Institut für Sport und Sportwissenschaft

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Ehemals Institut für Sport und seine Didaktik

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Skaten & Klugschei$en - Wissenschaftliche Perspektiven auf das Skateboarding
(2024-03) Büscher, Benjamin; Karpinski, Sebastian; Stemski, Cara Christina; Thorwarth, Anna
Cycling in primary progressive multiple sclerosis (CYPRO): study protocol for a randomized controlled superiority trial evaluating the effects of high-intensity interval training in persons with primary progressive multiple sclerosis
(2023-04-22) Kupjetz, Marie; Joisten, Niklas; Rademacher, Annette; Gonzenbach, Roman; Bansi, Jens; Zimmer, Philipp
Background: Primary progressive multiple sclerosis (PPMS) is the least prevalent multiple sclerosis (MS) phenotype. For persons with PPMS (pwPPMS), pharmacological treatment options are limited. As a complementary non-pharmacological treatment, endurance training improves the health-related quality of life (HRQoL), numerous MS symptoms, and MS-related performance impediments. High-intensity interval training (HIIT) has been shown to induce superior effects compared to moderate-intensity continuous training (MCT). As current evidence is based on MS samples with mixed phenotypes, generalizability to pwPPMS remains unclear. Methods: CYPRO is a parallel-group, single-center, and single-blind randomized controlled superiority trial evaluating the effects of HIIT compared to MCT in pwPPMS. Sixty-one pwPPMS are randomized (1:1) to perform volume-matched HIIT or MCT sessions on bicycle ergometers two to three times per week in addition to standard rehabilitative care during their three-week inpatient stay at Valens rehabilitation clinic, Switzerland. Standard rehabilitative care comprises endurance and strength training, physiotherapy, and occupational therapy. HIIT sessions include six 90-second intervals at 95% peak heart rate (HRpeak), interspersed by 90-second active breaks with unloaded pedaling, aimed to reach 60%HRpeak. MCT represents the standard treatment at Valens rehabilitation clinic and is performed as continuous cycling at 60%HRpeak for the duration of 26 minutes. The primary outcome is cardiorespiratory fitness, assessed as peak oxygen consumption (V̇O2peak) during cardiopulmonary exercise testing (CPET). Secondary outcomes include peak power output during CPET, walking capacity, cognitive performance, HRQoL, fatigue, anxiety and depressive symptoms, and blood-derived biomarkers (e.g., serum neurofilament light chain, glial fibrillary acidic protein, kynurenine pathway metabolites) related to MS pathophysiology. All outcomes are assessed at baseline and discharge after three weeks. Venous blood sampling is additionally performed immediately and two hours after the first HIIT or MCT session. Discussion: CYPRO will expand current knowledge on symptom management and rehabilitation in MS to the subpopulation of pwPPMS, and will contribute to the exploration of potential disease-modifying effects of endurance training in MS. The superiority design of CYPRO will allow deriving explicit recommendations on endurance training design in pwPPMS that can be readily translated into clinical practice. Trial registration: CYPRO has been prospectively registered at ClinicalTrials.gov on 8 February 2022 (NCT05229861).
Heterogenität der Effekte von Ausdauertraining zur Steigerung der kardiorespiratorischen Fitness bei Personen mit Multipler Sklerose
(2023) Schlagheck, Marit Lea; Zimmer, Philipp; Heesen, Christoph
Körperliches Training gewinnt als nicht-medikamentöse Therapiemaßnahme bei Multipler Sklerose (MS) zunehmend an Bedeutung. Die aktuelle Studienlage zeigt jedoch uneinheitliche Effekte von Ausdauertraining hinsichtlich verschiedener physiologischer, biologischer und patientenzentrierter Endpunkte. Die vorliegende Dissertation untersucht potenzielle Einflussfaktoren auf die Heterogenität der Ergebnisse: (i) die Qualität der Interventionsinhalte und deren Dokumentation, (ii) die Aussagekraft der Ergebnismessung, und (iii) Faktoren der individuellen Trainingsresponse. Die Ergebnisse zeigen, dass fundamentale Trainingsprinzipien in bisherigen Interventionsstudien unzureichend berücksichtigt wurden. Fehlende signifikante Ergebnisse können auf Unzulänglichkeiten in der Trainingsgestaltung zurückzuführen sein, was zu einer Unterschätzung der Effekte von körperlichem Training führt. Nur knapp 50% der untersuchten Studien berichten adäquat über Trainingsinhalte und nur 3% über die Trainingsadhärenz, was die Interpretation und die Reproduzierbarkeit einschränken. Publikation 2 zeigt, dass über 40% der Personen mit MS in stationärer Rehabilitation die allgemeinen Kriterien einer maximalen kardiorespiratorischen Belastung während eines Ausbelastungstests nicht erfüllen. Dies schränkt die Beurteilung des Fitnesszustandes, der Effektivität von Trainingsprogrammen und die Trainingssteuerung ein. Schließlich bestätigen die Ergebnisse der Interventionsstudie in Publikation 3 signifikante Verbesserungen der kardiorespiratorischen Fitness auf Gruppenebene sowohl nach hochintensivem Intervalltraining (HIIT) als auch nach moderat-intensivem kontinuierlichem Training. Auf individueller Ebene profitierten jüngere, weniger fitte Personen, die HIIT durchführten, am meisten von der dreiwöchigen Trainingsintervention. Zusammenfassend zeigen die Ergebnisse der Arbeit, dass die heterogenen Studienergebnisse zu den Effekten von Ausdauertraining bei MS durch Mängel in der Interventionsgestaltung, eine unzureichende Aussagekraft der Ergebnismessung und interindividuelle Unterschiede in der Trainingsresponse beeinflusst werden. Um die Evidenz für körperliches Training mit der Evidenz für medikamentöse Behandlungen vergleichbar zu machen, ist es unerlässlich, dass die Gestaltung und Dokumentation den entsprechenden Standards gleichkommen. Zukünftige Studien sollten optimierte Möglichkeiten zur Beurteilung der kardiorespiratorischen Fitness und zur Trainingssteuerung bei Personen mit MS untersuchen. Darüber hinaus ist es wichtig, Faktoren der individuellen Trainingsresponse zu berücksichtigen, um personalisierte Trainingsansätze zu entwickeln, die den Bedürfnissen der Betroffenen gerecht werden. Die Berücksichtigung dieser Aspekte kann das Verständnis und die Anwendung von Ausdauertraining als therapeutische Maßnahme bei MS verbessern.
