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Breaking hat sich mit seiner Mischung aus anspruchsvollen Tanzbewegungen und komplexen akrobatischen Bewegungen zu einer weltweit praktizierten Ausdrucksform entwickelt, welche nun in das Programm der Olympischen Spiele aufgenommen wurde. Eine damit einhergehende Professionalisierung und Steigerung von Trainingsumfängen und -intensitäten erhöht dabei auch die Ansprüche an das muskuloskelettale System der Sportler. Über Verletzungsmuster, Ausmaß, Ursache und Präventionsansätzen ist bisher noch wenig bekannt. Ziel dieses systematischen Reviews ist es , Verletzungsprofile im Breaking zu identifizieren und herauszufinden, welches Trainingsverhalten zu Verletzungen beiträgt, um infolgedessen effektive Präventionsmaßnahmen zu entwickeln. Es erfolgte eine systematische Literaturrecherche in verschiedenen Datenbanken (PubMed, web of science, SAGEPub, JStor und CINAHL). Von den initial 24 Treffern wurden nach Anwendung der Ein- und Ausschlusskriterien 9 Studien untersucht und analysiert. Es konnte ein detailliertes Verletzungsprofil mit Angaben zu Trainingsverhalten und verschiedenen Verletzungsparametern erstellt werden: 78,4% des Trainings findet ohne Anleitung statt. Die am häufigsten verletzten Körperregionen sind Hand (18,8%), Wirbelsäule (17,9%) und Knie (17,4%). Die häufigste Verletzungsursache ist eine insuffiziente Erwärmung (57,7%). Anhand dieser und weiterer Ergebnisse wurden erste Präventionsmaßnahmen abgeleitet. Neben der dem Breaking inhärenten intensiven körperlichen Belastung scheint die Art der Trainingsgestaltung für das hohe Verletzungsrisiko mitverantwortlich zu sein. Mit den Erkenntnissen kann das Verständnis bei medizinischem und trainingswissenschaftlichem Personal für diese Tanzform verbessert werden und das Training hinsichtlich der Verletzungsprävention optimiert werden. Die Maßnahmen umfassen Trainingsrhythmus und -dauer, Schutzbekleidung, Bodenbeschaffenheit, ergänzendes Fitnesstraining und das Erkennen von Frühwarnzeichen. Außerdem zeigte sich, dass es weiteren Forschungsbedarf gibt, um die Trainingsgestaltung weiter zu professionalisieren. Breaking, with its mixture of demanding dance moves and complex acrobatic movements, has become a form of dance expression practiced worldwide, which has now been included in the program of the Olympic Games. The accompanying professionalization and increase in training volumes and intensity also increases the demands on the musculoskeletal system of athletes. However, little is known about the extent, cause, injury patterns and prevention approaches. The aim of this systematic review is to identify injury profiles in breaking, highlight training behaviors that contribute to injuries and to propose effective prevention measures. A systematic literature search was conducted using various databases (PubMed, web of science, SAGEPub, JStor and CINAHL). The initial search produced twenty-four results. However, only nine met the inclusion criteria and where further analyzed. A detailed injury profile with information on training behavior and various injury parameters could be created: 78.4% of the training takes place without supervision. The most frequently injured body regions are: hand (18.8%), spine (17.9%) and knee (17.4%). The most common cause of injury was an insufficient warm-up (57.7%). Based on these and other results, initial prevention measures were derived. In addition to the intense physical stress inherent in breaking, the way training is designed seems to be partly responsible for the high risk of injury. The findings can be used to improve the understanding among medical and kinesiological staff for this dance form and to optimize Breaking training with regard to injury prevention. For injury prevention, we suggested dancers take into consideration: training rhythm and duration, protective gear, floor conditions, supplemental fitness training, and recognition of early warning signs. Lastly our findings suggest a need for further research in order to further professionalize the training design. [ABSTRACT FROM AUTHOR]

