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Purpose: This study analyzed the physiological response during Yo-Yo Intermittent Recovery Level 1 (YYIR1) test and re-test by in-field ergospirometry and time-series analyses of respiratory parame...

Circulatory microRNAs (c-miRNAs) are regulated in response to physical activity and may exert anti-atherosclerotic effects. Since the vascular endothelium is an abundant source of c-miRNAs, we aimed to identify novel vasculoprotective exercise-induced c-miRNAs by the combined analysis of published endothelial miRNA array data followed by in vivo and in vitro validation. We identified 8 different array-based publications reporting 185 endothelial shear stress-regulated miRNAs of which 13 were identified in ≥3 independent reports. Nine miRNAs had already been associated with physical activity. Of the remaining novel miRNAs, miR-98-3p and miR-125-5p were selected for further analysis due to reported vasculoprotective effects. Analysis in two different 4-week high-intensity interval training (HIIT) groups (group 1 [n=27]: 4x30 s, group 2 [n=25]: 8x15 s; all-out running) suggested significantly elevated miR-98 and miR-125a-5p levels in response to acute exercise at baseline and at follow-up. Endothelial in vitro shear stress experiments revealed increased miR-125a-5p and miR-98-3p levels in medium of human umbilical vein endothelial cells at 30 dyn/cm2 after 20 and 60 min, respectively. Our results suggest that miR-98-3p and miR-125a-5p can be rapidly secreted by endothelial cells, which might be the source of increased c-miR-98-3p and -125a-5p levels in response to HIIT. Both miRNAs attenuate endothelial inflammation and may mediate vasculoprotective effects of physical exercise including HIIT.

Background High-intensity interval training (HIIT) is an important training component to improve aerobic and anaerobic exercise capacity. Higher HIIT workloads in general may generate additional effects on the improvement of exercise capacity, while missing adherence to more strenuous training regimes may affect training success. This study investigated if higher training workload generated by progressive HIIT (proHIIT) is superior to HIIT when used in an uncontrolled setting. Methods Thirty-four moderately trained females and males performed a 4-week training intervention with three exercise sessions per week. Participants were randomized into two HIIT groups using the individual lactate threshold at baseline: Group 1 (N.=17), HIIT, four runs at maximal speed (all-out) with 30 s active recovery (total: 48 runs), Group 2 (N.=17), proHIIT, 4 runs at maximal speed (all-out) with 30-second active recovery with one extra repetition every week (up to seven runs, for a total of 66 runs). An incremental field test protocol with standard blood lactate (LA) diagnostic and heart rate monitoring was used to access changes in exercise capacity. Results Overall, power output (running speed) at LA threshold (baseline LA+1.5 mmol/L) increased by +3.6% (P=0.004, effect size [ES] 0.38) after 4 weeks of HIIT. However, no significant between-group differences pre- vs post-intervention were detected. Conclusions Our data suggest that proHIIT does not provide additional improvement of running speed at individual lactate threshold over HIIT in an uncontrolled setting.

High-intensity interval training (HIIT) has been proposed to exert vasculoprotective effects. This study aimed to evaluate whether HIIT affects the microvasculature, including the endothelial glycocalyx barrier, and to identify associated microRNAs (miRNAs). Fifty healthy participants (23.1 ± 3.0 yr) performed a 4-wk 4 × 30-s all-out running HIIT. Sidestream dark-field imaging was performed at baseline and follow-up to detect changes of the sublingual microvasculature including the endothelial glycocalyx. Exercise parameters were determined by continuous running field test and documentation of high-intensity runs. miRNAs potentially associated with glycocalyx thickness were selected by structured literature search and blood samples for miRNA, and lactate measurements were drawn at baseline and follow-up HIIT. At baseline, a correlation between maximal exercise performance capacity and glycocalyx thickness (determined by perfused boundary region) was detected ( P = 0.045, r = 0.303). Increased exercise performance at follow-up also correlated with glycocalyx thickness ( P = 0.031, r = 0.416), and increased high-intensity sprinting speed was associated with an increased number of perfused vessels ( P = 0.0129, r = 0.449). Literature search identified miR-143, -96-5p, and -24, which were upregulated by HIIT already at baseline and showed an association with peak blood lactate levels after sprints (all P < 0.05). Moreover, increased baseline miR-143 levels predicted increased glycocalyx thickness at follow-up (AUCmiR-143 = 0.92, 95% confidence interval, 0.81–1.0, P = 0.0008). Elevated resting miR-126 levels after the intervention were associated with cell-free versican mRNA levels. We conclude that HIIT induces changes in the endothelial glycocalyx of the microvasculature. Associated miRNAs such as miR-143 may represent a tool for monitoring early vasculoprotective adaptations to physical activity.NEW & NOTEWORTHY High-intensity interval training is known to improve health-related fitness in general and in lifestyle-induced chronic diseases. To visualize microvasculature structure and to detect exercise-induced changes, sublingual sidestream dark-field imaging microscopy was used, and circulating miRNAs were measured. This study shows that exercise-induced changes correlate with associated circulating miRNA, which might be useful for monitoring vasculoprotective effects. Furthermore, sidestream dark-field imaging may represent a sensitive tool for the early detection of exercise-induced systemic vascular changes.