Electromyography of scapular stabilizers in people without scapular dyskinesis during push-ups
(2023-12-05) Arghadeh, Ramin; Alizadeh, Mohammad Hossein; Minoonejad, Hooman; Sheikhhoseini, Rahman; Asgari, Mojtaba; Jaitner, Thomas
Background: Push-up (PU) is widely considered an effective exercise to stabilize the scapular, especially if performed on unstable surfaces. However, available studies cover a wide range of exercise variations and differ according to exercise prescription, muscle selection and study design. Therefore, findings are contradictory, and conclusions for a proper application of the PU are difficult to draw. Objective: To synthesize the available literature on the changes in the activity of the periscapular muscles in individuals without scapular dyskinesis while performing different types of PU on unstable surfaces. Search procedure: Four online databases were searched from the earliest publications to 9 August 2023, using predefined keywords. Out of the 2,850 potential references identified in the primary search, 92 studies were reviewed in detail, of which 38 met the inclusion criteria and were included. Methodological quality was evaluated using a standardized form based on the Newcastle‒Ottawa scale for observational studies. Data combination was performed using CMA (v3), and the random-effects model was used to calculate the standardized mean difference (SMD) with a 95% confidence interval (CI). Results: The use of unstable surfaces in people without scapular dyskinesis led to increased activity of the upper trapezius during the PU (p = 0.017; I2 = 84.95%; SMD = 0.425 [95% CI 0.077, 0.773]) and knee PU (p = 0.023; I2 = 70.23%; SMD = 0.474 [95% CI 0.066, 0.882]) exercises and increased activity of the middle trapezius (MT) (p = 0.003; I2 = 64.50%; SMD = 0.672 [95% CI 0.225, 1.119]) and serratus anterior (SA) (p = 0.039; I2 = 4.25%; SMD = 0.216 [95% CI 0.011, 0.420]) muscles during the push-up plus (PUP) exercise. Conclusion: Using an unstable support base during PU does not necessarily increase the activity of all scapular stabilizers. The amount of muscle activity depends on the type of PU other than the type of support base. If an unstable surface is used, PUP exercise appears to be the most effective modality to increase the quality of training, improve performance, and prevent the occurrence of scapular dyskinesis due to the increase in the activity of the MT and SA muscles.
Positive influence of neuromuscular training on knee injury risk factors during cutting and landing tasks in elite youth female handball players
(2022-10-07) Schmidt, Marcus; Nolte, Kevin; Terschluse, Benedikt; Willwacher, Steffen; Jaitner, Thomas
Anterior cruciate ligament (ACL) ruptures are frequent in the age group of 15–19 years, particularly for female athletes. Although injury-prevention programs effectively reduce severe knee injuries, little is known about the underlying mechanisms and changes of biomechanical risk factors. Thus, this study analyzes the effects of a neuromuscular injury-prevention program on biomechanical parameters associated with ACL injuries in elite youth female handball players. In a nonrandomized, controlled intervention study, 19 players allocated to control (n = 12) and intervention (n = 7) group were investigated for single- and double-leg landings as well as unanticipated side-cutting maneuvers before and after a 12-week study period. The lower-extremity motion of the athletes was captured using a three-dimensional motion capture system consisting of 12 infrared cameras. A lower-body marker set of 40 markers together with a rigid body model, including a forefoot, rearfoot, shank, thigh, and pelvis segment in combination with two force plates was used to determine knee joint angles, resultant external joint moments, and vertical ground reaction forces. The two groups did not differ significantly during pretesting. Only the intervention group showed significant improvements in the initial knee abduction angle during single leg landing (p = 0.038: d = 0.518), knee flexion moment during double-leg landings (p = 0.011; d = −1.086), knee abduction moment during single (p = 0.036; d = 0.585) and double-leg landing (p = 0.006; d = 0.944) and side-cutting (p = 0.015;d = 0.561) as well as vertical ground reaction force during double-leg landing (p = 0.004; d = 1.482). Control group demonstrated no significant changes in kinematics and kinetics. However, at postintervention both groups were not significantly different in any of the biomechanical outcomes except for the normalized knee flexion moment of the dominant leg during single-leg landing. This study provides first indications that the implementation of a training intervention with specific neuromuscular exercises has positive impacts on biomechanical risk factors associated with ACL injury risk and, therefore, may help prevent severe knee injuries in elite youth female handball players.