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The University of Wisconsin Running Injury and Recovery Index (UWRI) was developed as an evaluative patient-reported outcome measure of perceived running ability and recovery after running-related injuries. To date, the questionnaire was not translated into German language and studies on its clinical feasibility and validity are sparse. Prospective cohort study. Outpatient sports medicine clinic. The UWRI questionnaire was translated to German language using a state-of-the art back-translation method including three translators and two back-translators. Clinical feasibility and validation were assessed in 14 injured runners. UWRI total score, running volume. The translation process was completed without major discrepancies. Feasibility and preliminary evaluation were demonstrated in a cohort of 14 injured runners. The UWRI total score significantly improved throughout 12 weeks of recovering from running-related injuries (p < 0.001). Relative running volume significantly correlated with UWRI score (p < 0.001). The University of Wisconsin Running Injury and Recovery Index was successfully translated into the German language. Its usage may hold promise for better rehabilitation surveillance following running-related injuries. • The UWRI provides information on the recovery from a running-related injury. • This patient-reported outcome measure can be successfully translated and culturally adapted. • This study indicates its feasibility and validity in a clinical setting. • Usage of the UWRI may hold promise for better rehabilitation surveillance. [ABSTRACT FROM AUTHOR]

Die weltumspannende COVID-19-Pandemie hat auch die tägliche Arbeit der Mannschafts- und Verbandsärzte entscheidend verändert. Bislang kaum bedeutsame Arbeitsfelder kamen hinzu und insbesondere organisatorische Aufgaben stellen den betreuenden Sportmediziner vor große Herausforderungen. Präventive Maßnahmen wie die Erstellung von Hygienekonzepten und Umsetzung von Teststrategien sind zentraler Bestandteil einer Verhinderung von Infektionsgeschehen (und deren Ausbreitung) und somit Voraussetzung der Fortführung von Trainings- und Wettkampfmaßnahmen. Erforderlich sind Kenntnisse im direkten medizinischen Umgang mit SARS-CoV-2, inklusive geeigneter medizinischer Maßnahmen zur gefahrlosen Wiederaufnahme der Sportausübung. Auch sekundäre Folgen der Pandemie, wie beispielsweise Einschränkungen notwendiger operativer und rehabilitativer Maßnahmen oder das Auftreten psychischer Erkrankungen, müssen berücksichtigt werden. Eine teaminterne, offene und vertrauensvolle Kommunikation ist Grundlage der Akzeptanz der vereinbarten Maßnahmen. Durch die sich stetig ändernde Pandemiesituation und den Zuwachs an wissenschaftlichen Erkenntnissen ist eine fortlaufende Re-Evaluation der ausgesprochenen Empfehlungen und vereinbarten Prozedere notwendig. The global COVID 19 pandemic has also decisively changed the daily work of team physicians. Previously insignificant fields of work have been added and organisational tasks in particular pose great challenges for the sports physician in charge. Preventive strategies such as the development of hygiene concepts and the implementation of testing strategies are a central part of preventing the occurrence (and spread) of infections and are thus a prerequisite for the continuation of training and competition measures. Knowledge of the direct medical handling of SARS-CoV-2 is required, including appropriate medical measures for the safe resumption of sporting activities. Secondary consequences of the pandemic, such as restrictions on necessary surgical and rehabilitative treatments or the occurrence of mental illnesses, must also be taken into account. Open and trusting communication within the team is basic for acceptance of the agreed measures. Due to the constantly changing pandemic situation and the increase in scientific knowledge, a continuous re-evaluation of the recommendations and agreed procedures is necessary. [ABSTRACT FROM AUTHOR]

