4%), the strength of the WB-EMS group improved significantly in 4 of the 6 muscle groups tested. In this group, the strength of knee flexors increased significantly by 20.68 ± 21.55%, knee extensors by 31.43 ± 37.02%, hip adductors by 21.70 ± 12.86% and trunk flexors by 33.72 ± 27.43%. The rates of strength increase are partly in line with other studies, partly clearly higher, which might be explained by the athletically active target group. A 10-week superimposed WB-EMS training improves the strength of certain leg, hip and trunk muscles in male adolescent elite soccer players to a greater extent than a pure athletic strength training of the same duration., (© Journal of Sports Science and Medicine.)

This study examined a potential age-dependency of both posture and stability (balance) control in children and adolescents in a healthy population. Body posture with open and closed eyes was examined for a total of 456 test persons (age 6.7-17.6 years. Posture parameters (posture index, upper body tilt, trunk tilt) were assessed in the sagittal plane. Additionally, the oscillation of the center of pressure with open and closed eyes was additionally analyzed in a sub-sample of 318 subjects. Absolute values of stability control parameters changed significantly during childhood and adolescence for both boys (p = 0.005) and girls (p = 0.01). Relative changes of stability and posture parameters when closing the eyes did not change (p > 0.05) and were independent of age, gender or sports activity in healthy children and adolescents. The shifting of the body segments towards each other, as a result of the loss of visual information, does not seem to be primarily responsible for the increase in COP fluctuation. This is a further indication that stability control and posture control are complex interdependent mechanisms whose interaction is not yet fully understood., (© 2020 The Authors.)

[Purpose] Whole-body electromyostimulation (WB-EMS) is an extension of the EMS application known in physical therapy. In WB-EMS, body composition and skinfold thickness seem to play a decisive role in influencing the Ohmic resistance and therefore the maximum intensity tolerance. That is why the therapeutic success of (WB-)EMS may depend on individual anatomical parameters. The aim of the study was to find out whether gender, skinfold thickness and parameters of body composition have an influence on the maximum intensity tolerance in WB-EMS. [Participants and Methods] Fifty-two participants were included in the study. Body composition (body impedance, body fat, fat mass, fat-free mass) and skinfold thicknesses were measured and set into relation to the maximum intensity tolerance. [Results] No relationship between the different anthropometric parameters and the maximum intensity tolerance was detected for both genders. Considering the individual muscle groups, no similarities were found in the results. [Conclusion] Body composition or skinfold thickness do not seem to have any influence on the maximum intensity tolerance in WB-EMS training. For the application in physiotherapy this means that a dosage of the electrical voltage within the scope of a (WB-) EMS application is only possible via the subjective feedback (BORG Scale)., (2020©by the Society of Physical Therapy Science. Published by IPEC Inc.)

The difference in the efficacy of altered stimulation parameters in whole-body-electromyostimulation (WB-EMS) training remains largely unexplored. However, higher impulse frequencies (>50 Hz) might be most adequate for strength gain. The aim of this study was to analyze potential differences in sports-related performance parameters after a 10-week WB-EMS training with different frequencies. A total of 51 untrained participants (24.9 ± 3.9 years, 174 ± 9 cm, 72.4 ± 16.4 kg, BMI 23.8 ± 4.1, body fat 24.7 ± 8.1 %) was randomly divided into three groups: one inactive control group (CON) and two training groups. They completed a 10-week WB-EMS program of 1.5 sessions/week, equal content but different stimulation frequencies (training with 20 Hz (T20) vs. training with 85 Hz (T85)). Before and after intervention, all participants completed jumping (Counter Movement Jump (CMJ), Squat Jump (SJ), Drop Jump (DJ)), sprinting (5m, 10m, 30m), and strength tests (isometric trunk flexion/extension). One-way ANOVA was applied to calculate parameter changes. Post-hoc least significant difference tests were performed to identify group differences. Significant differences were identified for CMJ (p = 0.007), SJ (p = 0.022), trunk flexion (p = 0.020) and extension (p=.013) with significant group differences between both training groups and CON (not between the two training groups T20 and T85). A 10-week WB-EMS training leads to significant improvements of jump and strength parameters in untrained participants. No differences could be detected between the frequencies. Therefore, both stimulation frequencies can be regarded as adequate for increasing specific sport performance parameters. Further aspects as regeneration or long term effects by the use of different frequencies still need to be clarified., (© Journal of Sports Science and Medicine.)