Verletzungsprävention im Nachwuchsleistungsfußball
(2023) Kolodziej, Mathias; Jaitner, Thomas; Groll, Andreas
Die Erforschung von Risikofaktoren für Verletzungen wird sowohl aus theoretischer als auch aus praktischer Perspektive aus zwei Gründen befürwortet: um zu verstehen, warum es zu Ver- letzungen kommt und um vorherzusagen, wer ein Risiko trägt, eine Verletzung zu erleiden. Insbesondere im Nachwuchsleistungsfußball spielt diese präventive Handlungsstrategie eine bedeutsame Rolle, da diese Population durch die Kombination aus einem unreifen muskuloske- lettalen System und dem Belastungsprofil im Fußball besonders anfällig für kontaktlose Verlet- zungen der unteren Extremitäten ist. Jedoch wurden in der bisherigen Forschung zur Verlet- zungsprävention im Nachwuchsleistungsfußball überwiegend Messverfahren verwendet, die im Vergleich zu Goldstandardverfahren keine zufriedenstellenden Testgütekriterien aufweisen und deren Zusammenhang zu Verletzungen bisweilen widersprüchlich oder unbekannt ist. Die Zielstellung dieser kumulativen Dissertation bestand daher in der Identifizierung verletzungsrelevanter Risikofaktoren und ihrer Interaktionen im Nachwuchsleistungsfußball mittels laborbasierter biomechanischer Messverfahren einschließlich der Überprüfung ihrer Fähigkeit zur Verletzungsvorhersage. Die Beantwortung der Frage, warum eine Verletzung auftritt und inwiefern das Zustandekommen einer Verletzung das Ergebnis einer nicht linearen Interaktion zwischen multiplen Risikofaktoren ist, stand am Anfang des Forschungsprogramms. Die Analyse dieses methodischen Ansatzes konnte durch die Erhebung von neuromuskulären und biomechanischen Leistungsparametern einige verletzungsrelevante Risikofaktoren und Risikoprofile identifizieren. Es scheint, dass die Untersuchung der Gleichgewichtsfähigkeit unter statischen und instabilen Bedingungen, der Kraftfähigkeiten der Oberschenkelmuskulatur sowie der Bewegungsmuster bei der einbeinigen Landung und einem Richtungswechsel einen guten Hinweis auf das Verletzungsrisiko bei Nachwuchsleistungsfußballern ermöglicht. Eine aus der Verwendung der Classification and Regression Tree (CART)-Methode resultierende, wissenschaftliche Neuerkenntnis zeigte, dass sowohl neuromuskuläre als auch biomechanische Risikofaktoren in einem komplexen nicht linearen System ihren Einfluss auf das Verletzungsrisiko teilweise verändern, sobald ein weiterer Risikofaktor auftritt und hierarchisch untergeordnet ist. Die Möglichkeit, das Verletzungsrisiko vorherzusagen, unterscheidet sich methodisch von dem Ansatz der Erklä- rung, warum eine Verletzung aufgetreten ist. Aufgrund dieser unterschiedlichen methodischen Herangehensweise hat die prädiktive Modellierung des Verletzungsrisikos das Forschungsprogramm abgeschlossen. Das umfassende laborbasierte Risiko-Screening lieferte eine große Anzahl möglicher Prädiktoren, wodurch die Standardschätzungen der klassischen logistischen Regression oft instabil oder sogar undurch- führbar werden (Fall p > n). Darüber hinaus treten insbesondere dann, wenn auch multiple Interaktionseffekte der Prädiktoren einbezogen werden, Probleme mit Multikollinearität auf. In diesen Situationen werden Regularisierungstechniken und Methoden zur Variablenselektion relevant. Dank der erstmaligen Verwendung der LASSO-Regression zur Verletzungsvorhersage konnte gezeigt werden, dass die Regularisierung mit diesen Problematiken umgehen kann, sodass mithilfe dieses Ansatzes letztlich ein Vorhersagemodell erstellt werden konnte. Eine geringere Kraftfähigkeit der kniestreckenden Muskulatur unter konzentrischer Arbeitsweise, ein höheres Innenrotationsmoment des Hüftgelenks bei der einbeinigen Landung und eine geringer ausgeprägte Gleichgewichtsfähigkeit unter statischen Bedingungen erhöhten das zu er- wartende Verletzungsrisiko, was die Verletzung als multifaktorielles Ereignis unterstreicht. Die schwache Vorhersagekraft des erstellten Modells deutet jedoch auf die Schwierigkeit der Vor- hersage von Verletzungen im Nachwuchsleistungsfußball hin. Nichtsdestotrotz erweitern die Ergebnisse dieses Forschungsprogramms das Wissen über verletzungsrelevante Risikofaktoren und sind ein wertvoller erster Schritt zu einer zuverlässigen Abschätzung des Verletzungsrisikos im Nachwuchsleistungsfußball.