The aim of this study was to assess the extent of exercise intolerance in Fabry disease (FD) patients and to report individual effects of physical exercise. Exercise capacity and strength of 14 patients (mean age 46 years, 6 females) were determined using cycle ergometry and isokinetic measurements. Patients performed a strength/circuit exercise training protocol for 12 months. The mean relative maximum performance of the group was low at baseline and increased by 12.1% (baseline: 1.9 [0.9−3.4] W·kg −1 vs . re-test: 2.1 [1.1–3.8] W·kg −1 ; p =0.035) during the study. Patients’ mean baseline maximum performance blood lactate of 5.4 [1.3–9.9] mmol·L −1 increased to a mean of 7.2 (2.4–10.2) mmol·L −1 ( p =0.038). Mean strength of the lower limbs (left/right extensors and flexors, total work of 5 sets) changed from 2269 (1017–2913) kg·m 2 ·s - 2 to 2325 (1359–3107) kg·m 2 ·s -2 (not significant). Patients reported increased well-being, daily activity and reduced fatigue during the study. Our results indicate that exercise intolerance in FD patients often results from physical inactivity. FD patients may perform exercise training to improve exercise capacity and muscle strength. Future studies will address the clinical benefits of exercise in FD.

Aim: MicroRNA-222 (miR-222) and miR-29c have been identified as important modulators of cardiac growth and may protect against pathological cardiac remodeling. miR-222 and -29c may thus serve as functional biomarkers for exercise-induced cardiac adaptations. This investigation compared the effect of two workload-matched high-intensity interval training (HIIT) protocols with different recovery periods on miR-222 and -29c levels.Methods: Sixty-three moderately trained females and males (22.0 ± 1.7 years) fulfilled the eligibility criteria and were randomized into two HIIT groups using sex and exercise capacity. During a controlled 4-week intervention (two sessions/week) a 4 × 30 HIIT group performed 4 × 30 s runs (all-out, 30 s active recovery) and a 8 × 15 HIIT group performed 8 × 15 s runs (all-out, 15 s active recovery). miR-222 and -29c as well as transforming growth factor-beta1 (TGF-beta1) mRNA levels were determined during high-intensity running as well as aerobic exercise using capillary blood from earlobes. Performance parameters were assessed using an incremental continuous running test (ICRT) protocol with blood lactate diagnostic and heart rate (HR) monitoring to determine HR recovery and power output at individual anaerobic threshold (IAT).Results: At baseline, acute exercise miR-222 and -29c levels were increased only in the 4 × 30 HIIT group (both p < 0.01, pre- vs. post-exercise). After the intervention, acute exercise miR-222 levels were still increased in the 4 × 30 HIIT group (p < 0.01, pre- vs. post-exercise) while in the 8 × 15 HIIT group again no acute effect was observed. However, both HIIT interventions resulted in elevated resting miR-222 and -29c levels (all p < 0.001, pre- vs. post-intervention). Neither of the two miRNAs were elevated at any ICRT speed level at baseline nor follow-up. While HR recovery was improved by >24% in both HIIT groups (both p ≤ 0.0002) speed at IAT was improved by 3.6% only in the 4 × 30 HIIT group (p < 0.0132). Correlation analysis suggested an association between both miRNAs and TGF-beta1 mRNA (all p ≤ 0.006, r ≥ 0.74) as well as change in speed at IAT and change in miR-222 levels (p = 0.024, r = 0.46).Conclusions: HIIT can induce increased circulating levels of cardiac growth-associated miR-222 and -29c. miR-222 and miR-29c could be useful markers to monitor HIIT response in general and to identify optimal work/rest combinations.

Over the last decade, proprioceptive function gained increasing attention in joint disorders such as instability of the shoulder. Common tests for evaluation of proprioception are limited by their complexity and high technical demands. Thus, they are hardly applicable during daily routine. Our hypothesis was that the simplified “laser-pointer assisted angle reproduction test” (LP-ART) presented here allows for clinically feasible assessment of proprioceptive shoulder function. Active angle reproduction capability as an aspect of sensorimotor function was evaluated with the new method in patients with shoulder instability (n = 24) and healthy controls (n = 24). 15 patients had traumatic, 9 non-traumatic anterior instability (6 bilateral), 17 were treated surgically, 13 non-operatively. Tests were performed in flexion and abduction in different angles (55°, 90°, 125°) in randomized order. Angle reproduction capability was worst below shoulder level (55°) in all groups. Best results were achieved at shoulder level (90°). Healthy controls showed overall better results than patients with instability. Patients after surgical stabilization had better results in 55° and 90° abduction compared to instability patients before surgery. The new LP-ART presented here is a technically simple, yet effective instrument for evaluation of the proprioceptive function of the shoulder. In contrast to former test setups it is feasible in daily routine. Compared to healthy controls, patients with unstable shoulder joints show significant proprioceptive disorders that can be quantified by the LP-ART.

Purpose The purpose of this study was to evaluate joint position sense (JPS) in patients with posttraumatic glenohumeral instability. Materials and methods In 28 patients with posttraumatic instability and in a matched control group of 30 subjects proprioception capability was evaluated. For documentation of proprioception an angle reproduction test (ART) was performed with which joint positions sense (JPS) was measured for abduction, flexion, and rotation in three angles each. Results In both groups there was a significant better JPS with visual control than without. In contrast to the control group the patients were not able to increase angle reproduction capability without visual control when comparing positions below shoulder level with positions at or above shoulder level. When comparing the patients to the controls there were differences in most of the ARTs with worse results in the patient group. These differences were significant in 150 degrees flexion with and without visual control, in 150 degrees abduction without and in 100 degrees abduction with visual control. For rotation there were trends for almost all joint positions, however, the differences were significant only in the -45 position. When comparing the noninjured contralateral shoulder of the patients with the control group, there still were differences. Again these were not in all joint positions significant, but significant worse JPS could be demonstrated in 150 degrees abduction without visual control, 50 degrees flexion without visual control, -45 degrees rotation without and 0 degrees rotation with visual control. Conclusions A proprioceptive deficit can be documented in patients with posttraumatic glenohumeral instability. This may be one reason for permanent instability. The contralateral joint also shows reduction in joint position sense. For consecutive treatment as well as for rehabilitation both shoulder joint should be addressed.

