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AK Exergames - Innovative Trainingsansätze für Prävention, Rehabilitation und Sport!?, Einleitung: Exergaming - körperlich aktives Spielen - bietet ein großes Potenzial für die Rehabilitation nach Knieverletzungen im Sport, da es physische und kognitive Herausforderungen kombiniert. Bevor jedoch die Anwendung in der Sportrehabilitation als sicher und zuverlässig empfohlen werden kann, ist es erforderlich, die Biomechanik, die mit Knieverletzungen assoziiert ist - ein abduziertes, innenrotiertes Knie bei 10-30° Flexion - zu überprüfen (Koga et al., 2010). Das Ziel dieser Studie war es, den Knievalgus (KV) und die Knieinnenrotation (KIR) während 10-30° Knieflexion zwischen gesunden Personen ohne vorherige Knieverletzungen und Patient:innen in der Rehabilitation nach Knieverletzungen in zwei Übungen eines hochintensiven, immersiven Exergames (ExerCube) zu vergleichen. Methode: Die Kinematik von 18 gesunden Personen (25,2 ± 3,3 Jahre, 9 weiblich) und 6 Patient:innen (25,0 ± 5,9 Jahre, 2 weiblich) wurde mittels markerbasierter Bewegungsanalyse (Vicon) während eines 25-minütigen Exergame-Trainings erfasst. Der durchschnittliche maximale KV- und KIR-Winkel während 10-30° Knieflexion wurde für das rechte Bein mittels Welch's t-Test zwischen Gesunden und Patient:innen im Squat (65,4 ± 8,6 Wiederholungen) und im rechten Punch (78,5 ± 9,1 Wiederholungen) verglichen. Ergebnisse: Beim Squat zeigten sich signifikante Unterschiede mit geringer Effektgröße sowohl im KV (t(745) = -2,29, p < .001, d = -0,13) als auch in der KIR (t(1778) = 6,12, p < .001, d = 0,35). Ähnliche Ergebnisse zeigten sich beim Punch nach rechts. Es zeigten sich signifikante Unterschiede mit geringer Effektgröße im KV (t(777) = -6,02, p < .001, d = -0,32) und in der KIR (t(741) = 8,51, p < .001, d = 0,46). Deskriptive Ergebnisse zeigten bei beiden Übungen einen durchschnittlich höheren KV, aber eine verminderte KIR bei den Patient:innen. Diskussion: Während eines Exergame-Trainings zeigen Patient:innen einen erhöhten KV. Um die Belastung des Knies in frühen Rehabilitationsphasen zu reduzieren

References Koga, H., Nakamae, A., Shima, Y., Iwasa, J., Myklebust, G., Engebretsen, L., Bahr, R., & Krosshaug, T. (2010). Mechanisms for Noncontact Anterior Cruciate Ligament Injuries: Knee Joint Kinematics in 10 Injury Situations from Female Team Handball and Basketball. The American Journal of Sports Medicine, 38(11), 2218–2225. https://doi.org/10.1177/0363546510373570, Exergaming - physically active gaming - offers great potential for rehabilitation after knee injuries in sports, as it combines physical and cognitive challenges. However, before its use in sports rehabilitation can be recommended as safe and reliable, it is necessary to assess the biomechanics associated with knee injuries - an abducted, internally rotated knee at 10-30° of flexion (Koga et al., 2010). The aim of this study was to compare knee valgus (KV) during 10-30° knee flexion between healthy individuals without previous knee injuries and patients undergoing rehabilitation after knee injuries in three exercises of a high-intensive, immersive exergame (ExerCube). The kinematics of 18 healthy subjects (25.2 ± 3.3 years, 9 female) and 6 patients (25.0 ± 5.9 years, 2 female) were recorded using marker-based movement analysis (Vicon) during 25 minutes of exergame training (Sphery Racer, ExerCube). The average maximum KV angle during 10-30° knee flexion was compared between healthy subjects and patients in the squat, jump, and burpee for the right leg using a linear mixed model. The average maximal KV in the squat was 4.3° for healthy subjects and 4.8° for patients. In the jump, an average maximal KV of 5.9° (healthy subjects) and 6.8° (patients) was found. With an average of 6.9° in the maximal KV of healthy subjects and 8.6° in patients, the burpee showed the highest KV of all exercises. A significant main effect was found for exercise (F(2,45) = 57.03, p < .001), but not for the difference between groups (F(1, 22) = 0.45, p = 0.51). There are no significant differences in KV between healthy participants and patients undergoing rehabilitation after knee injuries. This indicates that the pre-injury movement pattern was restored in the patients, and it can be assumed that the studied exercises during exergaming are safe for use in this stage of rehabilitation.

