Alpine Skiing With total knee ArthroPlasty (ASWAP): effects on strength and cardiorespiratory fitness.

This study investigated the effect of a 12-week recreational skiing intervention on lower limb muscle strength and cardiorespiratory fitness in participants with unilateral total knee arthroplasty (TKA). Twenty-seven older adults (70 ± 5 years) were assigned to the intervention (n = 13) or control group (n = 14) after surgery (2.5 ± 1 years). Leg muscle strength was measured using an IsoMed 2000 dynamometer and cardiorespiratory fitness was determined by cycle ergometry before and after the intervention as well as after an 8-week retention period. The skiing intervention led to increased muscle strength in the operated leg during unilateral single joint isometric extension (maximal force: 11%; P < 0.05; rate of torque development: 24%; P < 0.05) and during the unilateral multi-joint isokinetic single leg strength test (8%; P < 0.05). This resulted in a decreased asymmetry index in the isokinetic test (13% to 5%; P < 0.05). These adaptations remained unchanged toward the retention test. No effect was observed for cardiorespiratory fitness. The results demonstrate that muscle contraction forces required during recreational skiing in individuals with TKA seem adequate and effective to increase quadriceps and hamstrings muscle strength in the initially weaker operated leg and to reduce an augmented post-operative asymmetry index.

Alpine Skiing With total knee ArthroPlasty (ASWAP): effects on gait asymmetries.

The aim of the study was to examine the effect of a 12-week recreational skiing intervention on functional gait performance in people with unilateral total knee arthroplasty (TKA). Twenty-three older adults (71 ± 5 years) were assigned to the intervention (IG) or control group (CG). Test time and ground reaction forces (GRF) were recorded at pre- and post-intervention and in the retention phase during functional gait tests. Ground contact was recorded bilaterally and divided into the weight acceptance and push-off phases. In IG, a faster stair descent time (16%) was observed at post-test with no further change at the retention test. The asymmetry indices for all analyzed variables were decreased in stair descent and during weight acceptance in stair ascent and level walking without further changes between post- and retention test. The reduced asymmetries occurred mainly because of increased loading of the operated leg. Most variables were unchanged in CG. Similar to the force data, the asymmetry index for temporal stride characteristics was reduced in all stair descent variables. These results demonstrate that alpine skiing as a leisure-time activity has a beneficial effect on gait performance and leads to a more balanced load distribution between the legs during daily activities.

Alpine Skiing With total knee ArthroPlasty (ASWAP): symmetric loading during skiing.

The aim of this pilot study was to determine the pressure distribution, symmetry of load between operated (OP) and non-operated (NOP) leg, and pain level during alpine skiing in participants with unilateral total knee arthroplasty (TKA). The responses of the dependent variables were analyzed following a 10-week guided skiing intervention of 2-3 days of skiing per week. Ground reaction force (GRF) was recorded bilaterally and was determined for 13 participants with TKA (65 ± 4 years) at pre- and post-test. Additionally, pain perception was determined using a numeric rating scale in the OP leg at both test sessions and after each skiing day. No statistical differences were observed between OP and NOP legs for peak and average GRF as well as the asymmetry indices at pre-test. Pain perception was low and was not increased as a consequence of the skiing intervention. In conclusion, alpine skiing did not lead to increased or decreased loading of the OP leg compared with the NOP leg. Therefore, alpine skiing may be allowed for patients with skiing experience and a good clinical outcome.

Motor abilities and anthropometrics in youth cross-country skiing.

The purposes were to validate whether general motor abilities and anthropometrics are determinants of youth cross-country (XC) skiing performance; evaluate gender-specific differences; and to establish noninvasive diagnostics. Fifty-one youth XC skiers (34 boys; 13.8 ± 0.6 years and 17 girls; 13.4 ± 0.9 years) performed motor skill and laboratory tests, and anthropometric data were collected and correlated with XC skiing performance. Anthropometrics and maturity status were related to boys but not to girls XC skiing performance. Push-ups and 20-m sprint were correlated to XC skiing performance in both boys and girls. XC skiing performance of boys was predominantly influenced by upper body and trunk strength capacities (medicine ball throw, push-ups, and pull-ups) and jumping power (standing long and triple jump), whereas XC skiing of girls was mainly influenced by aerobic capacities (3000-m run). Laboratory measures did not reveal greater correlations to XC skiing performance compared with simple test concepts of speed, strength, and endurance. Maturity was a major confounding variable in boys but not girls. Use of noninvasive simple test concepts for determination of upper body strength, speed, and endurance represent practicable support for ski clubs, schools, or skiing federations in the guidance and evaluation of young talent, being aware of the effect of maturity especially in boys.

[Balance trainability using the Nintendo Wii balance board in sportive people]. / Trainierbarkeit der Gleichgewichtsfähigkeit mit dem Nintendo Wii Balance Board bei sportlich aktiven Personen.