PURPOSE OF THE STUDY To compare the proprioceptive abilities of total knee arthroplasty patients and a control group. METHOD In a knee arthroplasty patient group of 28 and in 25 healthy volunteers the proprioceptive function was examined. To measure the proprioceptive function the motion analysis system with reflecting markers was chosen. In each patient 16 measurements from different starting points in different joint positions with and without visual controlling were performed. RESULTS The results demonstrated significant differences between the patients and volunteers independent of the starting point, the joint position and the visual controlling. Also the comparison with the 30 and 60 degree position showed significant differences. In the patient group were not shown significant values comparing the starting position, the visual controlling and the comparison with the healthy leg. CLINICAL RELEVANCE Knee arthroplasty conducts to loss of proprioception in the operated and healthy leg. Visual controlling can not solve these problems. The worst results were achieved in 60 degrees position. The starting position can not influence the results.

UNLABELLED In 30 healthy volunteers (12 female, 18 male; age: 22-36 years) we evaluated the proprioceptive function of the glenohumeral joint. The volunteers were asked to place the arm in different positions with and without visual control. The test was performed for the dominant as well as for the non dominant extremity. The following joint positions were measured: 50 degrees, 100 degrees, 150 degrees abduction, 50 degrees, 100 degrees, 150 degrees flexion, +45 degrees, 0 degree, -45 degrees rotation in 90 degrees of abduction. The documentation of the joint position was performed with a motion analysing system with passive reflecting markers. The results showed significant differences between the measurements with and without visual control. Without visual control we found the worst results for flexion and extension below shoulder level. We documented significant differences of the results with and without visual control for this range of motion. However, for external rotation above the shoulder level we could not demonstrate significant differences. In neutral rotation as well as internal rotation we found again significant differences. Therefore, proprioception seems to be worse below the shoulder level (50 degrees abduction, flexion). Better results in comparison with the entire group had two volunteers with general good coordinative capabilities. We could not demonstrate differences between the dominant and non dominant extremity nor between male and female. CLINICAL RELEVANCE Our results demonstrated low variance of the proprioceptive function of the glenohumeral joint in healthy volunteers. This may serve as a base for further evaluations in different patient populations.

Modern therapy options offer haemophiliacs more and more possibilities for an active participation in sports. The purpose of the present study was to investigate the attitude of these patients towards sports, their participation in school and leisure time sports activities, and differences between juveniles and adults. We investigated 44 children and adolescents (aged from 4 to 16 years) and 27 adults (aged from 18 to 72 years) with haemophilia by means of a questionnaire. 79.6% of the juvenile patients participated always or almost always in school sports, while this percentage was significantly (P < 0.05) lower in the former school time of the adults (37%). Sports play an important or very important role in leisure time activities for 75% of the adolescent and 55.5% of the adult haemophiliacs (P < 0.05). Bleeding complications occurred in 17.6% of all patients; there was no correlation with any particular type of sports. There were only slight differences between both groups, regarding their motivation to participate in sports activities. The main reasons involved social aspects and having fun. The results show that the modern therapy of haemophilia probably leads to a more positive attitude towards sports and to a wider spectrum of practised sports. This, however, may be associated with an increasing potential of health risks, which require a high level of sports medical care.

The aim of this study was to investigate the influence of reduced plantar sensation on gait patterns during walking in 20 healthy subjects (25.9±1.2 years, 61.6±11.5 kg, 178±9.5 cm) with no history of sensory disorders. Force plate measurements, electromyography (EMG) measurements and a three-dimensional movement analysis were performed simultaneously during barefoot walking before and after reduction of plantar sensation using an ice immersion technique. The results show that reduced plantar sensation leads to significant changes in gait patterns that are present at the ankle, knee and hip joint and indicate a more cautious ground contact and push-off with modified EMG and motion patterns.

The aim of the current study was to evaluate the isokinetic strength of the knee in patients with unicondylar prostheses, to compare these results with healthy control subjects of the same age, and to correlate these results with clinical scores.Seventeen patients were examined an average of 21.5 mos after surgery. Clinical examination was done using the Hospital for Special Surgery, Knee Society, and patellar scores and a visual analog scale for pain. Quality of life was assessed by the Short Form 36 Health Questionnaire. Isokinetic evaluation of knee extensor and flexor muscles was done using a Cybex 6000 dynamometer at angular velocities of 60 and 180 degrees/sec. Eleven healthy subjects of comparable age served as a control group.Clinical results differed significantly in all categories. Quality of life differed only in the items of physical functioning, role limitation because of physical problems, and bodily pain. Isokinetic strength in patients showed a loss of torque of approximately 30% in extension and flexion at 60 and 180 degrees/sec compared with the control group. The flexion and extension ratio and the angles of maximum torque did not differ between the groups.In comparison with healthy control subjects, persons with an implanted unilateral sledge prosthesis have strength deficits in extension and flexion. A deficit of the extensor muscles, as it has been described previously for patients with a total knee arthroplasty, could not be found.