Im Sport-, Fitness- und Rehabilitationssektor finden zunehmend neue Technologien Anwendung. Eine vielversprechende Entwicklung stellt hierbei das sogenannte Exergaming dar, welches körperliche Aktivität mit digitalen Spieltechnologien verbindet und so das Training verschiedener körperlicher und kognitiver Funktionen auf spielersche Weise ermöglicht. Darüber hinaus kann das Training mit Exergames durch den hohen Unterhaltungswert die Trainingsmotivation und -bereitschaft positiv beeinflussen. Aufgrund der Vielseitigkeit von Exergames finden diese Anwendung in unterschiedlichsten Bereichen, wie der Prävention von Bewegungsmangel oder der Rehabilitation von neurologischen Erkrankungen bis hin zum Athletiktraining und Sport. Auch werden verschiedenste Nutzer:innengruppen angesprochen. Bisher wurden spezifische Effekte von Exergaming jedoch nur selten nachgewiesen. Um die Effektivität und Attraktivität von Exergame-basiertem Training zu gewährleisten, bedarf es einer systematischen und interdisziplinären Herangehensweise bei der Konzeption, Entwicklung und Erforschung. In diesem Zusammenhang werden im Arbeitskreis Studien mit Exergames in verschiedenen Anwendungsbereichen vorgestellt, welche vielversprechende Ergebnisse liefern und potenzielle Anwendungsbeispiele aus der Praxis und der Exergame-Entwicklung aufzeigen. Im ersten Beitrag wird die Biomechanik der unteren Extremitäten während eines Exergames in Abhängigkeit von der durchgeführten Bewegung beschrieben. Es werden Risikofaktoren für Knieverletzungen identifiziert und Empfehlungen für Exergames in der Rehabilitation daraus abgeleitet. Im zweiten Beitrag wird das forschungsbasierte und interdisziplinäre Vorgehen bei der Entwicklung eines spezifischen Exergames für die Sportrehabilitation präsentiert. Die einzelnen Arbeitsschritte beinhalten die Erhebung der Bedürfnisse von Endnutzer:innen, eine biomechanische Analyse der Bewegungsmuster, die darauf basierende Entwicklung eines Bewegungskonzepts sowie die Überführu

AK Exergames – Innovative Trainingsansätze für Prävention, Rehabilitation und Sport!?, Einleitung: Nur 65% der Sportler:innen kehren auf das gleiche Leistungsniveau wie vor einer Knieverletzung zurück. Die Rehabilitationsphase ist langwierig und bereitet die Sportler:innen nur bedingt auf die Anforderungen im Sport vor. Durch einen nutzerzentrierten Ansatz bei der Entwicklung therapeutischer Interventionen werden die Bedürfnisse der Betroffenen sowie wissenschaftliche Evidenz berücksichtigt. Exergaming, körperlich aktives Spielen, bietet eine Möglichkeit für motivierendes und funktionales Training. Das Ziel dieses Projekts war es, ein spezifisches Exergame für die Rehabilitation nach Knieverletzungen zu entwickeln. Methode: Es wurde eine biomechanische Analyse des Spielens eines bestehenden Exergame-Szenarios im "ExerCube" (Martin-Niedecken et al., 2020) durchgeführt. Zusätzlich wurden in Fokusgruppen die Bedürfnisse der primären und sekundären Endnutzer:innen ermittelt. Basierend auf diesen Ergebnissen wurden in einem iterativen und interdisziplinären Designprozess ein spezifisches funktionelles Bewegungskonzept sowie ein neues Game-Szenario entwickelt und in ein neues Exergame für den ExerCube integriert. Ergebnisse: Die Fokusgruppen ergaben, dass die Patient:innen möglichst schnell zum Sport zurückkehren wollen, jedoch Bedenken hinsichtlich der vielen Reize während des Trainings haben. Physiotherapeut:innen wünschen sich ein Gerät, das zusätzliches eigenständiges Training mit neuen therapeutischen Reizen ermöglicht. Dementsprechend enthält das Bewegungskonzept für das neue Exergame Kraft- und Gleichgewichtsübungen sowie ein Mini-Game für Ausdauer-, Reaktions- und Geschicklichkeitstraining. Durch drei Schwierigkeitsstufen kann die Komplexität und Geschwindigkeit variiert werden, und biomechanische Risikofaktoren werden erst bei zunehmender Schwierigkeit eingeführt. Diskussion: Der interdisziplinäre und evidenzbasierte Ansatz ermöglichte eine systematische Erarbeitung der Anforderungen an ein Reha-Exergame und gewährleistete eine nutzerzentrierte Ums