Schwimmen lernen von Kindern und Jugendlichen mit Migrationshintergrund
(2022-04-01) Wolter, Veronique; Sendt, Anna; Jaitner, Thomas
Acute effects of the FIFA11+ and Football+ warm-ups on motor performance. A crossover randomized controlled trial
(2023-04-20) Asgari, Mojtaba; Schmidt, Marcus; Terschluse, Benedikt; Sueck, Maximilian; Jaitner, Thomas
Introduction: Few studies including contradictory results have addressed the acute effects of the 11+ on motor performance, indicating a potentially reduced applicability of the program for warming up before competitions. This study aims to compare the acute effects of a soccer-specific warm-up (Football+) and the 11+ on motor performance. Materials and methods: Thirty-eight volunteer collegiate players (22 males; age = 21.1±1.9 years, height = 1.81± 0.06 m, weight = 73.4± 9.5 kg; 16 females; age = 21.3±1.5 years; height = 1.71± 0.07 m, weight = 67.8± 8.5 kg) underwent the 11+ and the Football+ in a randomized crossover design with a one-week washout. The Football+ starts with a self-estimated 40–50 percent running, followed by dynamic stretching of the hip muscles, shoulder contact, controlled lunge, Copenhagen exercise, and modified Nordic hamstring exercise. The second part involves roughly intensive small-sided games, followed by plyometric and anaerobic exercises in the third part. The warm ups’ effects on performance were determined by a linear sprinting test (20 m), countermovement jump performance (CMJ), Illinois agility (IA), and dribbling speed (DS) tests. Within-subject differences were reported as the means and SD. Pairwise t tests at the significance level of p<0.05 were used to calculate the significant differences. Results: Overall, except for the CMJ (mean = -0.43±3.20 cm, p = 0.21, d = -0.13), significant differences for the 20 m sprint (mean = 0.04±0.10 s, p = 0.005, d = 0.42), IA (mean = 0.65±0.45 s, p = 0.01, d = 1.43), and DS (mean = 0.60±1.58 s, p = 0.012, d = 0.38) were observed. In females, significant differences observed only for IA (mean difference = 0.52±0.42 s, p<0.001, d = 1.24) and DS (mean difference = 1.29±1,77 s, p = 0.005, d = 0.73), with the Football+ showing superiority. In males, significant differences were found only for 20 m sprinting (mean difference = 0.06±0.09, p = 0.005, d = 0.60) and IA (mean difference = 0.74±0.46, p<0.001, d = 1.62), with the Football+ having superiority. Discussion: Although practicable for injury prevention, the 11+ may not optimize acute performance and prepare players for high-intensity physical tasks as well as a well-structured, roughly intensive warm-up. Further gender-specific studies should evaluate the long-term effects of the Football+ on performance and injury prevention.