Objective. The aim of the present investigation was to test the stability of 10 different ankle braces under passive and rapidly induced loading conditions in a population suffering from chronic ankle instability in order to provide objective information to choose or recommend an appropriate model for specific needs. In addition, the relationship between passive and rapidly induced testing of the stabilizing effect against inversion was evaluated to identify if passive support characteristics of braces are reflected under rapidly induced conditions. Design. An experimental in vivo study with a repeated-measures design was used. Background. Ankle braces are commonly used for treatment, rehabilitation, and prevention of ankle injuries. A variety of products exists but there is few information available to assist clinicians, physiotherapists and coaches as well as consumers in choosing a brace on a basis of objective information. Furthermore, there is a lack of studies that provide data for both passively and rapidly induced movement of the ankle joint when using different ankle braces. Methods. Twenty-four subjects with chronic ankle instability participated in the project. Passive ankle range of motion measurements were performed in a custom-built fixture and simulated inversion sprains were elicited on a tilting platform. Results. The tested braces restrict range of motion significantly compared to the no-brace condition for both the passively and rapidly induced inversion and marked differences between braces were revealed. A close relationship between passive and rapidly induced test results for inversion was found. Conclusions. Passive as well as rapidly induced stability tests provide a basis of objective information to describe the characteristics of different ankle braces. Combined results of passive and rapidly induced inversion as well as correlation between results demonstrate that passive support characteristics of braces are reflected under rapidly induced conditions but the amount of restriction is reduced. Therefore, caution should be taken when recommending braces for applications under dynamic circumstances only on the basis of passive support characteristics. Relevance A basis of information regarding the stability characteristics of different ankle braces under passive and rapidly induced conditions will help the clinician and consumer in choosing the most appropriate brace model for specific use. The results also provide more insights into factors that influence stability characteristics of ankle braces.

There is growing evidence that exhaustive exercise can induce a suppression of the innate immune functions. Most studies so far describe exercise induced changes in cell counts or functional responses while information regarding intracellular signal transduction parameters is lacking. Therefore in the present study we investigated in granulocytes the regulation of intracellular calcium ([Ca2+]i) which is an important intracellular second messenger. Healthy volunteers underwent a treadmill exercise test at 80% of their maximal oxygen uptake until exhaustion. Granulocytes were separated before and 1 hour after the test. [Ca2+]i was analyzed spectrophotometrically using the Ca2+ sensitive fluorescent dye Fura-2, while the oxidative burst and phagocytosis were measured by flow cytometry. While resting [Ca2+]i levels were unchanged, the Ca2+ transient induced N-formyl-methionyl-leucyl phenylalanine (fMLP) and platelet activating factor (PAF) were enhanced 1 hour after the test compared to pre-exercise values although fMLP receptor density did not change. In contrast, oxidative burst and phagocytosis evoked by fMLP and phorbol-myristate-acetate (PMA) were decreased after exercise. Together, our data support the view that exhaustive exercise affects regulation of Ca2+ signaling in granulocytes. The potentiation of Ca2+ signals is not accompanied by an enhancement of cellular functional parameters suggesting a blockade in intracellular signalling pathways.

31P saturation-transfer nuclear magnetic resonance spectroscopy was used to study skeletal muscle phosphocreatine (PCr) flux in healthy male volunteers. Data analysis included consideration of effects from incomplete saturation and radiofrequency spillover. Spectra were recorded from the resting gastrocnemius muscle before and after 6 days of creatine monohydrate (Cr-H2O) intake (20 g/day). Parallel to an improved muscle performance during maximal intermittent exercise following Cr-H2O supplementation, the concentration of PCr increased (P=0.01) by 23% (34.9+/-2.8 mmol/l vs. 28.6+/-2.7 mmol/l), whereas other metabolites were unaffected (inorganic phosphate: 4.3+/-1.4 mmol/l, free intracellular Mg(2+): 1.1+/-0.7 mmol/l, cytosolic pH: 7.04+/-0.02). Forward and reverse fluxes through the creatine kinase (CK) reaction did not change significantly from their baseline levels (v(for): 11.8+/-5.4 mmol/l per second vs. 15.3+/-6.8 mmol/l per second, (v(rev): 9.5+/-3.4 mmol/l per second vs. 10.9+/-3.7 mmol/l per second). The rate of PCr resynthesis in resting muscle is not limited by the CK reaction, which is near equilibrium. Consequently, the post-load increase in total creatine has no effect on the unidirectional CK reaction rates.

Nineteen patients were examined at an average follow-up of 2 years after total knee joint replacement without patella resurfacing. They were compared with 22 healthy subjects of the same age. Using the Hospital for Special Surgery (HSS) score the operated knee joints scored an average of 77 points, the contralateral side scored 87 points and the control group 97 points. In the SF-36 health questionnaire the patients showed highly significant deviations. Isokinetic measurements revealed a clear loss of isokinetic strength of more than 50% on average in flexion as in extension when compared to the control group and there were considerable asymmetries between the operated and the contralateral legs.

The goal of this study was to evaluate the differences in angle reproduction capability after nonconstrained posterior cruciate ligament retaining total knee arthroplasty after a follow-up time of 63.9 months compared with the healthy contralateral leg and a control group. In 28 total knee arthroplasty patients (mean age, 65.7 yr) and 25 control subjects (mean age, 55.7 yr), 16 measurements were made between 0 degrees and 90 degrees in 30 degree steps. The leg was positioned by the examiner and then relaxed; afterward, the subject was asked to reproduce the original position. Each measurement was made with the patient or control being blindfolded and not blindfolded to assess the influence of visual control. We found significant differences in total knee arthroplasty patients in contrast to healthy subjects. Without visual control, the mean deviation of the total knee arthroplasty group starting with a 0 degree angle was 7.7+/-5.9 degrees and 4.6+/-4.7 degrees for the healthy subjects. With visual control, the mean deviation in the patient group was 11+/-7.5 degrees, and in the control group, it was 7.2+/-5.0 degrees. Total knee arthroplasty patients did not show significant differences between the operated on and the contralateral knee. Also, in the total knee arthroplasty group, significant differences could not be found comparing reproduction with and without visual control and comparing both starting positions. In the control group, significant differences could be found comparing visual and nonvisual control in the 60 degree angle. The comparison between the 30 and 60 degree repositioning from both 0 and 90 degree starting positions showed a significant difference in the 60 degree angle. In summary, reduced proprioceptive capabilities are present after knee arthroplasty in both the operated on and the contralateral leg in our study group. Postoperative complaints can perhaps be explained by a loss of proprioceptive capabilities, especially at the 60 degree angle. The operative technique should involve special care of ligaments and muscles to preserve stability and receptors as well. Rehabilitation should pay more attention to the remaining receptors.