Exercise interventions have become more important in the treatment of mental disorders. High-intensity interval training (HIIT) has achieved promising results in the treatment of different mental disorders, like depression or panic disorder. To our knowledge, no study investigated the efficacy of HIIT as a sole treatment in a sample of individuals with fully diagnosed PTSD. 40 participants with PTSD were randomized to either HIIT or a control group (low intensity training, LIT). They underwent a 12-day training period. The primary outcome were PTSD symptoms as assessed by the Clinician-Administered PTSD Scale (CAPS). Secondary outcome were self-reported posttraumatic, depressive and dissociative symptoms and overall psychological distress assessed at baseline, post treatment (one week after training) and follow up (six weeks post treatment). We used linear mixed models to assess the differential effects of the two trainings on clinical symptoms. In both HIIT and LIT group, clinician- and self-rated PTSD symptom severity as well as depressive and dissociative symptoms and overall psychological distress decreased significantly from baseline to follow up with medium effect sizes related to PTSD symptomatology (Cohen's d = 0.76, p <.001) and small effect sizes related to depressive (Cohen's d = 0.45, p <.001), dissociative symptoms (Cohen's d = 0.42, p <.001) and overall psychological distress (Cohen's d = 0.43, p <.001). There were no differences in symptom change between groups. In our pilot study, HITT did not seem to be superior to LIT in a sample of individuals with PTSD. • PTSD symptom severity decreased with medium effect sizes from baseline to follow up in both groups. • Depressive and dissociative symptoms decreased with small effect sizes from baseline to six to follow up both groups. • Overall psychological distress decreased with small effect sizes from baseline to follow up both groups. • Despite methodological limitations results suggest a potential beneficial effect of HIIT and LIT in participants with PTSD [ABSTRACT FROM AUTHOR]

Copyright of Sport-Orthopadie - Sport-Traumatologie is the property of Elsevier B.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.)

Copyright of Sport-Orthopadie - Sport-Traumatologie is the property of Elsevier B.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.)

Zusammenfassung Seit Mitte der 80er Jahre erlebt der Sport Snowboarden in Amerika und auch in Europa einen enormen Aufschwung. Auch wenn die Zahl der Snowboarder in den letzten Jahren von 2,2 Millionen in 2014 auf 1,98 Millionen in 2017 [9] zurückging, übt der Sport nach wie vor eine hohe Anziehungskraft vor allem auf junge Wintersportler aus [9]. Die ständige Weiterentwicklung der Sportart und des Materials führt auch zu einer Veränderung des Verletzungsmusters und zu speziellen Charakteristika von snowboard-spezifischen Verletzungen. Ein solches Verletzungsmuster konnte anhand von Studien nachgewiesen werden und lässt sich in ein Verletzungsprofil des Snowboardens zusammenfassen. In dem folgenden Review-Artikel wurde ein Verletzungsprofil der Sportart Snowboarden anhand einer systemischen Literaturrecherche erstellt. Zur Erstellung des Verletzungsprofils wurden verschiedene prospektive und retrospektive, klinische Studien der letzten 20 Jahre im Breitensport untersucht. Es wurden hauptsächlich Studien der Evidenzniveaus I und II untersucht. Aus den untersuchten Studien lässt sich ableiten, dass die Sportart Snowboarden eine höhere Prävalenz von Verletzungen als das alpine Skifahren zeigt. Die oberen Extremitäten sind dabei besonders verletzungsgefährdet. Die häufigste Verletzung stellt mit mehr als 50% aller erlittenen schweren Verletzungen der handgelenknahe Bruch speziell bei Anfängern dar [8]. Dem Einsatz von Helmen zur Prävention von Kopfverletzungen konnte ein positiver Einfluss nachgewiesen werden. Die Prävention umfasst auch die Möglichkeit, Verletzungen durch körperliche Vorbereitung und Snowboardschulung mit Sturztraining vorzubeugen oder Unfallrisiken durch intelligente Pisten-Strategien zu minimieren. Es ist wichtig, dass medizinische Versorger die Sportart Snowboarden und ihre Verletzungsmuster kennen und vorbereitet sind, Snowboard Verletzungen richtig zu bewerten und zu behandeln. Summary Since the 1980s snowboarding gained huge popularity in America as well as in Europe. Even though data show a slow decline of snowboarders in Germany from 2.2 million in 2014 to 1.98 million in 2017 [9], snowboarding still attracts a lot of young winter sport athletes [9]. The constant development of Snowboarding and the equipment leads to a changing injury pattern and distinct characteristics of snowboarding related injuries. Recent studies showed the existence of a distinct injury pattern which can be summarized in an injury profile of snowboarding. Specific injury patterns and characteristics of snowboard-related trauma were identified and are summarized in a snowboard-specific injury profile. The most affected body region reported in a lot of snowboard injury studies are the wrists more than 50% of severe injuries, especially for beginners [8]. Intelligent slope strategies and physical preparation can be realized to minimize the risk of injuries in snowboarding. It is important for medical providers to obtain knowledge about the snowboarding and to be prepared for evaluation and treatment of snowboard injuries. [ABSTRACT FROM AUTHOR]

