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Zusammenfassung Hintergrund Physikalische Maßnahmen oder manualtherapeutische Techniken (MTTe) wie Mobilisationen, Manipulationen oder Weichteiltechniken führen zu einer Verbesserung des Metabolismus oder einer Senkung hypertoner Muskulatur und werden auch zur Balanceregulierung bei zentralnervösen Veränderungen des autonomen Nervensystems (ANS) eingesetzt. Bisher fehlen empirische Erkenntnisse über Wirkungsmechanismen und Reizorte von MTTe auf das ANS. Das Ziel dieses vorliegenden Scoping Reviews war es, einen Überblick zu geben über den Erkenntnisstand der Anwendung von MTTe auf diverse Niveaus der Wirbelsäule auf das ANS. Methode Als Grundlage für die Durchführung des Scoping Reviews dienten die Datenbanken CENTRAL, Osteopathic Research Web, PEDro und PubMed. Umfang und Inhalte der Literatur wurden dokumentiert. Die Ergebnisse der einbezogenen und herangezogenen Studien wurden in narrativer Weise zusammengefasst, wobei der Fokus auf den signifikantesten klinischen Aspekten lag. Ergebnisse Manipulationen, Mobilisationen, myofasziale Techniken und zervikale Traktionen wurden als MTTe definiert. In 27 von 35 Studien wurden gesunde Probanden therapeutisch behandelt. Zehn Studien analysierten unmittelbare Effekte an Patienten, während 2 Studien als Longitudinalstudie bei Bluthochdruckpatienten konzipiert waren. In einem Zeitraum von 4–8 Wochen betrug die Interventionshäufigkeit wöchentlich zwischen einer und 3 MTTe-Einheiten. Schlussfolgerung Die Studienergebnisse erweisen sich als heterogen. Aus diesem Grund lassen sich keine verbindlichen, eindeutigen und allgemeingültigen Aussagen ableiten, in welcher Form, Intensität sowie in welchem Umfang MTTe angewendet werden sollen, um gezielt positive Wirkungsmechanismen am ANS in Gang zu setzen. Für zukünftige Studien sind demzufolge Longitudinalstudien mit Follow-up empfehlenswert. Darüber hinaus sollten umfassende Effekte von MTTe bei Patientengruppen mit unterschiedlichen Ausprägungen untersucht werden.

Zusammenfassung Hintergrund Zu den Veränderungen in der Welt, die für Gesundheitsberufe von Bedeutung sind, gehören der tiefgreifende soziale und demografische Wandel, zunehmende Technologisierung, Digitalisierung, Umweltzerstörung sowie die Ökonomisierung des Gesundheitswesens. Diese komplexen, neuen Herausforderungen verlangen Anpassungen von Berufsrollen und Aufgaben aller Fachkräfte im Gesundheitssystem. Ziel Zeitgemäßer Fortschritt in der Physiotherapie ist nur auf Basis einer grundsätzlichen kritischen Analyse und Weiterentwicklung möglich. 2014 gründete sich das Critical Physiotherapy Network (CPN), das diese kritische Arbeit weltweit durch Forschung, Veröffentlichungen, Kurse und Konferenzbeiträge vorantreibt. Mit einer wachsenden Zahl von Mitgliedern aus dem deutschsprachigen Raum war es Zeit, eine deutschsprachige CPN-Sektion (DCPN) ins Leben zu rufen, um die Vernetzung und Zusammenarbeit zu erleichtern und die im deutschsprachigen Raum noch junge Kritische Physiotherapie zu fördern. Methode Beantwortung erster Fragen hinsichtlich Notwendigkeit, Ziele, Arbeitsweise, Handlungsfelder und Perspektiven der Kritischen Physiotherapie. Methodologisch eng mit der qualitativen Forschung verwandt, ermöglicht die Kritische Physiotherapie eine professionelle Weiterentwicklung, die sich an den Bedürfnissen von Individuum und Gesellschaft in ihrer ökologischen Eingebundenheit orientiert. Schlussfolgerung Durch das Hinterfragen von Selbstverständlichkeiten und Grundfesten der physiotherapeutischen Handlungspraxis und Wissenschaft eröffnet die Kritische Physiotherapie ein neues Selbstverständnis und neue Handlungsräume.

Ein Drittel der Personen über 65 Jahre stürzt einmal pro Jahr 13 und zwei Drittel der Gestürzten fallen innerhalb eines Jahres nochmals hin 10. Ältere Menschen erleiden dabei häufig eine distale Radiusfraktur. In der handtherapeutischen Behandlung dieser Patienten ist deshalb die Sturzprävention ein wichtiges Thema. Das Dual-Tasking bietet eine einfache und effektive Möglichkeit dafür.

Rogan, S, Haehni, M, Luijckx, E, Dealer, J, Reuteler, S, and Taeymans, J. Effects of hip abductor muscles exercises on pain and function in patients with patellofemoral pain: A systematic review and meta-analysis. J Strength Cond Res 33(11): 3174-3187, 2019-This systematic review and meta-analysis considered the effects of hip strengthening (i.e., abductor and external rotator muscles) vs. no hip strengthening on pain and of hip strengthening combined with knee strengthening vs. knee strengthening (i.e., quadriceps muscles) alone on pain and functional status in patients with patellofemoral pain (PFP). Eleven, randomized, controlled trial (RCT) studies and 1 non-RCT study were included, totaling 604 participants. Female athletes were included in one study, whereas untrained participants were included in the other studies. On average, the studies showed a low methodological quality. Hip muscle strengthening showed greater pain-reducing effects when compared with no hip strengthening (standardized mean difference [SMD] = -1.91; 95% confidence interval [CI], -2.92 to -0.9; p = 0.0002). When comparing a combined hip and knee muscle strengthening with knee muscle strengthening alone, pain was reduced in the combined hip and knee-strengthening group (SMD -0.99; 95% CI, -1.99 to 0.02; p = 0.05), whereas function showed a SMD of 0.70 (95% CI, 0.25-1.14; p = 0.002) again favoring the combined hip and knee-strengthening group. This meta-analysis showed evidence that the strengthening of the hip abductor muscles can reduce pain and function in patients with PFP. Because studies including highly trained patients with PFP are currently lacking, one should be careful when applying the clinical findings of this meta-analysis when working with athletes. Trial registration: PROSPERO 2014:CRD42014010716.