The difference in the efficacy of altered stimulation parameters in whole-body-electromyostimulation training (WB-EMS) has hardly been examined. Higher impulse frequencies (>50 Hz) might be most adequate for strength gains because of the force frequency relationship (FFR), which describes a greater force production by increasing the applied frequency. Frequencies below this value, however, also seem to have positive influences on muscle strength increases. Therefore, the aim of this study was to analyze possible muscle length changes to different stimulation frequencies of the dissected mouse triceps surae muscle. A bending rod transducer was used to measure and compare changes in muscle lengths at different frequencies in relation to the initial length in the prepared muscle. We found significant differences between the muscle shortening at different frequencies ( p < 0.001). At 20 Hz the largest muscle shortening was observed (20 Hz = 3.32 ± 2.06, 60 Hz = 0.77 ± 0.58, 85 Hz = 0.32 ± 0.29, 100 Hz = 0.31 ± 0.29). From a frequency of 60 Hz, the muscle shortening decreased progressively, at stimulation frequencies above 60 Hz the lowest shortenings were recorded. The results demonstrate a different behavior of the isolated triceps surae muscle of the mouse in an ex vivo environment. Even if there is no FFR in this investigation, the results indicate a higher metabolic demand using higher frequencies in electromyostimulation, despite the experimental execution in ex vivo design. Therefore, future studies should take this faster fatigue into account when drawing up training protocols in order to counteract possible frequency modulations., (Copyright © 2020 Zart, Berger, Ludwig, Knauth and Fröhlich.)

The importance of well trained and stable neck flexors and extensors as well as trunk muscles for intentional headers in soccer is increasingly discussed. The neck flexors and extensors should ensure a coupling of trunk and head at the time of ball contact to increase the physical mass hitting the ball and reduce head acceleration. The aim of the study was to analyze the influence of a 6-week strength training program (neck flexors, neck extensors) on the acceleration of the head during standing, jumping and running headers as well as after fatigue of the trunk muscles on a pendulum header. A total of 33 active male soccer players (20.3 ± 3.6 years, 1.81 ± 0.07 m, 75.5 ± 8.3 kg) participated and formed two training intervention groups (IG1: independent adult team, IG2: independent youth team) and one control group (CG: players from different teams). The training intervention consisted of three exercises for the neck flexors and extensors. The training effects were verified by means of the isometric maximum voluntary contraction (IMVC) measured by a telemetric Noraxon DTS force sensor. The head acceleration during ball contact was determined using a telemetric Noraxon DTS 3D accelerometer. There was no significant change of the IMVC over time between the groups (F=2.265, p=.121). Head acceleration was not reduced significantly for standing (IG1 0.4 ± 2.0, IG2 0.1 ± 1.4, CG -0.4 ± 1.2; F = 0.796, p = 0.460), jumping (IG1-0.7 ± 1.4, IG2-0.2 ± 0.9, CG 0.1 ± 1.2; F = 1.272, p = 0.295) and running (IG1-1.0 ± 1.9, IG2-0.2 ± 1.4, CG -0.1 ± 1.6; F = 1.050, p = 0.362) headers as well as after fatigue of the trunk musculature for post-jumping (IG1-0.2 ± 2.1, IG2-0.6 ± 1.4; CG -0.6 ± 1.3; F = 0.184, p = 0.833) and post-running (IG1-0.3 ± 1.6, IG2-0.7 ± 1.2, CG 0.0 ± 1.4; F = 0.695, p = 0.507) headers over time between IG1, IG2 and CG. A 6-week strength training of the neck flexors and neck extensors could not show the presumed preventive benefit. Both the effects of a training intervention and the consequences of an effective intervention for the acceleration of the head while heading seem to be more complex than previously assumed and presumably only come into effect in case of strong impacts., (© Journal of Sports Science and Medicine.)