Effects of the FIFA 11+ and a modified warm-up programme on injury prevention and performance improvement among youth male football players
(2022-10-20) Asgari, Mojtaba; Alizadeh, Mohammad Hossein; Shahrbanian, Shahnaz; Nolte, Kevin; Jaitner, Thomas
Introduction The effects of the FIFA11+ programme (the 11+) on ankle and groin injuries and performance have remained questionable. The latter, particularly, has potentially reduced the implementation rate and applicability of the programme. This study aimed to evaluate the mid-to-long-term effects of the 11+ and a modified programme including football-specific exercises on injury prevention and performance improvement. Materials and methods Three teams of the Iranian Youth League (division two) volunteered to participate in this study and were randomly assigned to two intervention groups (F11+; n = 29, M11+; n = 31) and a control group (n = 30). The F11+ followed the FIFA 11+ programme, whereas the M11+ performed modified exercises three times weekly as a warm-up protocol before training and competition through a football season. The control group carried out its routine warm-ups, including joggings, basic football drills, and static stretches, while having no injury prevention approaches. Lower extremity injuries, as well as exposure time for each player, were recorded. The football-specific performance was assessed using the Illinois Agility and Slalom Dribbling tests. ANOVA, Fisher Freeman Halton, and chi-square tests were used to analyze the data. Results Injury incidences differed significantly between groups (p = 0.02, C = 0.40), with M11+ reporting the lowest incidence. Significant differences between the pre- and posttest as well as differences between the groups for development over time were revealed for the Illinois agility and dribbling speed (p≤0.01). Both performance tests demonstrated a large time effect, as the effect sizes for time in agility and dribbling speed were 0.74 (CI = [0.66; 0.79]) and 0.86 (CI = [0.79; 0.87]), respectively. The effect size for the interaction can be categorized as medium, with 0.38 (CI = [0.25; 0.49]) for agility and 0.52 (CI = [0.40; 0.61]) for dribbling speed. M11+ showed the largest improvement in both. Discussion Mid-to-long-term application of a structured dynamic warm-up that integrates injury prevention and performance approaches may lower injury incidences and improve youth subelite players’ performance. Although additional studies with larger samples are needed to prove the results of the current study, the amateur clubs/teams could integrate such twofold dynamic warm up into their routine training plan and benefit its advantages on injury prevention and performance improvement.
Biografien geflüchteter Leistungsfußballer: Eine sozialwissenschaftliche Analyse
(2022) Michelini, Enrico; Bruland, Jennifer; Janning, Oliver
Dieses Projekt untersucht die Forschungsfrage „Wie lassen sich Sportbiografien von geflüchteten Leistungsfußballern beschreiben?”. Um dieser Frage nachzugehen, wurden acht Leistungsfußballer mit Fluchthintergrund und zwei Fußballexperten interviewt. Das Videomaterial wurde durch qualitative inhaltsanalytische Methoden untersucht und auf Grundlage eines sozialisationstheoretischen Rahmens interpretiert. Die Ergebnisse zeigen, dass die Karrieren der Interviewten sehr stark von den Ereignissen der Zwangsmigration beeinflusst wurden. Deswegen ist eine Beschreibung der Biografien nach Migrationsphasen erklärungsfähiger als nach klassischen altersbedingten Entwicklungsphasen. Auch nach der Umsiedlung lassen sich die direkten und indirekten Konsequenzen dieser Ereignisse auf die Re-Inklusion im Fußball deutlich erkennen, unter anderem in Bezug auf Faktoren wie: die Verzerrungen in der wahrgenommenen Zeit, das aktuelle suboptimale Leistungsniveau, der problematische Bezug zu Fußballvereinen, die instabile persönliche Situation, der starke Ehrgeiz hohe sportliche Ziele zu erreichen. Das Thema ist unter wissenschaftlichen sowie sozialen Aspekten relevant und hat eine hohe Bedeutung für die Entwicklung von Maßnahmen, um talentierte Spieler:innen mit Erfahrungen einer Zwangsmigration angemessen zu unterstützen und zu fördern. Die Diskussion beschäftigt sich besonders mit der letztgenannten Thematik unter der Perspektive des deutschen Sportssystems und der geflüchteten Fußballer.
Fitness, physical activity, and exercise in multiple sclerosis
(2022-01-27) Walzik, David; Zimmer, Philipp; Joisten, Niklas; Proschinger, Sebastian; Kuhwand, Puya; Rademacher, Annette; Warnke, Clemens
Background A moderate to high level of physical activity, including regular exercise, represents an established behavioral and rehabilitative approach for persons with multiple sclerosis (pwMS). Although being increasingly proposed to limit disease activity and progression, high-quality evidence is lacking. Objective The objective of the study is to provide valuable information for MS clinicians and researchers by systematically evaluating the current state of evidence (i) whether exercise interventions affect established clinical measures of disease activity and progression in pwMS (i.e., EDSS, relapse rate, lesion load, brain volume, MSFC) and (ii) how the physical activity and fitness level interact with these measures. Methods Literature search was conducted in MEDLINE, EMBASE, CINAHL, and SPORTDiscus. Evaluation of evidence quality was done based on standards published by The American Academy of Neurology. Results It is likely that exercise improves the MSFC score, whereas the EDSS score, lesion load, and brain volume are likely to remain unchanged over the intervention period. It is possible that exercise decreases the relapse rate. Results from cross-sectional studies indicate beneficial effects of a high physical activity or fitness level on clinical measures which, however, is not corroborated by high evidence quality. Conclusions A (supportive) disease-modifying effect of exercise in pwMS cannot be concluded. The rather low evidence quality of existing RCTs underlines the need to conduct more well-designed studies assessing different measures of disease activity or progression as primary end points. A major limitation is the short intervention duration of existing studies which limits meaningful exercise-induced effects on most disability measures. Findings from cross-sectional studies are difficult to contextualize regarding clinical importance due to their solely associative character and low evidence quality.
Physical activities for older adults: are local co-operations of sports clubs and care partners an option to increase access?