Sensomotory function after ACL-reconstruction was tested prior and after a proprioceptive rehabilitation program with the Kinesthetic Ability Trainer (KAT 2000) which documented the static balance index (SBI). A control group consisting of healthy subjects was also tested two times with a time interval of six weeks. The results showed an adaptation effect to the testing device in the control group with an 17.12% increase of the SBI. There were no differences between the dominant and non dominant extremity. The active sensomotory function in the healthy knee of the operated patients showed no difference to the control group. Proprioceptive capabilities of the acl-reconstructed knee joints was significant reduced 6.42 weeks after surgery. A special proprioceptive rehabilitation program for six weeks significantly reduced this deficit. In the patient group sensomotory function of both knee joints could be increased to a level higher than in the control group. In the operated extremity the static balance index increased 27.75% and in the non injured extremity the SBI increased 16.88%.

UNLABELLED We documented the effect on sports specific capabilities of long lasting wear of ankle braces in 14 handball players. For a period of 4 months half of the team performed all athletic activities with an ankle brace. The other players served as control performing the same athletic activities without wearing a brace. For documentation of the coordinative capabilities a special jump-test with a COMET-system was used. This test was performed after a standardised warm-up at the beginning and at the end of the 4 months observation period with and without an ankle brace. The results showed that wearing the used ankle brace for a period of 4 months did not lead to a negative effect on jumping capabilities. The brace group showed even an increased ability in the used test. This could be documented in short as well as long term effects. CONCLUSION Long wear of ankle braces do not lead to negative side-effects in sports specific capabilities that are represented by the performed jump-test.

UNLABELLED In 8 male subjects we undertook acceleration measurements under standardised conditions at the tibia, the hip and the head. The measurements were performed on a normal flat street as well as on a bicycle route with velocities of 15 km/h, 20 km/h and 25 km/h. Additionally we documented the range of motion at the knee joint. Maximal positive acceleration at the head sensor was 10.75 m/s2 at a velocity of 25 km/h on the bicycle route. At the hip the highest measured value was documented with 15.10 m/s2 at 25 km/h also on the bicycle route. Die maximal tibia acceleration was 55.8 m/s2 at 25 km/h again on the bicycle surface. The amplitude averaged signals showed the highest suppression between tibia and hip. CONCLUSION Compared to other athletic activities acceleration and joint load in in line-skating is only low.

Bei 15 mannlichen kniegesunden Probanden und 10 mannlichen Patienten mit insuffizientem Kreuzband wurden mit und ohne unterschiedlichen Kniebandagen koordinative Fahigkeiten bei einem 9-3-6-3-9-Lauf sowie bei einem Einbeinsprungtest uberpruft. Im Rahmen der Untersuchung wurden die Patelladyn-, die Kasseler Patellarsehnen-, die Super-Genuplus-, und die Genuhit-Kniebandage getestet. Zusatzlich wurde durch die Probanden eine subjektive Bandagen-Bewertung durchgefuhrt. Beim 9-3-6-9-Lauf ergaben sich in der Kontrollgruppe keine signifikanten Unterschiede. Ohne Bandage ergab sich beim Vergleich der verletzten Gruppe mit der Kontrollgruppe ein hochst signifikanter Unterschied. Alle Bandagen fuhrten bei den Patienten zu einer deutlichen Verbesserung, ohne jedoch das Niveau der unverletzten Extremitaten zu erreichen. Beim Einbein-Sprungtest ergaben sich in der Kontrollgruppe keine signifikanten Differenzen. Mit dem verletzten Bein wurden die Sprungzeiten nach Anlage einer Bandage signifikant besser. Bei der subjektiven Bandagenbewertung beurteilten beide Gruppen die Patelladyn-Bandage am besten. In 15 male healthy volunteers and 10 male patients with ACL-deficiency sports specific capabilities were evaluated with a 9-3-6-3-9-run and a single-leg jumping test. Each subject was tested with and without different knee bandages. We evaluated the Patelladyn-, the Kasseler-, the Super-Genuplus-, and the Genuhit-bandage. Additionally a subjective assessment of each bandage was performed by the volunteers. There were no significant difference performing the 9-3-6-3-9-run between all of the bandages in the control-group. Comparing the injured group with the control there were significant differences. All bandages led to improvement without reaching the running time, which was used by the controls. Performing the Single leg jumping test there were also no differences with the different bandages in the healthy control group. However, after applying a bandage in the injured subjects, the time improved significantly. In the subjective assessment the Patelladyn-bandage scored best.

An important detail referring to the whiplash syndrome is the relationship between the position of the head restraint and the head, because the head restraint protects the head in case of a rear-end accident. This relationship was evaluated in a representative study in 601 nonselected volunteers. A horizontal distance between the head and head restraint of maximal 9 cm was present in 69.6%. An optimal distance of 0 cm was only found in 7.4%. Just 50% of the adjustment distance was used by the car drivers. Even in completely distracted adjustments in 50% a deficit of more than 8 cm, and in 20.9% a deficit of even more than 12 cm was present. These results show that passive protection, on the one hand, is not guaranteed because of the lack of proper height adjustment. On the other, the volunteers did not use the best adjustment each time.