Background Well-established manual/musculoskeletal interventions on the ankle joint are used in addition to diagnosis-orientated mobilisation of the tarsal joints in everyday practice in patients with chronic unstable ankle joint. Diagnosis-oriented manual/ musculoskeletal intervention means to perform a mobilisation in the talocrural joint and the tarsal joints with existing restrictions. However, this approach is lacking in research settings. In this context only the talocrural joint is mobilised. The procedure of diagnosis-oriented mobilisation in the talocrural joint and the tarsal joints in which restrictions exist are not taken into account. Objective The primary aim of this pilot study is the presentation of the feasibility of the recruitment process, adherence and the safety of the investigation process and investigation. The secondary aim is the evaluation of nine mobilisations in the talocrural joint and mobilisations of the tarsal joints in which restrictions exists on postural control and muscle activation of the flexor muscles and thigh muscles in patients with chronic ankle instability (CAI) for four weeks. Method This cross-over-design will recruit, include and evaluate a minimum of 30 patients with CAI. Cross-over effects will be assessed using L-Statistic of Puri & Sen. To analyse treatment effects and periodic effects the non-parametric Wilcoxon Rank Sum test will be used. Conclusions It is assumed that selective mobilisation of the talocrural joint as well as of the tarsal joints with existing restrictions improve muscle activity and postural control of the affected leg in patient with chronic unstable ankle joint.

Zusammenfassung Hintergrund Zweikämpfe an der Bande oder Kontakt mit dem Puck, Eishockeyschläger oder Schlittschuhen können Verletzungen bei Eishockeyspielern verursachen. Für eine adäquate Prävention von Verletzungen und Planung des Verletzungsmanagements ist eine gute epidemiologische Datenlage notwendig. In der Schweiz fehlen bis dato solche epidemiologischen Daten im Amateur-Eishockey. Diese Arbeit hatte das Ziel, die Verletzungshäufigkeit, Verletzungslokalisationen, Verletzungsart, Schweregrad, Verletzungsmechanismen, Präventionsmaßnahmen sowie Zugang zu Erstversorgung nach einer Verletzung in Zweitliga-Amateur-Eishockeymannschaften des Kantons Bern aufzuzeigen. Probanden/Methodik Diese deskriptive Studie wurde mittels einer retrospektiven, selbstrapportierten Fragebogenerhebung am Ende der Saison 2017/18 durchgeführt. Erhoben wurden anthropometrische Merkmale, Angaben zum Trainings- und Wettkampfvolumen, zur Verletzungshäufigkeit, Verletzungslokalisationen, Verletzungsart, Schweregrad, Verletzungsmechanismen und Präventionsmaßnahmen sowie zur klinischen Versorgung im Fall einer Verletzung. Ergebnisse 86 von 96 Fragebögen konnten ausgewertet werden. Während der letzten 12 Monate verletzten sich 44 Spieler 1-mal und 5 Spieler 2-mal. Die Verletzungshäufigkeit betrug im Training 0,7 Verletzungen pro 1000 Stunden und im Wettkampf 4,7 pro 1000 Stunden. Die meist genannten Verletzungslokalisationen waren Knie (17,9 %), Fuß (14,3 %), Kopf (12,5 %) und Schulter (10,7 %). Verletzungen wurden vorwiegend durch externe Faktoren produziert. Distorsionen, Frakturen und Kontusionen waren die häufigsten Verletzungsarten. 19 Verletzungen hatten eine Auszeit von mehr als 4 Wochen zur Folge („schwer“). Schlussfolgerung Die Verletzungshäufigkeit war im Wettkampf 6,35-mal höher im Vergleich zum Training. Die Hälfte aller Verletzungen wurde in der unteren Extremität lokalisiert, davon 18 % am Knie. 19 Verletzungen wurden als „schwer“ eingestuft. Verletzungen wurden vorwiegend durch externe Faktoren produziert. Mögliche Präventionsmaßnahmen sind Fördern von Fairplay, das Anpassen von Spielregeln, Förderung zum Tragen von Schutzausrüstung, das Üben des peripheren Sehens und Krafttraining für die Rumpf- und Beinmuskulatur. Um die Vergleichbarkeit solcher Studien zu erhöhen, ist das Handhaben von standardisierten Definitionen bzgl. „Verletzung“ und „Verletzungsschweregrad“ notwendig.

Background: To date, in-depth knowledge about how to structure guided self-study for the enhancement of the competencies of examination and treatment techniques in physiotherapy undergraduate students in the field of geriatrics, internal medicine and orthopedics is still lacking. For undergraduate physiotherapy students at Bern University of Applied Sciences—Health of Department a module on internal medicine and geriatrics as well as a module on orthopedics are scheduled in the third semester of the educational program. Objective: This pilot study will evaluate the feasibility and effectiveness of a guide self-study on examination and treatment competencies of undergraduate physiotherapy students in their third semester. Method: This study protocol describes a randomized-group controlled pilot educational study that will assess the feasibility and effectiveness of guided self-study units on the learning success of undergraduate physiotherapy students. Fifty physiotherapy students will be allocated into a guided self-study group (SG) or control group (CG). During the third semester, SG will receive three tutor supervised guided self-study sessions of 90 min each. One week prior to the guided self-study session, the case and the learning goals will be provided to the students via the institutional electronic learning system. Students will prepare the cases in groups of five to six peers. The students will be guided by a tutor during this preparation time. The results of the group works will be presented and reflected during a moderated plenum session. The primary outcome will be the feasibility of implementing the guided self-study in the existing educational program including assessment of protocol adherence and evaluation of the quality of the proposed cases. The secondary outcomes will be the total score in the objective structured clinical examination (OSCE) exams and written exams that demonstrate the learning success of the undergraduate physiotherapy students. Conclusion: This pilot study evaluates the feasibility and preliminary effects of implementing guided self-study units on active learning in bachelor’s degree physiotherapy students.

Es besteht Evidenz, dass bei Menschen mit chronischen muskuloskelettalen Schmerzen das Trainieren uber der Schmerzgrenze analgesierender wirkt als das Uben im schmerzfreien Bereich. Um den Patienten ihre Angst vor den Bewegungsschmerzen zu nehmen, sollten Physiotherapeuten gezielt Aufklarungsarbeit leisten und „Sicherheitshinweise“ einsetzen. Fur die Praxis eignet sich ein Stufenmodell, das Ausdauer- und Krafttraining kombiniert.