BACKGROUND: A multivariable training has a positive impact on balance skills and risk of injury. To date the effect of this training using the Nintendo Wii balance board in sportive people has not yet been investigated. OBJECTIVE: The aim of this study was to investigate whether training with the Nintendo Wii balance board can improve balance skills. METHOD: 20 people were randomized into a control and an intervention group each with 10 people who performed a unilateral stance test with eyes open and closed as well as the star excursion balance test before and after the intervention. The control group completed their usual sports and the intervention group an adjunct training with the Nintendo Wii balance board for 4 weeks. RESULTS: Adjunct Training using the Nintendo Wii Balance Board did not improve sportive people's balance skills significantly. The intervention group, however, attained better results in the star excursion balance test, whereas the control group did not show any changes. The unilateral stance tests did not provide significant differences before and after training within both groups. CONCLUSION: The use of the Nintendo Wii balance board should be further investigated by employing individual difficulty levels.

Biomechanical analysis of the herringbone technique as employed by elite cross-country skiers.

This investigation was designed to analyse the kinematics and kinetics of cross-country skiing at different velocities with the herringbone technique on a steep incline. Eleven elite male cross-country skiers performed this technique at maximal, high, and moderate velocities on a snow-covered 15° incline. They positioned their skis laterally (25 to 30°) with a slight inside tilt and planted their poles laterally (8 to 12°) with most leg thrust force exerted on the inside forefoot. Although 77% of the total propulsive force was generated by the legs, the ratio between propulsive and total force was approximately fourfold higher for the poles. The cycle rate increased with velocity (1.20 to 1.60 Hz), whereas the cycle length increased from moderate up to high velocity, but then remained the same at maximal velocity (2.0 to 2.3 m). In conclusion, with the herringbone technique, the skis were angled laterally without gliding, with the forces distributed mainly on the inside forefoot to enable grip for propulsion. The skiers utilized high cycle rates with major propulsion by the legs, highlighting the importance of high peak and rapid generation of leg forces.

Effect of instability training equipment on lower limb kinematics and muscle activity.

To improve the effectiveness of training or therapy, it is important to know the benefits for each type of instability training equipment. The aim of this study was to show differences in lower limb kinematics and muscle activation during single leg standing on a slackline (SL) compared to a multi-functional rocker board (MD) and an air cushion (AC). In 14 subjects, mean angular velocity of the hip, knee and ankle, as well as the muscle activity (iEMG) from six lower limb muscles were recorded during 12 s of single leg standing task. Ankle in-/eversion and knee ab-/adduction angular velocity were highest for SL followed by MD and AC (all p < 0.05), as well as in the hip flex-/extension angular velocity with higher values for SL compared with AC (p < 0.01). Regarding iEMG, the rectus femoris muscle showed higher values for SL compared with MD (p < 0.05) and AC (p < 0.01). iEMG of biceps femoris muscle demonstrated higher values for MD compared to AC (p < 0.05), but with no difference to SL. Balancing on a SL is a more challenging exercise for the postural control system compared to MD and AC, and affects the knee and hip joint motion in particular.

Spine kinematics and trunk muscle activity during bipedal standing using unstable footwear.

The current study was conducted to evaluate the effects of unstable footwear on spine kinematics and trunk muscle activity during bipedal stance. Therefore, spinal alignment and concurrent angular velocity measures were assessed in 27 asymptomatic adults while standing with unstable Masai Barefoot Technology (MBT) shoes and standard footwear, respectively, employing a multisegmental three-dimensional trunk model. Electromyographic (EMG) analyses included recordings of the rectus abdominis, internal oblique, external oblique, upper thoracic paraspinals, lower thoracic erector spinae, and lumbar erector spinae. Kinematic and EMG variables were compared for the two shoe conditions via paired Student's t-tests (α = 0.05). Results showed that wearing unstable MBT shoes increased flexion at the mid-thoracic level (0.8°; P = 0.001) and led to greater mean velocities of angular displacement at the thoracolumbar (11.2%; P = 0.003) and at the lumbopelvic (10.8%; P = 0.02) regions, accompanied by more lumbar erector spinae activity (18.2%; P = 0.003). Accordingly, using MBT shoes may have potential implications in promoting spine tissue health, notably at the low back area, through expected improvements in terms of muscle conditioning and/or motor performance. However, additional investigations are warranted to further examine the framework of unstable footwear constructions within prevention and rehabilitation settings.

Biomechanical determinants of oxygen extraction during cross-country skiing.