Introduction: Incidence rates in anterior cruciate ligament (ACL) injuries, which are linked to multiple factors, are higher in females than males (Sutton & Bullock, 2013). However, the main contributors to the difference in risk are biomechanical factors such as increased knee valgus (KV), knee internal rotation (KIR), or decreased hip flexion (HF; Seyedahmadi et al., 2022). Returning back to sports after an injury requires extensive rehabilitation as well as training of dual-task situations in order to be physically and cognitively prepared. Exergaming represents a dual task including a cognitive and a motor component and may be used as training modality during rehabilitation. It is known that performing a dual-task leads to altered landing movement patterns in healthy athletes (Dai et al., 2018). Before an exergame for rehabilitation after ACL injury can be implemented and tailored to the specific needs of female and male athletes, the movement patterns of males and females need to be understood. Therefore, the aim of this study was to identify biomechanical differences between males and females when performing a high-intensive exergame. Methods: Using 3D-motion capture (Vicon) kinematics were measured in 18 healthy athletes (9 male, 9 female) during a 25-min exergame (Sphery Racer, ExerCube). The exergame included nine different exercises of which 8 were used for analysis. The exercises were separated into neutral (squat, jump, burpee) and side-specific exercises (low-touch, mid-touch, high-touch, punch, lunge). For analysis, the maximal KV, maximal KIR, and the minimal HF were extracted during 10-30° knee flexion. These maximal values were then compared between the sexes, the exercises, and both legs with a linear mixed model, for each the neutral and the side-specific exercises. Results: A main effect of sex was only found for side-specific exercises in KIR (F(1, 16) = 6.1, p = .02) with females exhibiting higher values. For KV and HF in side-specific exercise

Dataset including maximal sEMG activity of people after stroke and healthy participants on a stable seat and a mobile seat during lateral flexion initiated by the thorax or pelvis.

Reaching movements are often used to assess selective trunk control in people with neurological conditions. Also, it is known that reaching performance after stroke is increased through training on a mobile seat compared to conventional physical therapy. However, the effect of a mobile seat on joint kinematics has not yet been investigated. This study aimed to quantify differences in the range of motion of the hip and trunk during reaching exercises on a mobile and stable sitting surface. Fifteen healthy participants performed reaching beyond arm's length on a mobile and a stable seat in four different directions: ipsilateral, anterior, contralateral, and contralateral diagonal. Biomechanical data were collected, including kinematics of the hip and trunk, and surface electromyography of the trunk muscles. The mobile sitting surface led to a higher range of motion in the trunk and the hip in the frontal and sagittal plane, but not in the rotational plane. Differences between reaching directions were found in all joint directions, except that of trunk flexion. Hence, movement patterns of the hip and trunk differ during reaching on different sitting surfaces and in different directions. A larger range of motion in the frontal or sagittal plane while training on the mobile seat provides added neuromuscular stimuli to the trunk muscles (= a higher demand on trunk muscles), which could result in more efficient training and therefore, increased trunk control after stroke. However, this has to be investigated in a future study with people after stroke.