Background Mechanical forces and joint misalignment are considered risk factors for the development of knee osteoarthritis (KOA). Early detection of KOA and distinction between lateral and medial compartment overloading (CO), might be important to inform appropriate preventative interventions. This study evaluated reliability and validity of a test battery consisting of ten clinical tests to predict knee CO. Methods Independent observers examined 30 participants with symptoms of KOA. Inter-rater reliability of the ten tests, as well as the anticipated CO based on the whole test battery, was determined. All participants received a SPECT-CT, which served as reference standard for CO. The agreement for CO between SPECT-CT and clinical examination was assessed to determine criterion validity. Results The Kappa coefficients ( k ) for the ten individual clinical tests ranged from 0.19 to 0.80. The k for determining CO was 0.52 (95% CI = 0.28–0.76). The agreement for CO between SPECT-CT and clinical examination (i.e. criterion validity) yielded a k of 0.26 (95% CI = −0.06 - 0.58). Logistic regression indicated that valgus alignment was strongly related with lateral CO. No other relationships were found between individual tests and CO. Conclusion Accurate measurement of frontal plane knee angle is important to determine CO. This particular test yielded good reliability, but low validity. Reliability of the nine remaining clinical tests was fair to moderate. Criterion validity of the clinical examination to predict CO was low. Therefore, this test battery in its current form cannot be used in practice to determine CO.

Part of the Special Issue Health Care from Patients' Perspective, Multiple sclerosis (MS) is a chronic, inflammatory autoimmune disease of the central nervous system mainly of adults ranging from 20 to 45 years of age. The risk of developing MS is 50% higher in women than in men. Most people with MS (PwMS) experience a spectrum of symptoms such as spasticity, continence dysfunctions, fatigue, or neurobehavioral manifestations. Due to the complexity of MS and the variety of patient-centered needs, a comprehensive approach of interprofessional collaboration (IPC) of multiple health care professionals (HCP) is necessary. The aim of this qualitative study was to explore the meaning of IPC in the comprehensive care of PwMS from a HCP perspective. Focus groups (FG) with HCP were conducted, recorded, and transcribed verbatim. The sample contained HCP from three MS clinics in different phases of care and rehabilitation. Four main categories emerged: (a) experience with IPC, (b) relevant aspects for IPC in patients' treatment, (c) differences in in- and outpatient settings, and (d) influence of patient perspective. IPC plays a crucial role in the HCP perspective when treating PwMS, which can benefit from an IPC therapeutic approach because HCP work together in a patient-centered way. The inpatient setting of HCP strongly supports the implementation of IPC. This prerequisite does not exist in outpatient settings.

Background The new coronavirus SARS-CoV-2 led to the COVID-19 pandemic starting in January 2020. The Swiss Federal Council prescribed a lockdown of nonessential businesses. Students and employees of higher education institutions had to install home offices and participate in online lectures. Objective The aim of this survey study was to evaluate lifestyle habits, such as physical activity (PA), sitting time, nutritional habits (expressed as median modified Mediterranean Diet Score [mMDS]), alcohol consumption habits, and sleeping behavior during a 2-month period of confinement and social distancing due to the COVID-19 pandemic. Survey participants were students and employees of a Swiss university of applied sciences. Methods All students and employees from Bern University of Applied Sciences, Department of Health Professions (ie, nursing, nutrition and dietetics, midwifery, and physiotherapy divisions) were invited to complete an anonymous online survey during the COVID-19 confinement period. Information on the lifestyle dimensions of PA, sitting time, nutritional and alcohol consumption habits, and sleep behavior was gathered using adaptations of validated questionnaires. Frequency analyses and nonparametric statistical methods were used for data analysis. Significance was set at 5% α level of error. Results Prevalence of non-health-enhancing PA was 37.1%, with participants of the division of physiotherapy showing the lowest prevalence. Prevalence of long sitting time (>8 hours/day) was 36.1%. The median mMDS was 9, where the maximal score was 15, with participants of the division of nutrition and dietetics being more adherent to a Mediterranean diet as compared to the other groups. Prevalence of nonadherence to the Swiss alcohol consumption recommendations was 8.3%. Prevalence of low sleeping quality was 44.7%, while the median sleeping duration was 8 hours, which is considered healthy for adult populations. Conclusions In the group analysis, differences in PA, sitting time, and mMDS were observed between different divisions of health professions as well as between Bachelor of Science students, Master of Science students, and employees. Therefore, public health messages regarding healthy lifestyle habits during home confinement should be more group specific. The results of this study may provide support for the implementation of group-specific health promotion interventions at universities in pandemic conditions. Trial Registration ClinicalTrials.gov NCT04502108; https://www.clinicaltrials.gov/ct2/show/NCT04502108

BACKGROUND The new coronavirus SARS-CoV-2 led to the COVID-19 pandemic starting in January 2020. The Swiss Federal Council prescribed a lockdown of nonessential businesses. Students and employees of higher education institutions had to install home offices and participate in online lectures. OBJECTIVE The aim of this survey study was to evaluate lifestyle habits, such as physical activity (PA), sitting time, nutritional habits (expressed as median modified Mediterranean Diet Score [mMDS]), alcohol consumption habits, and sleeping behavior during a 2-month period of confinement and social distancing due to the COVID-19 pandemic. Survey participants were students and employees of a Swiss university of applied sciences. METHODS All students and employees from Bern University of Applied Sciences, Department of Health Professions (ie, nursing, nutrition and dietetics, midwifery, and physiotherapy divisions) were invited to complete an anonymous online survey during the COVID-19 confinement period. Information on the lifestyle dimensions of PA, sitting time, nutritional and alcohol consumption habits, and sleep behavior was gathered using adaptations of validated questionnaires. Frequency analyses and nonparametric statistical methods were used for data analysis. Significance was set at 5% α level of error. RESULTS Prevalence of non-health-enhancing PA was 37.1%, with participants of the division of physiotherapy showing the lowest prevalence. Prevalence of long sitting time (>8 hours/day) was 36.1%. The median mMDS was 9, where the maximal score was 15, with participants of the division of nutrition and dietetics being more adherent to a Mediterranean diet as compared to the other groups. Prevalence of nonadherence to the Swiss alcohol consumption recommendations was 8.3%. Prevalence of low sleeping quality was 44.7%, while the median sleeping duration was 8 hours, which is considered healthy for adult populations. CONCLUSIONS In the group analysis, differences in PA, sitting time, and mMDS were observed between different divisions of health professions as well as between Bachelor of Science students, Master of Science students, and employees. Therefore, public health messages regarding healthy lifestyle habits during home confinement should be more group specific. The results of this study may provide support for the implementation of group-specific health promotion interventions at universities in pandemic conditions. CLINICALTRIAL ClinicalTrials.gov NCT04502108; https://www.clinicaltrials.gov/ct2/show/NCT04502108