Zusammenfassung Die Stressfraktur des Kreuzbeins stellt eine oftmals fehldiagnostizierte Überlastungsverletzung bei Sportlern dar. Sie äußert sich in ihrer Initialphase latent und sehr unspezifisch als tiefsitzender, oftmals einseitiger Schmerz im LWS-/ISG- bzw. Gesäß-/Hüft-/Beckenbereich. Eine gesicherte Diagnose gelingt derzeit nur per MRT. Hierauf sowie auf ihre erfolgreiche konservative Therapie mittels Alternativtraining wird anhand zweier Kasuistiken aus dem Jahr 2016 (Elite-Langstreckenläufer und Amateur-Triathlet) eingegangen. Basierend auf einer verlaufsbegleitenden MRT-Diagnostik wird die radiologische Zeitskala der Knochenreparaturprozesse dargestellt und eine Halbwertszeit des ossären Ödemvolumens von 31 ± 7 Tagen abgeleitet. Aus therapeutischer Sicht wird insbesondere auf den Einsatz eines Teilschwerelosigkeitslaufbands (AlterG®) eingegangen. Ein Vergleich der unterschiedlichen individuellen Verläufe der beiden beschriebenen Fälle lässt vermuten, dass sich bei frühzeitiger Erkennung, adäquater Therapie und einem spezifischen Trainingswiedereinstieg die Heilungszeit verkürzen und der Trainingsrückstand deutlich reduzieren lassen können. Summary The stress fracture of the sacrum is a commonly misdiagnosed overuse injury among athletes. Its initial latent symptoms are highly unspecific and usually manifest themselves as a “deep”, often unilateral pain in the lumbar spine / sacroiliac joint or buttock, hip and/or pelvis, respectively. A reliable diagnosis is only obtainable by MRI. This is discussed based on two case studies from 2016 (elite distance runner and amateur triathlete), along with the option of a conservative therapy including cross-training. By means of an accompanying MRI monitoring, the radiologic time scale of the physiologic bone remodeling process is obtained, yielding an edema volume half-life of 31 ± 7 days. In terms of therapy, particular attention is paid to employing a body-weight supported treadmill (“anti-gravity” treadmill / AlterG®). Comparing the individual courses of the two cases presented, it may be suggested that, if a sacral stress fracture is early diagnosed, adequately treated and followed up by a specific return to sports program, the athlete's recovery time and training backlog may be reduced. [ABSTRACT FROM AUTHOR]

Zusammenfassung Belastungsinduzierte asthmatische Symptome und Asthma werden häufig bei hochtrainierten Athleten diagnostiziert. Ein belastungsinduziertes Asthma (EIA) und eine belastungsinduzierte Bronchokonstriktion (EIB) treten, je nach Sportart, in 15-45% aller Hochleistungssportler auf. Das EIA tritt nicht selten auch zusammen mit einer Vocal Cord Dysfunktion (VCD) in Erscheinung, die auch eigenständig als Differentialdiagnose in Betracht gezogen werden muss. Die Therapie basiert auf antiinflammatorischer Medikation (inhalative Glukokortikosteroide) und inhalativen Bronchodilatatoren (z.B. ß2-Agonisten). Im Allgemeinen dürfen, gemäß der Verbotsliste der Welt-Anti-Doping-Agentur (WADA), ß2-Agonisten bei Sportlern nicht zur Anwendung gelangen. Allerdings enthält die WADA-Liste spezifische ß2-agonistische Substanzen, die zur inhalativen Therapie verwendet werden dürfen. Summary Exercise induced asthma- like symptoms and asthma are frequently seen in highly trained athletes. Exercise induced asthma (EIA) and exercise induced bronchoconstriction (EIB) are estimated to be found in 15-45% of elite athletes. EIA is often experienced concurrently with vocal cord dysfunction (VCD), which needs to be considered as a differential diagnosis, in combination as well as a stand-alone diagnosis. The therapy is based on anti-inflammatory drugs (e.g. inhaled glucocorticosteroids) and inhaled bronchodilators (e.g. ß2-agonists). Generally, athletes may not use ß2-agonists according to the Prohibited List of the World Anti-Doping Agency (WADA). However, the WADA-List contains specific ß2-agonistic substances which are permitted to be used by inhalation. [ABSTRACT FROM AUTHOR]