Objective: Self-management is important to successfully managing chronic skin diseases. The Person-Centred Dermatology Self-care Index (PeDeSI) is a self-efficacy theory-based questionnaire tool to measure education and support needs of adults with long-term skin conditions. The aim of this research was to translate the PeDeSI into German (PeDeSI-G) and to explore the validity of this tool., Methods: The instrument was translated by five translators working independently. User understanding and relevance were evaluated by nurses, patients and physicians. The translated version was modified and applied in a subsequent validation study. Demographic and other variables, PeDeSI-G and Dermatology Life Quality Index (DLQI) scores of dermatological patients were obtained., Results: PeDeSi-G and DLQI scores were obtained from 100 patients. A conceptually and semantically equivalent German translation of the PeDeSI was developed. There was a statistically significant difference between in- and outpatients (p<0.001). PeDeSI-G scores were most strongly correlated with disease duration and DLQI scores., Conclusions: Validation results indicate that the PeDeSI-G is able to discriminate between patients with different educational and support needs for this patient group. Newly diagnosed patients and patients admitted to the hospital for the first time might benefit most from the PeDeSI-G assessment. The PeDeSI-G is a valid tool for assessing and evaluating the support needs of German-speaking patients with chronic skin disease.

Muscular imbalances of the trunk muscles are held responsible for changes in body posture. At the same time, whole-body electromyostimulation (WB-EMS) has been established as a new training method that enables simultaneous stimulation of many muscle groups. This study was aiming to analyze if a 10 weeks WB-EMS training changes posture-relevant parameters and/or improves isometric strength of the trunk extensors and flexors, and if there are differences based on stimulation at 20 Hz and 85 Hz. Fifty eight untrained adult test persons were divided into three groups (control, CON; training with 20 Hz stimulation, TR20; training with 85 Hz, TR85). Anthropometric parameters, trunk extension and flexion forces and torques, and posture parameters were determined before ( n = 58) and after ( n = 53: CON: n = 15, TR20: n = 19, TR85: n = 19) a 10 weeks WB-EMS training program (15 applications, 9 exercises). Differences between the groups were calculated for pre- and post-tests using univariate ANOVA and between the test times using repeated (2 × 3) ANOVA. Comparisons of pairs were calculated post hoc based on Fisher (LSD). No differences between the groups were found for the posture parameters. The post hoc analysis of both trunk flexion and trunk extension forces and torques showed a significant difference between the groups TR85 and CON but no difference between the other group pairs. A 10 weeks whole-body electrostimulation training with a stimulation frequency of 85 Hz in contrast to training with a stimulation frequency of 20 Hz improves the trunk muscle strength of an untrained group but does not significantly change posture parameters.

(1) Background: The importance of a strong and stable trunk musculature is well known, but there is a lack of reliable, valid and objective test batteries with the necessary test economy, practicability and cost-benefit ratio. The aim of the present study was to evaluate the Bourban test for the validity of its exercise selection representing the ventral, right/left lateral and dorsal muscle chain. (2) Methods: 33 male sports students (24.1 ± 2.4 years, 181.6 ± 5.5 cm, 80.8 ± 7.3 kg) participated in the study. Median Frequency (MDF) and Mean Frequency (MNF) were calculated from the electromyographic signals and used to check whether fatigue of the suggested target musculature actually occurs during the different exercises and thus the exercise is representative for this part of the trunk. (3) Results: In all exercises significant fatigue was measured for MDF and MNF in the muscles working as agonists. (4) Conclusion: It can be stated that the Bourban trunk muscle strength test is a valid and economic test instrument for the evaluation of trunk strength (endurance). Compared to technically supported measuring systems, the Bourban test seems to be a flexible and cost-effective alternative for the broad mass.