Background SARS-CoV-2, a novel coronavirus strain, has resulted in the COVID-19 pandemic since early 2020. To contain the transmission of this virus, the Swiss Federal Council ordered a nationwide lockdown of all nonessential businesses. Accordingly, students and employees of institutions for higher education were informed to continue their academic programs through home-office settings and online lectures. Objective This longitudinal survey aims to evaluate various lifestyle habits such as physical activity, nutritional habits, and sleep behavior among students and employees of a Swiss University of Applied Sciences during a 2-month period of confinement and social distancing due to the COVID-19 pandemic and 1 year thereafter. Methods This paper describes a protocol for a retrospective and prospective observational cohort study. Students and employees of Bern University of Applied Sciences, Department of Health Professions, were invited to anonymously complete a web-based survey during the COVID-19 confinement period. This will be followed by a second survey, scheduled 1 year after the lockdown. Information on various lifestyle aspects, including physical activity, nutritional habits, and sleep behavior, will be collected using adaptations of existing validated questionnaires. Results This longitudinal study started during the government-ordered confinement period in Switzerland in mid-April 2020 and will end in mid-2021. Conclusions The findings of this survey will provide information about the impact of confinement during the COVID-19 crisis on the physical activity, nutritional habits, and sleep behavior of students and employees of a Swiss institute. Trial Registration ClinicalTrials.gov NCT04502108; https://www.clinicaltrials.gov/ct2/show/NCT04502108 International Registered Report Identifier (IRRID) DERR1-10.2196/25051

Background: Self-directed learning or self-determined learning can be used in guided self-study (GSS) as an educational method with the goal to promote changes in the knowledge and skills of undergraduate physiotherapy students in higher education. Until now, there has been a lack of empirical evidence for the usage of GSS in physiotherapy higher education. At the Division of Physiotherapy in the Department of Health Professions (Bern University of Applied Sciences (BFH), Switzerland) the module ‘basic examination’–in the form of an objective structured examination (OSCE) and written exam–is scheduled in the first semester of the educational program. Objective: The primary aim of this study is to examine the feasibility of establishing GSS in an undergraduate physiotherapy degree program at the BFH. Secondary aim is to assess the effectiveness of GSS on the examination skills of first-semester undergraduate physiotherapy students will. Method: This paper describes the protocol of a randomized group-controllededucational feasibility study. 51 physiotherapy students from the first semester will be allocated into a guided self-study group (GSSG) or control group. The GSS takes place during the first semester, and consists of an eight-day cycle, with a presentation on the last day. Duration of this presentation is 90 min with supervision from a university lecturer. One week in advance of the presentation, the case and the learning goals are provided to the students electronically. The students prepare the cases in groups of five to six. The students are guided by the tutor during this preparation time. During a moderated plenum session, students present the results of group work and reflect upon the preparation phase and learning steps. Feasibility outcomes include the fidelity of implementation through exposure dosage, students’ responsiveness, program differentiation, and the degree of acceptability. Success criteria of feasibility are (1) exposure dosage as the number of 90-minute presentations that are conducted, and the content of cases and competences, (2) students’ responsiveness, with the aim of 100% willingness to participate, and (3) program differentiation, which will illustrate the alignment between GSS case content and the curriculum. Acceptability of intervention from the students’ perspective will be evaluated by a semi-structured interview. Secondary outcomes will be the achieved grades in the OSCE exams and written exams that demonstrate learning success. Conclusion: This feasibility study assesses the fidelity of implementation, the degree of acceptability and the effectiveness of GSS sessions on examination skills in undergraduate physiotherapy students at the BFH. Furthermore, this study will demonstrate whether guided self-study is feasible and can be implemented with fidelity in the BFH physiotherapy higher education curriculum.

Zusammenfassung Hintergrund Schnelle Richtungswechsel, Beschleunigungen, Abbrems- und Täuschungsmanöver mit Drehbewegungen führen im Unihockey zu einer erhöhten Verletzungsanfälligkeit. Zum heutigen Zeitpunkt fehlen Daten und Fakten aus der Schweizer Unihockeyliga, die aufzeigen, welche Verletzungen auftreten. Diese Arbeit hatte die Zielsetzung herauszufinden, welche Verletzungen im Schweizer-Nationalliga-A-Unihockey auftreten. Probanden/Methodik Die vorliegende Arbeit wurde im retrospektiven, nicht experimentellen Design als Fragebogenerhebung durchgeführt. 5 Schweizer-Unihockey-Nationalliga-A-Mannschaften wurden zum Expositionszeitraum von 12 Monaten schriftlich befragt. Die Verletzungsrate beschreibt die Verletzungsanzahl pro 1000 Expositionsstunden. Zur Signifikanzeinschätzung der Resultate wurde der Wilcoxon-Rangsummentest angewendet. Bei allen Testungen wurde das Signifikanzniveau auf p Ergebnisse In einem Kalenderjahr erlitten N = 71 aller Spieler (N = 101) im Schnitt 1,14 Verletzungen (± 1,05). Die Verletzungsrate betrug im präsentierten Datensatz 2,01. Die Verletzungsrate ist im Wettkampf 2-mal höher als im Training (Rate-Ratio (RR) = 2,04). Von den beschriebenen Verletzungslokalisationen sind das Sprunggelenk, der Oberschenkel, das Knie und der Rücken betroffen. Es zeigten sich am häufigsten Verstauchungen, Muskelverletzungen und Entzündungen. Muskelverletzungen traten dabei fast ausschließlich am Oberschenkel auf. Verstauchungen ereigneten sich meistens am Sprunggelenk. Schlussfolgerung Die vorliegende Arbeit bestätigt die Hypothese, dass im Unihockey die Verletzungsanfälligkeit während des Wettkampfs im Vergleich zum Training deutlich höher liegt. Es kann angenommen werden, dass Spieler, bei denen die sportliche Aktivität deutliche Müdigkeit und emotionalen Stress auslöst, verletzungsanfälliger sind. Weiterführende Studien sollten verschiedene Präventionsmaßnahmen überprüfen und einen Vergleich zur geschlechterspezifischen Verletzungsanfälligkeit herstellen.