Zusammenfassung Die Einführung der sogenannten „Needle Policy“ (NP), zunächst durch einzelne internationale Sportverbände und nachfolgend durch das Internationale Olympische Komitee (IOC) im Juni 2012, hat vor den Olympischen Sommerspielen in London zu Diskussionen und Unsicherheiten unter den betreuenden Sportmedizinern geführt. Bisher haben, unabhängig von den Regelungen bei den Olympischen Spielen, mindestens 5 internationale Sportverbände (FISA, FIG, UCI, UIPM, IWF) ebenfalls eine NP in ihr Regelwerk aufgenommen, zum Teil mit geringfügigen Unterschieden in den Formulierungen und Zielsetzungen. Weitere internationale Sportverbände haben die Einführung der NP angekündigt. Betreuende Sportmediziner müssen somit mit dem Inhalt der NPs vertraut sein und die ihnen dadurch obliegenden Pflichten kennen. Summary The introduction of the so-called “Needle Policy” (NP), first by single international sports federations and subsequently by the International Olympic Committee in June 2012 in advance to the Olympic Summer Games in London, has led to discussions and uncertainties among sports medicine physicians. To date, at least 5 international sports federations (FISA, FIG, UCI, UIPM, IWF) have incorporated the NP in their rules, some with slight differences in the wording and objectives. Other international sports federations have proposed the introduction of the NP in near future. Therefore, sports medicine physicians need to be familiar with the regulations of the NP and need to understand their duties and responsibilities resulting from these regulations. [ABSTRACT FROM AUTHOR]

Objective: To compare the cardio-metabolic risk profile between moderately obese and severely obese children and adolescents. Study design: Cross-sectional study involving 463 obese 6- to 19-year-olds who were referred to an inpatient weight-loss program. Anthropometric data were assessed and fasting blood samples were analyzed for lipid and glucose metabolism, adipokines, and inflammatory markers. Moderately obese individuals (percentiles corresponding to body mass index ≥30 to 35 kg/m2 at age 18 years) and severely obese individuals (percentiles corresponding to body mass index ≥35 kg/m2 at age 18 years) were defined by sex and age-specific cut-offs according to the International Obesity Task Force. Results: The prevalence of the metabolic syndrome was three times higher in severely obese individuals compared with those who are moderately obese. Mean values for proinsulin, insulin, homeostatic model assessment-insulin resistance, triglycerides, and interleukin-6 were 30%-50% higher in severe obesity compared with moderate obesity. Concentrations of leptin and high-sensitive C-reactive protein were about 1.5-fold higher, adiponectin levels were 12% lower, and resistin levels 10% higher in severely obese individuals compared with moderately obese (all P < .001). Conclusion: Severely obese individuals have a markedly more unfavorable cardio-metabolic risk profile than those who are moderately obese. The results of this study underscore the substantial effect of severe obesity on health and highlights that these children need to receive particular attention regarding obesity treatment. [Copyright &y& Elsevier]