(2021-10-13) Wolter, Veronique; Dohle, Miriam; Sobo, Lisa
Group-based physical activity brings high and long-term added value for the participants. Especially for older adults in need of care, this development is dependent on interdisciplinary thinking and the networking of local structures. Studies underline the consideration of the communication and access options that are needed to be able to promote the target group’s health through exercise programmes. Sports clubs are repeatedly mentioned as competent partners in health promotion, but in municipal practice—possibly due to very different basic structures to the system of care—they receive less attention. The project Moving Nursing Homes and Care Providers (2019–2022) is coordinated by the State Sports Federation of North Rhine-Westphalia, Germany. Local sports clubs cooperate with providers of outpatient and inpatient care to start new sports programs for older adults in need of care. As part of the scientific evaluation, the perspectives involved are equally considered and their motives and needs are analysed. For this paper, four conducted qualitative interviews with representatives of sports clubs were analysed with the focus on opportunities and barriers for local partnerships between sports clubs and care. Results show structural and personal parameters that have to be looked at from the beginning. Local networks are essential for sports clubs to get in contact with potential partners and to reflect initiated processes. Although aspects of (financial) organisation is an often named topic, sports clubs have the opinion that they have the social responsibility to influence developments in their neighbourhood for all generations positively.
Exercise reduces systemic immune inflammation index (SII) in childhood cancer patients
(2021-12-03) Winker, Matteo; Stössel, Sandra; Neu, Marie Astrid; Lehmann, Nadine; El Malki, Khalifa; Paret, Claudia; Joisten, Niklas; Bloch, Wilhelm; Zimmer, Philipp; Faber, Jörg
While exercise and physical activity have been suggested to reduce mortality and symptoms in cancer, knowledge on these associations in patients with childhood cancer (CCPs) is sparse. Anti-inflammatory properties of exercise might mediate these beneficial effects. We investigated the influence of exercise on the inflammation markers neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic-immune-inflammation index (SII) and associations to patient-reported-outcomes in CCPs in a randomized-controlled trial. Results show associations between inflammation markers and patient-reported outcomes. Compared to the control group, SII was significantly reduced following exercise (p=0.036). Anti-inflammatory effects of exercise are also present in CCPs and may underlie exercise-induced benefits on symptoms. Clinical Trial Registration Number: NCT02612025
Transferring clinically established immune inflammation markers into exercise physiology
(2021-03-31) Walzik, David; Joisten, Niklas; Zacher, Jonas; Zimmer, Philipp
Over the last decades the cellular immune inflammation markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII = NLR × platelets) have emerged in clinical context as markers of disease-related inflammation and are now widely appreciated due to their integrative character. Transferring these clinically established inflammation markers into exercise physiology seems highly beneficial, especially due to the low temporal, financial and infrastructural resources needed for assessment and calculation. Therefore, the aim of this review is to summarize evidence on the value of the integrative inflammation markers NLR, PLR and SII for depiction of exercise-induced inflammation and highlight potential applications in exercise settings. Despite sparse evidence, multiple investigations revealed responsiveness of the markers to acute and chronic exercise, thereby opening promising avenues in the field of exercise physiology. In performance settings, they might help to infer information for exercise programming by reflecting exercise strain and recovery status or periods of overtraining and increased infection risk. In health settings, application involves the depiction of anti-inflammatory effects of chronic exercise in patients exhibiting chronic inflammation. Further research should, therefore, focus on establishing reference values for these integrative markers in athletes at rest, assess the kinetics and reliability in response to different exercise modalities and implement the markers into clinical exercise trials to depict anti-inflammatory effects of chronic exercise in different patient collectives.
Sleep problems and their interaction with physical activity and fatigue in hematological cancer patients during onset of high dose chemotherapy
(2021-07-10) Castelli, Lucia; Elter, Thomas; Wolf, Florian; Watsonlter, Matthew; Schenk, Alexander; Steindorf, Karen; Bloch, Wilhelm; Hallek, Michael; Joisten, Niklas; Zimmer, Philipp
Purpose Sleep problems reported by hematological cancer patients are usually linked to higher levels of cancer-related fatigue. Although the awareness of sleep problems in solid cancer patients is rising, there has been less attention to the issue in hematological cancer patients. The present study assesses the differences in sleep by comparing physical activity and fatigue levels among hematological cancer patients during the onset of chemotherapy. Furthermore, it investigates the relationship between sleep, physical activity, and fatigue through mediation analysis. Methods The recruited sample consists of 58 newly diagnosed hematological cancer patients (47.1 ± 15.4 yrs; 51.7% males). Subjects completed questionnaires assessing sleep (PSQI), physical activity (visual analogue scale), fatigue (MFI-20), anxiety, depression (HADS), and quality of life (EORTC QLQ-C30) within two weeks from starting treatment. Results The sample reported more sleep problems in comparison to the German population norm. The classification as good (ca 25%) or bad sleepers (ca 75%) showed less frequent physical activity (p = .04), higher fatigue (p = .032), anxiety (p = .003), depression (p = .011) and pain (p = .011) in bad sleepers. The mediation analysis revealed significant indirect effects of sleep on fatigue through physical activity habits. Conclusions This study highlights the combined action of sleep problems and physical activity on fatigue during the onset of induction chemotherapy. These two parameters could represent meaningful intervention targets to improve a patient’s status during chemotherapy. Trial registration The study was registered on the WHO trial register (DRKS00007824).