ZusammenfassungHintergrund Applikationen mit elastischem Tape werden positive Wirkungen auf die Bewegung zugeschrieben. Unter anderem werden Attribute wie stoffwechselanregend, entstauend, kräftigend und schmerzlindernd genannt. Das Ziel dieser Interventionsstudie mit einem Within-Subject-Design war die Untersuchung verschiedener elastischer Tapes (Kinesiotape – KT, IQ-Tape – IQ, ohne Tape: OT) auf die neuromuskuläre Aktivierung der Beuge- und Streckkette der unteren Extremität während des Joggens, des Treppensteigens und bei Drop Jumps. Probanden/Methodik Achtzehn gesunde Erwachsene (5 Männer und 13 Frauen) mit einem Durchschnittsalter von 26,3 ± 3,6 Jahren und einem Body-Mass-Index von 22,3 ± 0,7 kg/m2 wurden rekrutiert. Die Teilnehmer absolvierten Laufintervalle mit 10 km/h, 12 km/h und 15 km/h, Treppensteigen und Drop Jumps (10 Versuche). Die Muskelaktivierung des M. vastus medialis und M. vastus lateralis, des M. bizeps femoris, des M. semitendionosus, des M. tibialis anterior, M. gastrocnemius medialis und lateralis wurden erhoben, um das Verhältnis der Muskelaktivierung des M. tibialis anterior zu M. gastrocnemius medialis und lateralis (T/G-ratio) und des M. vastus medialis und lateralis zum M. bizeps femoris und M. semitendinosus (V/I-ratio) zum Zeitpunkt vor (–150 bis 0 ms pre), während (0–30 ms post) und von 30 ms bis 150 ms post der ersten Bodenkontaktaufnahme mit Hilfe elektromyografischer Messungen darzustellen. Die statistische Prüfung erfolgte mittels des nonparametrischen L-Puri-Sen-Verfahrens. Das Signifikanzniveau wurde auf p Ergebnisse Zwei Probanden schieden während der Datenaufnahme aus der Studie aus. Damit konnten von 16 Probanden Daten analysiert werden. Beim Treppenheruntersteigen zeigt IQT in der Voraktivierung (–150 bis 0 ms) vor dem ersten Bodenkontakt einen signifikant erhöhten T/G-ratio im Vergleich zu OT (p = 0,01). Die restlichen Vergleiche von Applikationen mit KT, IQT und OT ergaben keine signifikanten Unterschiede (p > 0,05). Schlussfolgerung Es kann davon ausgegangen werden, dass Kinesiotape – KT und IQ-Tape – IQ keine relevanten detektierbaren Änderungen der Muskelaktivierung bei gesunden Personen hervorrufen. Zukünftige Studien sollten Patienten einschließen, die eine pathologisch veränderte neuromuskuläre Kontrolle aufweisen.

Kinesiotape application is said to have positive effects, e. g. metabolism-stimulating, decongesting, invigorating and analgesic effects, during exercise. The aim of this intervention study with a within-subject design was to examine the effects of different elastic tapes (Kinesiotape - KT, IQ-Tape - IQ, without tape: OT) on the neuromuscular activation of the flexor and extensor chain of the lower extremity when jogging, climbing stairs and performing drop jumps. Eighteen healthy adults (5 males and 13 females) with mean age of 26.29 ± 3.57 years and a body mass index of 22.3 ± 0.7 kg/m Two participants withdrew from the study. The raw data of 16 participants was analysed. During climbing down stairs, IQT shows a significantly better T/G ratio in the pre-activation phase (-150 to 0 ms) compared with no tape (p = 0.01). The comparison of the remaining applications with KT, IQT and no tape revealed no significant differences (p 0.05) CONCLUSION: It can be assumed that Kinesiotape (KT) und IQ-Tape (IQ) do not cause any relevant detectable changes in muscle activation in healthy individuals. Future studies should include patients with pathologically altered neuromuscular control.Hintergrund Applikationen mit elastischem Tape werden positive Wirkungen auf die Bewegung zugeschrieben. Unter anderem werden Attribute wie stoffwechselanregend, entstauend, kräftigend und schmerzlindernd genannt. Das Ziel dieser Interventionsstudie mit einem Within-Subject-Design war die Untersuchung verschiedener elastischer Tapes (Kinesiotape – KT, IQ-Tape – IQ, ohne Tape: OT) auf die neuromuskuläre Aktivierung der Beuge- und Streckkette der unteren Extremität während des Joggens, des Treppensteigens und bei Drop Jumps. Achtzehn gesunde Erwachsene (5 Männer und 13 Frauen) mit einem Durchschnittsalter von 26,3 ± 3,6 Jahren und einem Body-Mass-Index von 22,3 ± 0,7 kg/m Zwei Probanden schieden während der Datenaufnahme aus der Studie aus. Damit konnten von 16 Probanden Daten analysiert werden. Beim Treppenheruntersteigen zeigt IQT in der Voraktivierung (–150 bis 0 ms) vor dem ersten Bodenkontakt einen signifikant erhöhten T/G-ratio im Vergleich zu OT (p = 0,01). Die restlichen Vergleiche von Applikationen mit KT, IQT und OT ergaben keine signifikanten Unterschiede (p 0,05). Es kann davon ausgegangen werden, dass Kinesiotape – KT und IQ-Tape – IQ keine relevanten detektierbaren Änderungen der Muskelaktivierung bei gesunden Personen hervorrufen. Zukünftige Studien sollten Patienten einschließen, die eine pathologisch veränderte neuromuskuläre Kontrolle aufweisen.

Bewegung im Alter tut gut. Da verwundert es nicht, dass die Zahl an Bewegungsprogrammen für Senioren steigt. Aus der Fülle das richtige Konzept auszuwählen, gelingt mithilfe des „Systemisch-Medizinischen Mobilitätstrainings bei Senioren“. Entwickler und Physiotherapeut Prof. Dr. Slavko Rogan zeigt, wie das geht.

Acute Effects on TH4 Thoracic Spine Mobilisation Techniques on the Sympathetic Nervous System - a Cross-Over Feasibility Study Abstract. Up to date, empiric evidence about effects of thoracic spine mobilisation (TH4) on the sympathetic nervous system is lacking. The primary goal of this feasibility study was to determine adherence rate, side effects and the protocol as well as the implementation of the study design. The secondary goal was to analyse and interpret acute effects on the sympathetic nervous system after thoracic mobilisation in anterior thrust and posterior thrust on six healthy participants on two following days. The feasibility of this study was adequate. The spine mobilisations did not produce any adverse effects. The anterior thrust spine mobilisations showed a tendency in reducing the heart rate activity.

The aim of this systematic review and meta-analysis was to offer an updated overview of the current studies on all types of whole-body vibration (WBV), to determine the effects of WBV on balance in Go-Go (active, independent), Slow-Go (some physical activity limitations) and No-Go (in need of care) elderly and to provide recommendations on available evidence on WBV for clinicians and researchers. An electronic literature search was conducted in PubMed, Cochrane Register of Controlled Trials, Physiotherapy Evidence Database (PEDro) and CINAHL (Ebsco Host) to identify studies on WBV therapy in Go-Goes, Slow-Goes and No-Goes. Outcomes were static, dynamic and functional balance. Thirty-tree studies were included in this systematic review. Pooling was possible for static balance and dynamic balance. Effect size (SMD) of WBV on static balance was 0.34 (95% CI 0.18, 0.49) in Go-Goes. Effect size (SMD) of WBV on dynamic balance was -0.15 (95% CI -0.44, 0.15) in Slow-Go and -0.90 (95% CI -1.63, -0.17) in No-Go elderly people respectively. The results of this current meta-analysis suggest that WBV can be used for improving static balance in Go-Go elderly and that it has the potential to positively influence dynamic balance in Slow-Go and No-Go elderly.