Poor posture in childhood and adolescence is held responsible for the occurrence of associated disorders in adult age. This study aimed to verify whether body posture in adolescence can be enhanced through the improvement of neuromuscular performance, attained by means of targeted strength, stretch, and body perception training, and whether any such improvement might also transition into adulthood. From a total of 84 volunteers, the posture development of 67 adolescents was checked annually between the age of 14 and 20 based on index values in three posture situations. 28 adolescents exercised twice a week for about 2 h up to the age of 18, 24 adolescents exercised continually up to the age of 20. Both groups practiced other additional sports for about 1.8 h/week. Fifteen persons served as a non-exercising control group, practicing optional sports of about 1.8 h/week until the age of 18, after that for 0.9 h/week. Group allocation was not random, but depended on the participants' choice. A linear mixed model was used to analyze the development of posture indexes among the groups and over time and the possible influence of anthropometric parameters (weight, size), of optional athletic activity and of sedentary behavior. The post hoc pairwise comparison was performed applying the Scheffé test. The significance level was set at 0.05. The group that exercised continually (TR20) exhibited a significant posture parameter improvement in all posture situations from the 2nd year of exercising on. The group that terminated their training when reaching adulthood (TR18) retained some improvements, such as conscious straightening of the body posture. In other posture situations (habitual, closed eyes), their posture results declined again from age 18. The effect sizes determined were between η 2 = 0.12 and η 2 = 0.19 and represent moderate to strong effects. The control group did not exhibit any differences. Anthropometric parameters, additional athletic activities and sedentary behavior did not influence the posture parameters significantly. An additional athletic training of 2 h per week including elements for improved body perception seems to have the potential to improve body posture in symptom free male adolescents and young adults.

The core muscles play a central role in stabilizing the head during headers in soccer. The objective of this study was to examine the influence of a fatigued core musculature on the acceleration of the head during jump headers and run headers. Acceleration of the head was measured in a pre-post-design in 68 soccer players (age: 21.5 ± 3.8 years, height: 180.0 ± 13.9 cm, weight: 76.9 ± 8.1 kg). Data were recorded by means of a telemetric 3D acceleration sensor and with a pendulum header. The treatment encompassed two exercises each for the ventral, lateral, and dorsal muscle chains. The acceleration of the head between pre- and post-test was reduced by 0.3 G ( p = 0.011) in jump headers and by 0.2 G ( p = 0.067) in run headers. An additional analysis of all pretests showed an increased acceleration in run headers when compared to stand headers ( p < 0.001) and jump headers ( p < 0.001). No differences were found in the sub-group comparisons: semi-professional vs. recreational players, offensive vs. defensive players. Based on the results, we conclude that the acceleration of the head after fatiguing the core muscles does not increase, which stands in contrast to postulated expectations. More tests with accelerated soccer balls are required for a conclusive statement., Competing Interests: The authors declare no conflict of interest.

Background: Osteitis pubis is a common cause of chronic groin pain. Due to high clinical uncertainty and varying etiopathology, the diagnosis is often delayed. Especially athletes suffer from this disease, but patients with orthopaedic, traumatological, neurological, urological, gynaecological, and rheumatic complaints can also be affected. Osteitis pubis can be treated by conservative as well as surgical techniques., Material and Methods: Systematic literature research, descriptive presentation of the studies, and interpretation of evidence-based medicine results., Results: The scientific level of studies about osteitis pubis and the number of athletes included are low overall. A statistical comparison is methodically difficult due to the heterogeneity of publications. The leading clinical symptom of osteitis pubis is an aching symphysis pubica. Unfortunately, there are no characteristic clinical pathognomonic signs. The medical diagnosis is based on an exclusion of various differential diagnoses (e. g. sports hernia, femoroacetabular impingement, adductor lesion) and a comparison of medical history, clinical examination, and imaging methods. After a period of rest, osteitis pubis is quite often a self-limiting disease and will initially be treated conservatively. If this fails, surgical intervention has to be considered depending on concurrent pathologies., Conclusion: Specific guidelines for the diagnosis and treatment of osteitis pubis do not exist as yet. But there is consensus that a surgical intervention should only be performed if conservative treatment fails. The level of evidence for the studies is low. A meta-analytical evaluation based on the existing publications is not possible as yet. The number of recorded athletes in relation to the socio-economic consequences of the disease, especially in professional sport, is low., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