In 20 volunteers the relationship between rear-foot pronation and increasing physical exertion during treadmill ergometry was examined. In order to assess the influence of regularly performed running training a group of 10 endurance trained middle- and long-distance runners (age: 27.4 +/- 4.9 years; weight: 71.0 +/- 8.8 kg; height: 184.2 +/- 8.3 cm) was compared to another group of 10 untrained subjects (age: 24.7 +/- 2.1 years; weight: 73.3 +/- 9.8 kg; height: 179.1 +/- 8.3 cm). The examinations were carried out on a treadmill using a high-frequency motion analyzing system. Heart rate, blood lactate as well as rear-foot pronation were measured. Regarding heart rate and lactate concentration there were significant differences between trained and untrained volunteers. The pronation angle increased with higher speed up to a maximum of 6.54 +/- 4.22 degree for the trained group and 6.84 +/- 4.59 degree for the untrained group. With reference to maximal as well as submaximal stages the pronation angles showed no significant differences between both groups. Following the maximal exercise level the runners performed an additional 3 min run with a velocity reduced by 8 km/h compared to the maximal speed. At this level the total group as well as the untrained group showed significantly greater pronation angles compared to those of the corresponding velocity at the beginning of the test. The extent of the differences, however, was not significantly correlated with the lactate levels. Our results demonstrate that the increase of the pronation angle is a function of the running speed. But there is also an influence of fatigue, which depends neither on the running velocity nor on the lactate levels during exercise. Therefore, further investigations should emphasize the question which factors are responsible for this effect.

In 60 adolescent volunteers aged 8 to 16 years we assessed the proprioceptive capability of the shoulder complex by an angle reproduction test. The purpose of the study was to evaluate the proprioceptive capability of adolescent tennis players. 40 were tennis players, 20 non tennis players served as a control group. Documentation of the reproduced angle was performed by a motion analyzing system with passive markers. Angle reproduction of all volunteers was best in the midrange of motion (100 degrees flexion, 100 degrees abduction, neutral rotation in 90 degrees abduction). The worst results were documented below shoulder level (50 degrees flexion, 50 degrees abduction, internal rotation in 90 degrees abduction). A correlation to sex or dominant extremity could not be found. Subjects older than 12 years showed a tendency for better angle reproduction compared to the younger subjects. Tennis players older than 12 years demonstrated significant better capabilities for angle reproduction in some movements of the shoulder complex.

UNLABELLED In order to document sport specific skills, 23 athletes with functionally unstable ankle joints as well as 18 healthy volunteers were evaluated by performing a single leg jumping test. For external stabilization of the ankle an Aircast-Brace, a Ligafix-Air-Brace, a Malleoloc-Brace as well as a tape bandage were applied. There was no negative influence on the jumping performance of the tested stabilizing devices in the uninjured ankle joints. There was also no significant difference between the devices. For functional unstable ankle joints most of the devices showed significant improvement of jumping performance. The best results were achieved by the Aircast-Brace, followed by the Malleoloc-Brace, the Ligafix-Brace and the tape bandage. Again, there was no significant difference between these devices. While the reaction time showed no difference in all test situations, the time for stabilizing the ankle joint was significantly worse in those ankle joints without a brace. CLINICAL RELEVANCE For athletic activities, which are dominated by movement patterns comparable to the applied jumping test, the tested stabilizing devices seem to have no negative effect on sports specific capabilities.

We compared sport-specific skills in 23 athletes with functionally unstable ankle joints to those of 18 healthy volunteers by performing a Japan test as well as a specially designed single-leg jumping test. For external stabilization of the ankle, an Aircast brace, a Ligafix Air brace, a Malleoloc brace and a tape bandage were applied. For the Japan test in the group with uninjured ankle joints, the best results were obtained when wearing the Aircast brace, followed by tape bandage, Ligafix brace and no stabilizing device in descending order. The worst results were presented by the group with the Malleoloc brace. However, there were no significant differences among these devices. In the group with functionally unstable ankle joints, the best score was achieved with the tape bandage, followed by the Ligafix brace, Malleoloc brace and Aircast brace. The unstabilized group showed significantly worse results compared with all other groups. In the single-leg jumping test, the stabilizing devices had no negative influence on the jumping capability in the uninjured ankle joints. Additionally, there was no significant difference among the orthoses. Volunteers with unstable ankle joints experienced a significant improvement of jumping performance with most of the devices. The best results were achieved with the Aircast brace, followed by the Malleoloc brace, Ligafix brace and tape bandage. However, there was no significant difference among these orthoses. While the reaction time of the volunteers was the same for all test situations, the time for dynamically stabilizing the ankle joint appeared to be significantly worse in those ankle joints without a brace. For athletic activities, which are dominated by movement patterns comparable to the Japan test as well as the jumping test used, these stabilizing devices seem to have no negative effect on sport-specific capabilities.

In 27 healthy volunteers (9 females, 18 males) we evaluated the proprioceptive function of the glenohumeral joint. The volunteers were asked to place the arm in different positions with and without visual control. The test was performed for the dominant and for the nondominant extremity. The following joint positions were measured: 50 degrees, 100 degrees, 150 degrees abduction; 50 degrees, 100 degrees, 150 degrees flexion; +45 degrees, 0 degrees, -45 degrees rotation in 90 degrees abduction. Joint position was documented with a motion-analyzing system with passive reflecting markers. The results showed significant differences between the measurements with and without visual control. Proprioception was worse below the shoulder level (50 degrees abduction, flexion). Two volunteers with generally good coordinative capabilities showed better results than the rest of the group. We observed no differences between dominant and nondominant extremities nor between males and females. Our results demonstrated low variance of the proprioceptive function of the glenohumeral joint in healthy volunteers. Our findings serve as a base for further evaluations in different patients' populations.