Hintergrund: Manualtherapeutische Behandlungen werden oftmals auf der Hohe der thorakalen Wirbelsaule durchgefuhrt. Die segmentale Reaktion des sympathischen Nervensystems nach einer BWS-Mobilisation ist bislang unklar. Ziel: Ziele dieser Pilotstudie sind (1) die Darstellung der Durchfuhrbarkeit sowie (2) die Untersuchung der akuten Effekte einer thorakalen manuellen Mobilisationstechnik auf das SNS in Bauchlage mit in anteriorer bzw. im Sitz mit in posteriorer Schubrichtung mobilisiertem Brustwirbel. Methode: Fur diese Cross-Over-Pilotstudie sollen mindestens 10 gesunde Erwachsene rekrutiert und eingeschlossen werden. Cross-Over-Effekte werden mittels non-parametrischer L-Puri-Sen-Statistik berechnet. Um Unterschiede innerhalb bzw. der Gruppen untereinander zu ermitteln, werden der Friedman-Test bzw. der Mann-Whitney-U-Test angewendet. Schlussfolgerung: Aufgrund der Wechselwirkung des Spinalnervs und des SNS kann durch manualtherapeutische Techniken im Bereich der BWS eine Veranderung von Herzratenvariabilitat, Blutdruck, Puls sowie Hautdurchblutung und Hautrotung im entsprechenden Segment angenommen werden.

Background. The RehaWatch (R) system is a portable accelerometer for measurement of gait parameters that shows good validity in young adults; however, validity data are missing for elderly persons in long-term care (LTC).Aim. The aim was to evaluate the concurrent validity of the RehaWatch (R) system using the GAITRite (R) system as a criterion reference for gait assessment in the LTC elderly.Material and methods. In this study 23 elderly participants (mean age 90.9 +/- 8.4 years) performed 4 walking trials at normal and fast walking speed during single task and dual task walking. Data for both systems were collected simultaneously for each trial. Concurrent validity was assessed through limits of agreement (LoA) methodology using Bland-Altman plots.Results. No systematic bias could be determined. Mean biases for step duration, velocity and cadence were above the prespecified +/- 7 % value from zero lines for normal walking during single task and dual task walking. The LoA had a wide range between -21 % and 25 %. Only cadence showed small LoA for normal walking speed during single (-8.4 % to 7.7 %) and dual tasking (-4.1 % to 3 %). Heterogeneous bias was determined for step duration during fast walking during dual task and for velocity during fast walking during single task and dual task. Heteroscedasticity was shown for step length during normal walking under the dual task condition and fast walking during single task and dual task activities.Conclusion. No gait parameters are interchangeably usable between the two systems for normal walking during single task and dual task activities.

Purpose: This study aims to determine the validity of a mentoring programme questionnaire that should to be used for future evaluations in bachelor degree courses at the Bern University of Applied Sciences. Material and methods: One hundred and twenty-nine students were finally included in this study. Explorative factor analysis and confirmatory factor analysis was conducted and model fit was discussed. Results: The model fit shows a good RMSEA value of.064 and a good CFI value of.946. A non-significant chi-square value could be determined (χ 2 = 45.76, df =30, N = 129, p =.063). Conclusion: The current study determines a feasible model fit and suggests applying the mentoring programme questionnaire in bachelor degree courses at the Bern University of Applied Sciences Health with relatively good construct validity.

The aim of this article is to present functional exercises recommended for patellofemoral knee problems based on current clinical guidelines. These exercises can easily be performed by patients at home. The correct execution and quality of movement must be supervised so that the training can be implemented in a goal-oriented manner and ultimately lead to adequate muscular fatigue. Individual guidance and occasional monitoring by a physical therapist are helpful. The main focus is on training the gluteal and quadriceps muscles, as well as the corresponding muscular chains of the lower extremity and the trunk, which together provide the conditions for a stable leg axis. As a result, pain can be reduced and muscle function improved in people with patellofemoral knee problems.

Ein häufiges Beschwerdebild am Bewegungsapparat stellt der anteriore Knieschmerz (AKS) dar. Die Vielzahl beitragender Faktoren, die zum Beschwerdebild führen, erschweren im Alltag das Verständnis für ein gezieltes physiotherapeutisches Behandlungsmanagement. In Bezug auf eine symptomkomplexorientierte physiotherapeutische Versorgung kommt die Frage auf, welche Therapiemethoden bei welchem Beschwerdebild zur Anwendung kommen sollen. Um Therapiemassnahmen ableiten zu können, sind Kenntnisse des Krankheitsbildes und der gewählten Behandlungsmethode essenziell. Die vorliegende Arbeit möchte mit Hilfe eines heuristischen Modells ein Beschwerdebild- und Patienten-adaptiertes Behandlungskonzept vorstellen. Schlüsselwörter: anteriorer Knieschmerz, patellofemorales Schmerzsyndrom, Physiotherapie, Überbelastung, Krafttraining, Malalignment, A common complaint in the musculoskeletal system is the anterior knee pain (AKP) or the so called patellofemoral pain syndrome (PFPS). The large number of contributing factors that lead to the symptoms make a proper diagnosis and targeted physiotherapeutic treatment management difficult. With regard to symptom-complex-oriented physiotherapeutic care, the question arises as to which therapy methods should be used for individuals with AKP. In order to be able to identify adequate physical therapy methods, an understanding of the clinical condition and the chosen treatment method is essential. This article aims to present a heuristic model of objectives and situational physiotherapeutic treatment methods. Keywords: anterior knee pain, patellofemoral pain syndrome, physical therapy, Overuse, strength exercise, malalignment

Background Several studies have shown that the risk of burnout is high for people working in health professions. Many physiotherapists have either suffered from burn out personally or have seen colleagues suffer from it. In Switzerland, there is a lack of evidence concerning the risk factors and symptoms for burnout among physiotherapist. The aim of this study was to empirically identify risk factors and symptoms of burnout in physiotherapists working in the canton of Bern. Method Based on interview guidelines, three semi-structured interviews with physiotherapists who experienced burn out themselves were conducted. The questions were divided into two main categories: risk factors and symptoms. For analysis, the interviews were transcribed and assigned to individual categories. Results High personal expectations and the pressure that comes with working on patients with chronic complaints were the most common answers from the participants. In this study these factors can be considered as important risk factors. In particular, emotional exhaustion and depression seem to be relevant burnout symptoms which lead to a decrease in personal performance. Conclusion In this study physiotherapists with burn out working in an acute care hospital tend to suffer from symptoms of emotional exhaustion and depersonalization. For physiotherapists, sensitization to symptoms and risk factors of burnout is essential in daily work as well as in education. The results of this study might be of interest for physiotherapist or physiotherapists students to prevent and sensitive them for burnout symptoms.