[Purpose] This study examined possible interrelationships between postural sway and posture parameters in children and adolescents with a particular focus on posture weakness. [Subjects and Methods] 308 healthy children and adolescents (124 girls, 184 boys, aged 12.3 ± 2.5 years) participated in the study. Posture parameters (posture index, head protrusion, trunk inclination) were determined based on posture photos in the sagittal plane. Postural sway was measured during 20 seconds on a force plate. The Pearson's product-moment correlation coefficients between the anthropometric and posture parameters and the sway path length (SPL) were calculated, as well as the coefficient of determination R 2 . [Results] There is a weak but significant correlation between age or body mass index of the test subjects and the SPL. There is no statistically significant correlation between posture parameters and the SPL. Children and adolescents with posture weakness do not exhibit a changed SPL. [Conclusion] Therefore, therapy of poor posture must be considered separately from therapeutic measures for the improvement of balance skills.

More than 70% of all knee injuries in soccer occur in non-contact situations. It is known that increased lower limb dynamic knee valgus is associated with such situations. Little has been found out about differences in knee kinematics of the dominant (kicking) and non-dominant (supporting) leg during a single leg landing. A total of 114 male adolescent soccer players (age 14.6 ± 1.1 years) from elite (N = 66) and amateur soccer clubs (N = 48) performed a single leg drop landing down from a box. For each leg, the two-dimensional dynamic knee valgus angle (DKVA) was calculated. Paired t -tests were used to statistically determine significant differences between dominant and non-dominant leg DKVA, and t -tests were calculated between the two performance groups. Statistically significant differences ( p < 0.05) were identified for the DKVA between the dominant and non-dominant leg for both amateur and elite players, showing a greater DKVA for the dominant leg. Group differences for the DKVA between amateur and elite players were not found, neither for the dominant, nor for the non-dominant leg. It can be concluded that the non-dominant leg showed more stable dynamics than the dominant leg during unilateral landing regardless of the player's performance level. This could be due to adaptions to sport-specific requirements. Therefore, it is recommended that programs to prevent knee injuries among soccer players consider the dynamics of each leg individually.

In soccer, headers are a tactical measure and influenced by numerous factors. The goal of this study was to identify whether changes in kinematics and muscular activity, especially of the head-stabilizing muscles, occur during headers when the core musculature is fatigued. In two subgroups, muscular activity (12 amateur players, age 23.6 ± 4.2 years) and kinematics and dynamics (29 amateur players, age 23.7 ± 2.8 years) were examined during straight headers on a pendulum header. Data were collected before and after the core muscles were fatigued by an exercise program. Telemetric surface EMG, 3D acceleration sensor, force plate, and video recordings were used. Under fatigue, the activity of M. erector spinae and M. rectus abdominis was significantly reduced in the preparation phase of the header. The activity of M. sternocleidomastoideus was significantly increased during the jump phase, and the hip extension angle during maximum arched body tension was significantly reduced under fatigue. Jumping height, acceleration force impulse, and linear head acceleration were also significantly reduced. We conclude that fatigue of the core muscles affects the motion technique of the header and the activity of the muscle groups stabilizing the head. Therefore, the necessity of specific training in soccer should be emphasized from a medical-preventive point of view.