Evaluation of the Functional Movement Screen (FMS) in identifying active females who are prone to injury
(2021-11-22) Asgari, Mojtaba; Alizadeh, Shahab; Sendt, Anna; Jaitner, Thomas
Background: The validity of the Functional Movement Screen (FMS) in identifying active females who are predisposed to injury has not been specifically reviewed. This study aims to synthesize the literature on the ability of the FMS to identify at-risk active females. Methods: Six online databases, including PubMed, Medline, Web of Science, Science Direct, SPORTDiscus and Google Scholar, were searched for the period of April 2006 to September 2021. Out of the 61 potential references, 17 were reviewed in detail with respect to the inclusion criteria; ten were ultimately included. The risk of bias, applicability and level of the studies were then identified using the QUADAS-2 and a checklist for assessing methodological quality. The following data were obtained from the included studies: year of publication, title, study type, participants’ demographic, sample size, FMS cutoff point, injury definition, statistical analyses used, FMS results and study level. Results: Generally, the quality of eight studies was poor to moderate due to both small sample sizes and short follow-up periods. Except for a study on military members, all studies were carried out on team sports players. The overall bias of the studies was low, but there was an unclear amount of bias for participant selection. Two studies reported no predictive validity for the FMS, while three defended its predictive validity; the rest partially supported the FMS as a valid diagnostic tool. The reliability of the recommended cutoff point was confirmed, though cutoffs higher than 14 were significantly associated with the predictive ability of the FMS. Conclusion: Although the FMS is reliable for clinical practice, and the current literature shows promise regarding the predictive ability of the FMS among active females, concerns remain regarding its validity in identifying at-risk females. Given the lack of clarity in the literature on the use of the FMS in females, further well-organized studies with larger sample sizes and longer monitoring periods are highly recommended. The sensitivity and specificity of the recommended cutoff of ≤ 14 has considerably decreased , and higher cutoff values should be applied to increase the FMS predictive ability. Level of evidence: The level of evidence was determined to be 2b.
The ANHEQ evaluation criteria: introducing reliable rating scales for assessing Nordic Hamstring Exercise quality
(2021-12-11) Alt, Tobias; Schmidt, Marcus
Background: The Nordic Hamstring Exercise (NHE) is very popular for selective eccentric hamstring strengthening. However, NHE-related research is hindered by insufficient details about implementation and reporting. Available tools to assess study quality (e.g., PEDro or TESTEX scale) are too unspecific to account for the specific demands of NHE. Therefore, this study aimed to introduce two rating scales for Assessing Nordic Hamstring Exercise Quality (ANHEQ) of assessment and intervention studies. Methods: Eighteen graduated sports scientists, sports physiotherapists and elite coaches with scientific experience independently evaluated the quality of published NHE studies via ANHEQ scales, each comprising eight items and a maximal 13-point score. Inter-rater agreement was analyzed by using criterion-based reference values, while Krippendorff´s alpha determined inter-rater reliability. Systematic differences of the summated ANHEQ scores were determined using Friedman tests. Results: Inter-rater agreement was 87 ± 5% for NHE assessments and 88 ± 6% for interventions with single items ranging from 71 to 100%. Alpha values for inter-rater reliability ranged from fair (.250) to perfect (1.00) depending on the item. Total ANHEQ scores revealed coefficients of .829 (almost perfect) and .772 (substantial) without significant inter-rater differences (p = .292). Conclusions: The ANHEQ scales are suitable tools to rate NHE execution quality and data presentation. They facilitate a comprehensive review of NHE-related evidence and potentially improve the design and reporting of future NHE studies.