Background: Preventing falls and fractures from falls in residents of aged care facilities are an eminent public health goal. Evidence on the effectiveness of non-pharmaceutical methods to prevent falls and fall-related fractures in residential aged care facilities (RACFs) is unclear. This review aims to assess and rank the effectiveness of the most common fall- and fracture prevention strategies of non-pharmaceutical nature in RACFs. Method: This systematic review with network-meta-analysis follows the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P). We will conduct the systematic literature search across the medical databases MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials (CENTRAL). We will conduct pairwise meta-analyses with a random effects model. When appropriate, we will construct a network graph and conduct network meta-analyses within a Bayesian framework for all outcomes and interventions. Bayesian network meta-analysis (random effects models) will be used to compare the relative effectiveness of the different interventions under investigation. Conclusion: Our review should provide a broader picture of the evidence of benefits and harms of exercise and other non-pharmaceutical interventions in fall- and fracture prevention in residents of residential aged care facilities (RACFs). Findings will benefit public and individual health by contributing in the beneficence of multidisciplinary care of institutionalized seniors through optimization of fall- and fracture prevention programs. Registration: Protocol registration: PROSPERO 2018 CRD42018116446; Registration on 28 November 2018.

Purpose: Physical and mental functions allow classifying older adults as “Go-Go” (independent functioning); “Slow-Go” (in need of care with a slight handicap); and “No-Go” (in need of care with severe functional limitation). The latter group exhibits reduced exercise tolerance. More recently technology-based motor-cognitive types of training services emerged as a possible training service. This study examined the use of technology including stochastic resonance whole-body vibration and Exergame-dance training for motor-cognitive training in care home dwelling adults. Methods: Seventeen older adults (10 women, 7 men, age range: 79–98) were randomly assigned to the intervention (IG, n = 9) or the sham group (SG, n = 8). IG performed five sets of 1-min whole-body vibration with 1-min rest in between, three times a week for the first 4 weeks of the training period with varying frequency. From weeks five to eight the Exergame-dance training was conducted after the vibration sessions. SG performed a stochastic resonance whole-body vibration training with the same terms applied, however, with a fixed frequency of 1 Hz, Noise 1. From weeks five to eight a passive trampoline-programme of 5 min was applied following the vibration sessions. Primary outcome was the Short Physical Performance Battery (SPPB). Secondary outcomes were the Trail Making Test A and B (TMT A & B) and the Falls Efficacy Scale–International (FES-I). Outcomes were measured at baseline, after 4 and 8 weeks of intervention and at follow-up (4 weeks after the intervention). The non-parametric Puri and Sen rank-order test was applied, followed by an ANOVA for repeated measures to analyse main and interaction effects. Mann–Whitney U-Test was used to determine differences between the groups. Results: The post-hoc analysis showed significant effects on the SPPB total score with large effect sizes from baseline to 8 weeks (+72%, p = 0.005, η2 = 0.423). The TMT part B displayed significant improvements with large effect sizes from baseline to 8 weeks (+17.5%, p = 0.002, η2 = 0.779) and to follow-up (+21%, p = 0.001, η2 = 0.827). Conclusion: The technology based 8-week training programme consisting of a combination of stochastic resonance whole-body vibration and Exergame-dance training showed beneficial effects on both physical and cognitive performance in older care home dwelling adults.

High speed, fights at the hard boarder or contact with the puck, hockey sticks or skates may cause injuries in ice hockey players. Precise knowledge of epidemiologic data is needed for adequate prevention of hockey injuries and to plan their management. In Switzerland, to date, such epidemiological data are not available for amateur ice hockey. The aim of this study was to evaluate injury frequency, injury location, type of injury, injury severity and injury mechanisms, prevention measures and access to care in case of injury in second division amateur ice hockey teams of the Canton of Bern. This descriptive study was conducted using a retrospective, self-reported questionnaire at the end of the 2017/18 season. Anthropometric characteristics, training and competition volume, injury frequency, injury location, type of injury, injury severity, injury mechanisms and preventive measures as well as access to clinical care in case of injury were assessed. Eighty-six out of 96 questionnaires could be evaluated. During the previous 12 months, 44 players were injured once and five players were injured twice. The injury frequency during training was 0.7 injuries per 1000 hours; during competition it was 4.7 per 1000 hours. The four most often reported injury locations were knee (17.9 %), foot (14.3 %), head (12.5 %) and shoulder (10.7 %). Injuries were mainly produced by external factors. Distortions, fractures and contusions were the most common types of injuries. Nineteen injuries resulted in a break of more than four weeks ("severe injury"). The injury frequency was 6.35 times higher during competition as compared with training. Half of all injuries were located in the lower limb. Nineteen injuries were classified as "severe". Injuries were mainly produced by external factors. Possible prevention measures include promoting fair play, adapting the rules of the game, promoting the use of protective equipment, practising peripheral vision, and strengthening the trunk and leg muscles. To increase the comparability of such studies, the use of standardised definitions concerning "injury" and "injury severity" is necessary. Zweikämpfe an der Bande oder Kontakt mit dem Puck, Eishockeyschläger oder Schlittschuhen können Verletzungen bei Eishockeyspielern verursachen. Für eine adäquate Prävention von Verletzungen und Planung des Verletzungsmanagements ist eine gute epidemiologische Datenlage notwendig. In der Schweiz fehlen bis dato solche epidemiologischen Daten im Amateur-Eishockey. Diese Arbeit hatte das Ziel, die Verletzungshäufigkeit, Verletzungslokalisationen, Verletzungsart, Schweregrad, Verletzungsmechanismen, Präventionsmaßnahmen sowie Zugang zu Erstversorgung nach einer Verletzung in Zweitliga-Amateur-Eishockeymannschaften des Kantons Bern aufzuzeigen. Diese deskriptive Studie wurde mittels einer retrospektiven, selbstrapportierten Fragebogenerhebung am Ende der Saison 2017/18 durchgeführt. Erhoben wurden anthropometrische Merkmale, Angaben zum Trainings- und Wettkampfvolumen, zur Verletzungshäufigkeit, Verletzungslokalisationen, Verletzungsart, Schweregrad, Verletzungsmechanismen und Präventionsmaßnahmen sowie zur klinischen Versorgung im Fall einer Verletzung. 86 von 96 Fragebögen konnten ausgewertet werden. Während der letzten 12 Monate verletzten sich 44 Spieler 1-mal und 5 Spieler 2-mal. Die Verletzungshäufigkeit betrug im Training 0,7 Verletzungen pro 1000 Stunden und im Wettkampf 4,7 pro 1000 Stunden. Die meist genannten Verletzungslokalisationen waren Knie (17,9 %), Fuß (14,3 %), Kopf (12,5 %) und Schulter (10,7 %). Verletzungen wurden vorwiegend durch externe Faktoren produziert. Distorsionen, Frakturen und Kontusionen waren die häufigsten Verletzungsarten. 19 Verletzungen hatten eine Auszeit von mehr als 4 Wochen zur Folge („schwer“). Die Verletzungshäufigkeit war im Wettkampf 6,35-mal höher im Vergleich zum Training. Die Hälfte aller Verletzungen wurde in der unteren Extremität lokalisiert, davon 18 % am Knie. 19 Verletzungen wurden als „schwer“ eingestuft. Verletzungen wurden vorwiegend durch externe Faktoren produziert. Mögliche Präventionsmaßnahmen sind Fördern von Fairplay, das Anpassen von Spielregeln, Förderung zum Tragen von Schutzausrüstung, das Üben des peripheren Sehens und Krafttraining für die Rumpf- und Beinmuskulatur. Um die Vergleichbarkeit solcher Studien zu erhöhen, ist das Handhaben von standardisierten Definitionen bzgl. „Verletzung“ und „Verletzungsschweregrad“ notwendig.