Objectives: The assessment of the posture of children and adolescents using photometric methods has a long tradition in paediatrics, manual therapy and physiotherapy. It can be well integrated into the clinical routine and enables objective documentation. One-dimensional parameters such as angle sizes are mostly used in the diagnosis of postural defects in children and adolescents by means of photogrammetry. This study examined the posture index, a complex parameter, which evaluates the alignment of several trunk segments in the sagittal plane and is suitable for use as a screening parameter in everyday clinical practice., Methods: For this postural photographs were taken in the sagittal plane of the habitual posture in a subgroup of 105 adolescents (12.9 ± 2.6 years) for analysing validity, and in a subgroup of 25 adolescents (12.1 ± 2.8 years) for analysing reliability and objectivity. Marker spheres (12 mm) were placed on five anatomical landmarks. The posture was also evaluated clinically by experienced investigators (PT, MD, DSc). The distances of the marker points to the plumb line through the malleolus lateralis were calculated and the posture index calculated from these. In order to determine the objectivity, reliability and validity of the posture index, statistical parameters were calculated., Results: The posture index demonstrated very good objectivity (intraclass correlation coefficient ICC = 0.865), good reliability (Cronbach's alpha = 0.842) and good validity compared to the posture assessment done by the medical experts (Spearman's rho = 0.712)., Conclusions: The posture index reflects a doctor's assessment of the posture of children and adolescents and is suitable as a clinical parameter for the assessment of postural defects., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Peroneus longus acts as a foot evertor and pronator, thus ensuring stability of the talocrural joint by curbing inversion movement of the rearfoot. Increased activation of the peroneus longus muscle in the stance phase could have a stabilising effect on the ankle joint. This study aimed to determine whether the activity of the peroneus longus muscle could be increased by the targeted use of a specially formed lateral pressure element in a customised orthopaedic insole., Methods: This was a laboratory-based study that utilised a randomised crossover design. Thirty-four healthy participants walked along a walkway in neutral footwear wearing a control insole or a sensorimotor insole with a lateral pressure point adjacent to the tendon of the peroneus longus muscle. The electromyographic muscle activity of the peroneus longus and tibialis anterior muscles was measured using surface electromyography. Contact with the ground was recorded via two pressure sensors under the sole of the shoe. Muscle activity during the stance phase was analysed in the time and amplitude domains and compared statistically with paired t-tests for both insole types., Results: In 27 out of the 34 participants, an additional activity peak of the peroneus longus muscle was observed in the loading response phase with the sensorimotor insole, which reached its maximum at 29.7 % (±4.5 %) of the stance phase. When averaged over all 34 participants, the integrated electromyographic output for the peroneus longus in the mid-stance phase revealed a significant higher activity (p < 0.001, post hoc power = 0.98, effect size: Cohen's d = 0.71) with the sensorimotor insole (18.1 ± 11.3 % MVCs) than with the control insole (11.2 ± 7.7 % MVCs). No significant effects were established for the other gait phases or for the tibialis anterior., Conclusions: An increase of muscle activity of the peroneus longus muscle was observed during the loading response and mid-stance phase, when orthopedic insoles with a lateral pressure point were worn. We conclude that the pressure point changes afferent information and leads to an increased peroneus longus activation in the time interval in which the pressure point exerted pressure on the peroneal tendon.

Soccer and football players are exposed to a high risk of groin pain. In some cases, the pubic symphysis is the origin of the problems.This article presents a case report of a young elite soccer player who, over a period of two years, suffered from pain in the groin and symphysis area. The right leg was the kicking leg. Imaging techniques did not reveal pathological findings. Sports hernia, osteomyelitis, enthesopathy, adductor tendonitis, and muscle sprains, as well as rheumatic or urogenital disorders were excluded.A 3 D posture analysis was performed to examine the statics of the body and pelvis. The maximum isometric strength of the left and right leg adductors and abductors, as well as the knee flexors and extensors were measured.We found a muscular imbalance resulting from the type of sport the athlete engaged in with an unfavourable ratio between the right knee extensor and flexor muscles. Comparing sides, an imbalance was also identified between the right and left knee extensor. This imbalance resulted in a one-sided forward tilt of the right hemi-pelvis. This pelvic torsion may lead to an increase in shear forces in the pubic symphysis, which we suspected to be the reason for the recurring problems.After three months of specific training exercises, the pelvic position was harmonised and the muscular imbalances were significantly reduced. Even 6 months after completion of the specific training exercises, the player remained without complaints despite his unvaried soccer training intensity.Causal treatment of functional pain in the groin or symphysis area should take into account the ipsilateral and contralateral strength ratios of the knee extensors and flexors as well as the three-dimensional position of the pelvis., (© Georg Thieme Verlag KG Stuttgart · New York.)