Summary: Introduction: In the past several studies tried to identify parameters predicting success in elite alpine skiing. Most of these studies used cross-sectional designs. Therefore, the aim of this study was to determine influencing factors on alpine skiing performance in both a cross-sectional and a longitudinal design. Furthermore, the correlation between parameters of anthropometry, clinical chemistry, echocardiography and exercise testing and the success in alpine skiing (represented by FIS points) were investigated. Method: We analyzed the parameters of 143 elite athletes (69 male, 74 female, age 18.8±3.9 years, BMI 23.7±2.2 kg*m-2) of the German National Ski Team during a term of 5 years. Results: Athletes with higher fat free mass (FFM) and ferritin values were more successful than athletes with lower levels. In accordance, there were high correlation coefficients between FIS points and FFM (♀: r=-0.53, ♂: r=-0.73; all p<0.01) and ferritin (♀: r=-0.43, ♂: r=-0.69; all p<0.01), respectively. Conclusion: FFM and ferritin seems to be predicting factors for success in alpine ski racing. Therefore, training should be focused on the increase of FFM and iron status should be monitored carefully. [Copyright &y& Elsevier]

Summary: Nordic skiers are subject to highest demands, amplified by the increasing professionalism and the continuously rising level of performance. To ensure ideal health care and coaching, an enlargement and thus improvement of sports medicine and scientific knowledge is required. For identification of medical and performance characteristics, properties and parameters, data from 429 elite nordic ski athletes (cross country skiing, biathlon, nordic combination, ski jumping) were cross-sectional and longitudinal analysed. The comparison between sport, gender, age und performance level showed significant differences. By creating such particular sports medicine profiles, realistic assessments of results in age-matched comparison, both in terms of health-related, as well as performance-related tests, are prospective possible. [Copyright &y& Elsevier]

Abstract: The Arg16Gly single nucleotide polymorphism of the human β 2-adrenoceptor (ADRB2) gene was evaluated in a case-control study that included 313 white male elite endurance athletes and 297 white male sedentary controls (SCs) recruited in a multicenter project from North America, Finland, and Germany. The groups were matched by country of origin. The elite endurance athletes were required to have a maximum oxygen uptake ≥75 mL·kg−1·min−1 (mean [SD], 79.0 [3.5]), whereas SC subjects had to be sedentary with a measured maximum oxygen uptake ≤50 mL·kg−1·min−1 (40.1 [7.0]). Polymerase chain reaction technique was used to amplify the single nucleotide polymorphism–containing region in codon 16 of the ADRB2 gene. ADRB2 genotypes were in Hardy-Weinberg equilibrium in both groups. Genotypes did not differ between countries or sports of the athletes. The χ 2 analysis for the genotype distribution showed a significant difference between the 2 cohorts (P = .030), suggesting a positive association between the tested Arg16Gly polymorphism and endurance performance. Comparing carriers vs non-carriers for the 2 alleles, an excess of Gly allele carriers was seen in the SC group (P = .009), indicating an unfavorable effect of the Gly allele with respect to the performance status. In conclusion, we found suggestive evidence that the Arg16Gly polymorphism in the gene encoding for the β 2-adrenergic receptor may associate with endurance performance status in white men. [Copyright &y& Elsevier]

Objective: In overweight children, high leptin levels are independently associated with higher risk for cardiovascular disease, whereas adiponectin seems to be protective against type 2 diabetes and atherosclerosis. The study examines the predictive value of leptin for weight loss after a 4- to 6-wk inpatient therapy and again after 1 y; as well as the association among weight loss, leptin, and adiponectin levels and changes in cardiometabolic risk factors after therapy. Methods: Body mass index (BMI), blood pressure, Tanner stage, and cardiometabolic risk factors were studied in 402 children (59.2% females, 13.9 ± 2.3 y, BMI 33.8 ± 5.7 kg/m2) before and after a 4-to 6-wk inpatient intervention (exercise, diet, and behavioral therapy) and BMI 1 y later (n = 206). Results: BMI was reduced from 33.8 ± 5.7 to 30.5 ± 5.1 kg/m² (P < 0.001) during the lifestyle intervention and remained unchanged after 1 y. Baseline BMI was positively associated with leptin (r=0.60; P<0.001) and cardiometabolic risk factors (blood pressure, high-density lipoprotein [HDL] cholesterol, triglycerides). Baseline leptin was associated with BMI and triglycerides (r = 0.39; P < 0.001), baseline adiponectin with HDL-cholesterol (r = 0.40; P < 0.001). Baseline BMI explained 40.7% of the variance in weight loss during therapy. The combination of BMI, sex, and leptin explained 50.4% of the variance. Neither BMI nor leptin predicted weight changes over the long term. Conclusions: Overweight children maintained a substantial amount of weight loss after participation in a short-term inpatient lifestyle intervention. Baseline BMI was positively associated with weight reduction during the intervention, whereas baseline leptin had only a minor predictive value. [ABSTRACT FROM AUTHOR]