Introduction Previous studies have analyzed the effects of manual therapy techniques (MTT) in patients with chronic ankle instability (CAI). Clinicians treat patients according the finding-oriented MTT approach. This approach is seldom pursued in research. The purpose of this study was to evaluate the feasibility and efficacy of finding-oriented MTT applications in patients with CAI. Method In this randomized controlled, blinded assessor crossover feasibility trial, participants were randomized to receive nine finding-oriented MTT treatments or no treatment during a three-week period, followed by a six-day washout period after which participants were crossed-over. Criteria under evaluation were adherence and attrition rates, safety (adverse events (AEs)) and acceptability and preliminary effects of finding-oriented MTT on muscular activity (measured by surface Electromyography (sEMG)) and on dynamic balance (measured by time to stabilization (TTS) and the modified Star Excursion Balance Test (modified STBT)). Results Seven women and two men (mean age: 26 ± 6.1 years) with CAI enrolled in this feasibility study. Success criteria showed a high adherence (90%) and low attrition rate (10%). All data could be used for analysis. AEs such as tingling in the foot during a short time frame were reported after four finding-oriented MTT interventions. Preliminary effect sizes showed divergence and few statistically significant results for sEMG. Conclusion The participants were adherent to the finding-oriented MTT intervention. The acceptability of data recording and data analysis was good. In addition, the study protocol should be adapted by adding a 10-min warm up period, a participant familiarization to TTS and modified STBT, and test repetitions.

Objective: This pilot study examined the feasibility outcome recruitment, safety and compliance of the investigation for stochastic resonance whole-body vibration (SR-WBV) training. Another aim was to evaluate the effect size of one SR-WBV intervention session on Short Physical Performance Battery (SPPB), Expanded Timed Get Up-and-Go (ETGUG), isometric maximal voluntary contraction (IMVC) and rate of force development (IRFD) and chair rising (CR). Design: Randomised double-blinded controlled cross-over pilot study. Method: Feasibility outcomes included recruitment, safety and compliance. For secondary outcomes, SPPB, ETGUG, IMVC, IRFD and CR were measured before and 2-min after intervention. Nonparametric Rank-Order Tests of Puri and Sen L Statistics to Ranked Data were proposed. Wilcoxon signed-ranked tests were used to analyse the differences after SR-WBV intervention and sham intervention. Treatment effects between the interventions were compared by a Mann-Whitney U test. Results: Among 24 eligible frail elderly, 12 agreed to participate and 3 drop out. The adherence was 15 of 24 intervention sessions. For secondary outcome, effect sizes (ES) for SR-WBV intervention on SPPB, ETGUG and CR were determined. Conclusion: This pilot study indicate that the training protocol used in this form for frail elderly individuals is feasible but with modification due to the fact that not all defined feasibility outcomes target was met. SR-WBV with 6Hz, noise level 4 shows benefit improvements on SPPB (ES 0.52), ETGUG (part sit-to-stand movement: ES 0.81; total time: ES 0.85) and CR (ES 0.66). Further research is desired to determine whether a new adapted training protocol is necessary for SR-WBV in the "skilling up” phase in frail elderly individuals.

Hintergrund: Physiotherapeutische Interventionen werden haufig auf Hohe der thorakalen Wirbelsaule angewendet. Die segmentale Wirkung auf das sympathische Nervensystem nach einer Reizung der Haut und Muskulatur ist bislang unklar. Ziel: Das Ziel war die Evaluation (1) der Machbarkeit und (2) der Effekte der segmentalen Perfusion und Erythembildung nach Massage, Mobilisation, Manipulation und Placebotherapie auf Hohe der thorakalen Wirbelsaule, um daraus Studiendesigns zu kreieren und erste mogliche Hypothesen uber Veranderungen der segmentalen Perfusion und Erythembildung aufzustellen. Methode: In dieser Einzelfallstudie erhielt ein beschwerdefreier Proband an 4 Tagen jeweils 4 unterschiedliche physiotherapeutische Behandlungsmasnahmen. Im Gebiet zwischen Th3 und Th6 wurden Massage, Mobilisation, Manipulation und zusatzlich eine Placebointervention appliziert und vor, wahrend und sowie nach der Intervention die Perfusion sowie die Erythembildung im zugehorigen Dermatom wahrend 55 Minuten im Intervall von 5 Minuten gemessen. Ergebnisse: Manipulation und Mobilisation fuhrten akut zu einer Steigerung der Sympathikotonus, wahrend Massage und Placebointervention aufgrund einer Veranderung der Perfusionsmikrozirkulation eine Senkung hervorriefen. Schlussfolgerung: Das Studiendesign muss fur zukunftige Studien hinsichtlich Verblindung der Therapeuten und Messzeitpunkte angepasst werden. Von einer Hypothesenbildung soll abgesehen werden, da das Messinstrument fur die Erythembildung keine aussagekraftigen Werte lieferte.