Mobile Anwendungen gewinnen auch in therapeutischen Berufen an Popularität. Ihre Qualität zu beurteilen, ist eine Herausforderung.

Introduction: Exergaming – physically active gaming – is cognitively and physically challenging, and, therefore, has great potential for sports rehabilitation, for example after knee injuries. Before it can be recommended for rehabilitation, the biomechanics during exergaming needs to be understood. The occurrence of high-risk movement patterns for knee injuries, an abducted, internally rotated knee at 10-30° of flexion, needs to be monitored [1,2]. This study aimed to compare the amount of knee valgus (KV) and knee internal rotation (KIR) at 10-30° of knee flexion during different exercises of an immersive, high-intensive exergame in healthy athletes. Materials and Methods: Kinematics during a 25-minute exergame training (ExerCube) [3] were measured using marker-based motion capture (Vicon) in 18 athletes (9 female, 9 male) without prior knee injuries. The mean maximal KV and KIR angle during 10°- 30° knee flexion were compared between 9 exercises [4] using a two-way within-subject linear mixed model with post-hoc t-test. Results: A significantly higher KV compared to the other exercises, was found during the punch to the ipsilateral side of the investigated knee (Mean 8.5° (Standard Deviation 0.04°)) and high-touch to the contralateral side (8.5° (0.1°)). In addition, the ipsilateral KIR of the punch (13.2° (0.9°)), the high-touch (11.7° (0.6°)), and mid-touch (10.9° (1.3°)) were significantly larger than in the other exercises. Conclusion: High-touches, mid-touches, and punches result in knee kinematics related to an increased risk of injury in healthy athletes. The inclusion of these movements during exergame-based rehabilitation should be carefully managed and performed in later stages of rehabilitation.

Knowledge about the orientation of a representative ankle joint axis is limited to studies of tarsal morphology and of quasistatic movements. The aim of our study was therefore to determine the development of the axis orientation during walking. Intracortical bone pins were used to monitor the kinematics of the talus and tibia of five healthy volunteers. The finite helical axis was determined for moving windows of 10% stance phase and its orientation reported if the rotation about the axis was more than 2°. A representative axis for ankle dorsi- and plantarflexion was also estimated based on tarsal morphology. As reported by literature, the morphology-based axis was inclined more medially upwards for dorsiflexion than for plantarflexion. However, when a mean of the finite helical axis orientations was calculated for each walking trial for dorsiflexion (stance phase 15-25%) and for plantarflexion (stance phase 85-95%), the inclination was less medially upwards in dorsiflexion than in plantarflexion in four out of five participants. Thus, it appears that the inclination of a representative ankle joint axis for dynamic loading situations cannot be estimated from either morphology or quasi-static experiments. Future studies assessing muscle activity, ligament behaviour and articulating surfaces may help to identify the determining factors for the orientation of a representative ankle joint axis.

PURPOSE Non-ambulatory people with severe motor impairments due to chronic neurological diagnoses are forced into a sedentary lifestyle. The purpose of this scoping review was to understand the type and amount of physical activity interventions performed in this population as well as their effect. METHODS PubMed, Cochran and CINAHL Complete were systematically searched for articles describing physical activity interventions in people with a chronic, stable central nervous system lesion. The outcome measures needed to include physiological or psychological variables, measures of general health or quality of life. RESULTS Of the initial 7554 articles, 34 were included after the title, abstract, and full-text screening. Only six studies were designed as randomized-controlled trials. Most interventions were supported by technologies, mainly functional electrical stimulation (cycling or rowing). The duration of the intervention ranged from four to 52 weeks. Endurance and strength training interventions (and a combination of both) were performed and over 70% of studies resulted in health improvements. CONCLUSIONS Non-ambulatory people with severe motor impairments may benefit from physical activity interventions. However, the number of studies and their comparability is very limited. This indicates the need for future research with standard measures to develop evidence-based, specific recommendations for physical activity in this population.Key messagesPhysical activity interventions can have health benefits in non-ambulatory people with severe motor impairments. Even simple, low-tech interventions allow for health-enhancing training.