Endurance exercise training induces substantial adaptive cardiac modifications such as left ventricular hypertrophy (LVH). Simultaneously to the development of LVH, adipose tissue (AT) lipolysis becomes elevated upon endurance training to cope with enhanced energy demands. In this study, we investigated the impact of adipose tissue lipolysis on the development of exercise-induced cardiac hypertrophy. Mice deficient for adipose triglyceride lipase (Atgl) in AT (atATGL-KO) were challenged with chronic treadmill running. Exercise-induced AT lipolytic activity was significantly reduced in atATGL-KO mice accompanied by the absence of a plasma fatty acid (FA) increase. These processes were directly associated with a prominent attenuation of myocardial FA uptake in atATGL-KO and a significant reduction of the cardiac hypertrophic response to exercise. FA serum profiling revealed palmitoleic acid (C16:1n7) as a new molecular co-mediator of exercise-induced cardiac hypertrophy by inducing nonproliferative cardiomyocyte growth. In parallel, serum FA analysis and echocardiography were performed in 25 endurance athletes. In consonance, the serum C16: 1n7 palmitoleate level exhibited a significantly positive correlation with diastolic interventricular septum thickness in those athletes. No correlation existed between linoleic acid (18:2n6) and diastolic interventricular septum thickness. Collectively, our data provide the first evidence that adipose tissue lipolysis directly promotes the development of exercise-induced cardiac hypertrophy involving the lipokine C16:1n7 palmitoleate as a molecular co-mediator. The identification of a lipokine involved in physiological cardiac growth may help to develop future lipid-based therapies for pathological LVH or heart failure. [ABSTRACT FROM AUTHOR]

• Aerobic exercise (AE) is effective in the treatment of anxiety disorders. • Studies point to an "intensity-response" relationship of AE in these conditions. • This RCT investigated high intensity interval training (HIIT) in GAD. • HIIT was highly effective in reducing symptom severity and comorbid depression. • This type of training may supplement first-line treatment approaches in GAD. Aerobic exercise (AE) demonstrated an overall medium treatment effect in anxiety disorders (AD) but there is evidence for an "intensity-response" relationship. High intensity interval training (HIIT) was highly effective on a range of (mental) health parameters. However, so far no randomised-controlled trial (RCT) investigated the efficacy of HIIT in AD. 33 patients with generalized anxiety disorder (GAD) were randomly assigned to 12-day HIIT or a training of lower intensity (LIT). Anxiety, comorbid depression, stress-related bodily symptoms and perceived control over anxiety related stimuli (PC) were assessed at baseline, post-training and 30 days after baseline by using the Penn State Worry Questionnaire (PSWQ), the Hamilton Inventories for Anxiety and Depression (Ham-A, Ham-D), the Screening for Somatoform Symptoms-7 (SOMS-7) and the Anxiety Control Questionnaire (ACQ-R). Both interventions showed moderate or large effects on all clinical measures. However, effects for HIIT were generally about twice as high as for LIT. PC negatively correlated with GAD severity in the whole sample at baseline but an association of training-induced changes in PC and worrying were exclusively detectable in HIIT. HIIT was highly effective and fast acting in GAD. Therefore, it may complement first-line treatment approaches in this condition. [ABSTRACT FROM AUTHOR]