Zum differentiellen Einfluss von hoch-intensivem Intervall- und moderat kontinuierlichem Ausdauertraining auf die kognitive Leistungsfähigkeit bei Personen mit Multiple Sklerose
(2021) Rademacher, Annette; Zimmer, Philipp; Bloch, Wilhelm
Regelmäßiges körperliches Training kann bei vielen Multiple Sklerose (MS) spezifischen Symptomen positive Effekte hervorrufen. Einheitliche Evidenz zu den Effekten körperlichen Trainings auf die kognitive Leistungsfähigkeit existiert jedoch aufgrund verschiedener methodischer Limitationen und heterogenen Designs bestehender Untersuchungen nicht. Zugrundeliegende mechanistische Wirkweisen potentieller Verbesserungen bleiben ebenfalls weitestgehend ungeklärt. Neurofilament-Leichtketten-Proteine (NfL) als Biomarker für neurodegenerative Prozesse könnten möglicherweise zur Aufklärung mechanistischer Wirkweisen von körperlichem Training beitragen und als potentielles Bindeglied zwischen molekularen Mechanismen und neuropsychologischen Messverfahren der kognitiven Leistungsfähigkeit dienen. Die vorliegende Dissertation umfasst vier Publikationen. Ergebnisse der Publikationen 1-3 zeigen, dass der kognitive Status bei Studieneinschluss (eingeschränkte/ intakte kognitive Leistungsfähigkeit) ein Einflussfaktor für die Veränderung der kognitiven Leistungsfähigkeit in Folge einer dreiwöchigen Ausdauertrainingsintervention (hoch intensives Intervalltraining vs. Moderat kontinuierliches Training) zu sein scheint. Dabei profitierten Personen mit MS, die zu Studieneinschluss kognitive Einschränkungen aufwiesen signifikant stärker von der Trainingsintervention hinsichtlich einer Verbesserung der kognitiven Leistungsfähigkeit, als Personen, die keine Einschränkungen aufwiesen (Publikation 1 & 2). Bei Studieneinschluss wurde eine Assoziation zwischen pNfL und der kognitiven Leistungsfähigkeit erkannt. Insbesondere HIIT verglichen zu MCT induzierte eine Reduktion von pNfL-Konzentrationen nach einer akuten Trainingseinheit, welche ebenfalls drei Stunden nach Beendigung der Belastung messbar war. Nach der dreiwöchigen Trainingsintervention wurden hingegen keine Effekte auf die pNfL-Konzentration beobachtet (Publikation 3). Die Ergebnisse der vorliegenden Arbeit liefern relevante Erkenntnisse für die Gestaltung künftiger Studien, bei denen zur Untersuchung der Effekte körperlichen Trainings auf die kognitive Leistungsfähigkeit von MS-Betroffenen ausschließlich Personen eingeschlossen werden sollten, welche kognitive Einschränkungen aufweisen. Ob hoch-intensive Intervallbelastungen in der Tat moderater kontinuierlicher Belastung hinsichtlich der Effekte auf die kognitive Leistungsfähigkeit bei Personen mit MS überlegen sind, sollte in künftigen großangelegten randomisiert-kontrollierten Studien mit Kognition als primärem Endpunkt, einem längeren Interventionszeitraum und weiteren Interventionsgruppen sowie einer passiven Kontrollgruppe untersucht werden. Ferner bedarf es langfristiger Interventionsstudien zur Untersuchung chronischer Effekte auf die Veränderung der pNfLKonzentration und dessen potentielle Assoziationen zur kognitiven Leistungsfähigkeit. In künftigen Studien sollte außerdem der Frage nachgegangen werden, inwiefern ein regelmäßiges Training bei noch nicht eingeschränkten MS-Betroffenen das Auftreten der kognitiven Einschränkung womöglich im fortschreitenden Krankheitsverlauf zeitlich verzögert. Die Relevanz der kognitiven Funktion als Ziel der Bewegungstherapie wird letztlich in Publikation 4 der vorliegenden Arbeit fokussiert.
Comment on: “Effects of exercise training interventions on executive function in older adults: a systematic review and meta‑analysis”
(2020-10-31) Zimmer, Philipp; Javelle, Florian; Lampit, Amit
Cellular immune response to acute exercise
(2020-03-27) Schlagheck, Marit Lea; Walzik, David; Joisten, Niklas; Koliamitra, Christina; Hardt, Luca; Metcalfe, Alan J.; Wahl, Patrick; Bloch, Wilhelm; Schenk, Alexander; Zimmer, Philipp
Objectives: Exercise‐induced cellular mobilization might play a role in treatment and prevention of several diseases. However, little is known about the impact of different exercise modalities on immune cell mobilization and clinical cellular inflammation markers. Therefore, the present study aimed to investigate differences between acute endurance exercise (EE) and resistance exercise (RE) on cellular immune alterations. Methods: Twenty‐four healthy men conducted an acute EE (cycling at 60% of peak power output) and RE (five exercise machines at 70% of the one‐repetition maximum) session lasting 50 minutes in randomized order. Blood samples were collected before, after and one hour after exercise cessation. Outcomes included counts and proportions of leukocytes, neutrophils (NEUT), lymphocytes (LYM), LYM subsets, CD4/CD8 ratio, and the clinical cellular inflammation markers NEUT/LYM ratio (NLR), platelets/LYM ratio (PLR), and systemic immune inflammation index (SII). Results: Alterations in all outcomes were revealed except for CD8+ T cells, CD4/CD8 ratio, NLR, and PLR. EE induced a stronger cellular immune response and provoked alterations in more immune cell populations than RE. SII was altered only after EE. Conclusion: An acute EE session causes a stronger mobilization of immune cells than RE. Additionally, SII represents an integrative marker to depict immunological alterations.

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