Background Arthroscopic release of the capsule is a popular treatment option for chronic refractory frozen shoulder. Additional release of the intra-articular part of the subscapularis is controversial regarding possible impairment of subscapularis function. Hypothesis Arthroscopic release of the intra-articular part of the subscapularis produces good clinical results and does not lead to reduced internal rotation strength. Study Design Case series; Level of evidence, 4. Methods Twenty-two patients were retrospectively evaluated 53 months (range, 12–106) after undergoing arthroscopic anterior capsular release, including release of the intra-articular portion of the subscapularis. Clinical outcome was evaluated using the American Shoulder and Elbow Surgeons score and the Constant score. Isometric and isokinetic strength for internal and external rotation were determined at the time of follow-up in both shoulders using a Cybex dynamometer. Results The Constant score was improved significantly from 17.7 points to 82.8 points ( P < .0001) and the American Shoulder and Elbow Surgeons score increased significantly from 23.5 points to 76.8 points ( P < .0001). The mean range of motion was significantly improved for external rotation from 16° to 58°, from 66° to 142° for abduction, and from 76° to 155° for forward flexion. Isometric and isokinetic strength in the standard abduction position of the Cybex dynamometer showed no significant side-to-side difference. Conclusion Arthroscopic capsular release combined with a release of the intra-articular portion of the subscapularis tendon revealed good clinical results in the arthroscopic treatment of adhesive capsulitis without significant loss of internal rotation strength.

During the German championships in parachuting 78 paratroopers were asked about acute injuries and chronic pain using a questionnaire. A total amount of 131 injuries was described. These were evaluated in terms of dimension and localisation. Upper and lower parts of the body were injured with a comparable frequency. Bruises (42%), fractures (19%), sprainings (16%) and dislocations (10%) were most often described. The overall injury rate according to the total number of descents (0.09%) was lower than that reported by previous literature. Therefore it can be concluded that parachuting for experienced jumpers is less dangerous than assumed until today.

BackgroundProprioceptive capabilities play an important role in stability of the shoulder joint.HypothesisDecreased proprioceptive capabilities can improve by surgical repair of shoulder instability.Study DesignProspective long-term study.MethodsThe proprioceptive capabilities of 14 patients with recurrent anterior shoulder instability were examined preoperative and with a minimum follow-up of 5 years postoperative using the angle reproduction test. The patients' data were compared to a healthy control group.ResultsThe joint position sense improved significantly in abduction, flexion, and rotation (P< .05). The preoperative difference from the target joint position was 9.3 ° (SD, 4.6 °) for the summarized positions in abduction, 9.1 ° (SD, 4.5 °) in flexion, and 10.1 ° (SD, 5.1 °) in rotation. Postoperatively, it improved to 5.6 ° (SD, 2.9 °) in abduction, 5.6 ° (SD, 2.7 °) in flexion, and 5.0 ° (SD, 1.8 °) in rotation. The joint position sense of the uninvolved contralateral shoulder improved too.ConclusionsFive years after surgical repair for shoulder instability, the joint position sense improved significantly, to a level of normal, healthy shoulders.

Purpose To characterize in-shoe pressure measurements during different soccer-specific maneuvers on two playing surfaces to identify the main loading areas of the foot. Methods Twenty-one experienced male soccer players participated in the study (25.5 ± 1.8 years, 78.7 ± 5.4 kg, and 182.9 ± 5.7 cm). The Pedar Mobile system was used to collect plantar pressure information inside the soccer shoe. Four soccer-specific movements were performed (normal run, cutting maneuver, sprint, and goal shot) on both a grass and a red cinder surface. Results Results showed characteristic pressure distribution patterns with specific loading areas of the foot that correspond to the evaluated movements. In addition, loading patterns with higher pressure values than those observed during normal run were found. In cutting, the medial part of the foot; in sprinting, the first and second ray; and in kicking, the lateral part of the foot are predominantly loaded. No global effect of the two surfaces on pressure parameters was found. Conclusion The results of the present investigation suggest that the high load in soccer in combination with a high repetition may have an important influence in the development of overuse injuries.

With lateral ankle sprains being the most frequent sports-related injury, there is an evident demand for the preventive measures in active individuals with chronic ankle instability. Braces are commonly used for prevention and treatment of ankle injuries. Various investigations—mostly performed with healthy subjects—focused on this problem, yet they often compared only a few models or used only limited testing procedures. However, controversy exists whether braces affect sports performance. The purpose of the present study was to compare the effects of ten different ankle braces—one rigid, five semirigid, four soft models—in a comprehensive evaluation with multiple testing procedures in 34 subjects with self-reported chronic ankle instability. The multiple testing procedures evaluated objective performance-related parameters and subjective parameters related to comfort and stability. The subjects performed an agility course with maximal effort. The course included a vertical jump and a cutting maneuver, both on a force platform, a single leg hopping test on level and inclined plates, a combined straight and curve sprint and sidesteps. Three valid trials were measured and averaged for each brace and every subject. Subjective aspects were evaluated with a questionnaire about handling, perceived restrictions, support and comfort; it was completed after each brace was worn and tried. With regard to the objective parameters, no significant differences were found between the braces except for the rigid brace which showed decreased values for the vertical jump and longer times for the other tests compared to all other braces. The subjective evaluation of the braces revealed significant differences with respect to comfort and handling and therefore, permitted a distinction between semirigid and soft braces. Although significant differences between braces were found in subjective performance restriction, no significant differences were revealed in the objective evaluation. From that point of view, patients could choose a brace model according to their individual needs. A comfortable brace might have a positive influence on the athlete’s state of mind although other aspects like the brace’s stabilizing effect play an additional role and should also be taken into account for recommendation of braces.

The aim of the present study was to investigate the influence of reduced plantar sensation on pressure distribution patterns during gait of 40 healthy subjects (25.3+/-3.3 yr, 70.8+/-10.6 kg and 176.5+/-7.8 cm) with no history of sensory disorders. Plantar sensation in the subjects was reduced by using an ice immersion approach, and reduced sensitivity was tested with Semmes-Weinstein monofilaments. All subjects performed six trials of barefoot walking over a pressure distribution platform under normal as well as iced conditions. Plantar cutaneous sensation was significantly reduced after the cooling procedure (p

The aim of the present investigation was to test the stability of 10 different ankle braces under passive and rapidly induced loading conditions in a population suffering from chronic ankle instability in order to provide objective information to choose or recommend an appropriate model for specific needs. In addition, the relationship between passive and rapidly induced testing of the stabilizing effect against inversion was evaluated to identify if passive support characteristics of braces are reflected under rapidly induced conditions.An experimental in vivo study with a repeated-measures design was used.Ankle braces are commonly used for treatment, rehabilitation, and prevention of ankle injuries. A variety of products exists but there is few information available to assist clinicians, physiotherapists and coaches as well as consumers in choosing a brace on a basis of objective information. Furthermore, there is a lack of studies that provide data for both passively and rapidly induced movement of the ankle joint when using different ankle braces.Twenty-four subjects with chronic ankle instability participated in the project. Passive ankle range of motion measurements were performed in a custom-built fixture and simulated inversion sprains were elicited on a tilting platform.The tested braces restrict range of motion significantly compared to the no-brace condition for both the passively and rapidly induced inversion and marked differences between braces were revealed. A close relationship between passive and rapidly induced test results for inversion was found.Passive as well as rapidly induced stability tests provide a basis of objective information to describe the characteristics of different ankle braces. Combined results of passive and rapidly induced inversion as well as correlation between results demonstrate that passive support characteristics of braces are reflected under rapidly induced conditions but the amount of restriction is reduced. Therefore, caution should be taken when recommending braces for applications under dynamic circumstances only on the basis of passive support characteristics.A basis of information regarding the stability characteristics of different ankle braces under passive and rapidly induced conditions will help the clinician and consumer in choosing the most appropriate brace model for specific use. The results also provide more insights into factors that influence stability characteristics of ankle braces.

Die Anzahl der Inline-Skater ist in den letzten Jahren rasant gewachsen. Nach Einschatzungen des Weltverbandes der Sportartikelindustrie (WFSGI) ist Inline-Skating bis ins Jahr 2001 die weltweit am schnellsten wachsende Sportart. Weltweit belaufen sich die Schatzungen auf etwa 50 Millionen Inline-Skater (Ladig 1998). Fur Deutschland rechnet man mit etwa 10 Millionen. Der Deutsche Inline-Skate-Verband (DIV) geht davon aus, das zum Jahr 2000 ca. 20 Millionen Inline-Skater in Deutschland unterwegs sein werden (Pfeiffer 1998). Viele Menschen entdecken fur sich im Inline-Skating einen neuen Ausdauersport oder sehen hierin eine Erganzung ihrer bisherigen Konditionssportarten (Hottenrott 1998).

In a field study the injury pattern as well as the active and passive injury prophylaxis of 1036 inline skaters were evaluated. Of them, 60% had already been injured. Every 124 h an injury occurred during inline skating. While 61% of the injuries affected only soft tissue, 31% were joint distorsions, and 8% were fractures. Altogether 37% of the 626 injured skaters required medical treatment. The upper extremities are especially at risk: 78% of the fractures and 48% of the distorsions affected the fingers, wrist, forearm or elbow. It is obvious that the inline skaters' passive prophylaxis measures are still unsatisfactory. Only 17% of the questioned used complete protection, whereas 16% were wearing no protective gear at all. Of the rest, 49% were skating with wrist guards, 66% were using knee pads, and 31% elbow pads. A high percentage of injuries is due to the lack of basic knowledge and techniques. The survey revealed that only 24% can stop immediately. While 51% had only slight problems with braking, 16% admitted having great difficulties, and 7% were not able to brake at all. These numbers reveal that there are still large deficits regarding braking techniques and education on the risks of injury. Therefore, athletes who use this equipment for the first time should learn the basic techniques of skating, braking and falling with the help of a qualified instructor. Most of all those questioned wanted to have more information, and half would be interested in special educational programmes.

The ankle joints of 14 healthy volunteers and 16 patients with unstable ankle joints were tested for their functional and proprioceptive capabilities. All of them were active athletes. Three tests were used: the single-leg stance test, the single-leg jumping course test, and the angle-reproduction test. The influence of three stabilization devices-the lace-on brace (Mikros), the stirrup brace (Aircast), and taping-on the proprioceptivity of stable and unstable ankle joints was evaluated. The scores of the single-leg jumping course test without any stabilizing device ("standard" category) ranged between 8.06 and 13.68 (10.65 + 1.29). In the Mikros (9.95 + 0.99) and Aircast (9.99 + 1.14) brace categories, as well as the tape bandage (10.27 + 0.81) category, better scores were achieved. The differences between "standard vs Mikros" and "standard vs Aircast" revealed a significant reduction of the scores with the orthoses (P