To determine the relationship of muscle activation, force production, and cycle characteristics to O(2) extraction during high- and lower-intensity double poling (DP), nine well-trained male cross-country skiers performed DP on a treadmill for 3 min at 90% VO(2peak) followed by 6 min at 70%. During the final minute at each workload, arterial, femoral, and subclavian venous blood were collected for determination of partial pressure of O(2), partial pressure of CO(2), pH, and lactate. Electromyography (EMG) was recorded from six upper and lower body muscles, leg and pole forces were measured, and cardiorespiratory variables were monitored continuously. O(2) extraction was associated with time point of peak pole force (PF(peak)), duration of recovery, EMG activity, and lower body use. Arm O(2) extraction was lower than in the legs at both intensities (P < 0.001) and was reduced to a lesser extent upon decreasing the workload (P < 0.05). Arm root-mean-square EMG was higher during the poling phase and entire cycle compared with the legs (P < 0.001). Blood lactate was higher in the subclavian than in femoral vein and artery (P < 0.001) and independent of intensity. O(2) extraction was correlated to low muscle activation, later PF(peak) , prolonged poling time, and extensive dynamic lower body use. Cycle rate and recovery time were associated with O(2) extraction during high-intensity exercise only.

[Absolute and relative strength-endurance of the knee flexor and extensor muscles: a reliability study using the IsoMed 2000-dynamometer]. / Absolute und relative Kraftausdauer der Kniebeuge- und -streckmuskulatur: eine Reliabilitätsstudie unter Verwendung des IsoMed 2000-Dynamometers.

BACKGROUND: Isokinetic devices are highly rated in strength-related performance diagnosis. A few years ago, the broad variety of existing products was extended by the IsoMed 2000-dynamometer. In order for an isokinetic device to be clinically useful, the reliability of specific applications must be established. Although there have already been single studies on this topic for the IsoMed 2000 concerning maximum strength measurements, there has been no study regarding the assessment of strength-endurance so far. The aim of the present study was to establish the reliability for various methods of quantification of strength-endurance using the IsoMed 2000. METHODS: A sample of 33 healthy young subjects (age: 23.8 ± 2.6 years) participated in one familiarisation and two testing sessions, 3-4 days apart. Testing consisted of a series 30 full effort concentric extension-flexion cycles of the right knee muscles at an angular velocity of 180 °/s. Based on the parameters Peak, Torque and Work for each repetition, indices of absolute (KADabs) and relative (KADrel) strength-endurance were derived. KADabs was calculated as the mean value of all testing repetitions, KADrel was determined in two ways: on the one hand, as the percentage decrease between the first and the last 5 repetitions (KADrelA) and on the other, as the negative slope derived from the linear regression equitation of all repetitions (KADrelB). Detection of systematic errors was performed using paired sample t-tests, relative and absolute reliability were examined using intraclass correlation coefficient (ICC 2.1) and standard error of measurement (SEM%), respectively. RESULTS/CONCLUSION: In general, for extension measurements concerning KADabs and - in an weakened form - KADrel high ICC -values of 0.76-0.89 combined with clinically acceptable values of SEM% of 1.2-5.9 % could be found. For flexion measurements this only applies to KADabs, whereas results for KADrel turned out to be clearly weaker with ICC- and SEM% values of 0.42-0.62 and 9.6-17.7 % and leave considerable doubts on the clinical usefulness. However, if there should be after all a need to measure KADrel for flexion, it is - in view of the stronger reliability results - recommended (i) to concentrate on the calculation of KADrelB, (ii) to use the parameter Work and - in view of considerable familiariszation and learning effects of ≈10 % - (iii) to include a familiarisation period that extends exceeds the familiarisation session conducted in the present study.

Lower extremity joint loading during level walking with Masai barefoot technology shoes in overweight males.

The purpose of this study was to evaluate the effects of Masai barefoot technology (MBT) shoes on lower extremity joint loading in overweight males during level walking. Therefore, lower extremity kinematics, kinetics, and muscle electromyographic signals of the vastus lateralis (VL), biceps femoris (BF), and gastrocnemius medialis (GM) were recorded in 10 overweight males at a self-chosen walking speed with MBT shoes and conventional shoes. Selected peak joint moments, maximal joint force loading rates, mean muscle intensities, and co-activation indices of the VL/BF, as well as of the VL/GM were analyzed and compared for the two shoe conditions using paired Student's t-tests (α=0.05). Results showed that walking with MBT shoes reduced first peak knee adduction moments in overweight subjects. During midstance and terminal stance, increases in VL/GM co-activation, accompanied by increases in VL and GM (only terminal stance) intensities were found for the MBT situation. Kinetic variables analyzed to assess ankle and hip joint loading did not exhibit any statistical differences. These results suggest that using MBT shoes diminishes medial compartment loads at the knee without overloading hip or ankle joints in overweight males. However, the additional muscle loading should not be overlooked, and warrants further investigation.

Force interaction and 3D pole movement in double poling.

The aim of this study was to analyze double poling using combined kinetic and 3D kinematic analysis at high skiing speeds as regards pole force components, pole angles and pole behavior during the poling and swing phase. The hypothesis was that a horizontal pole force is more predictive for maximal skiing speed (V(max)) than the resultant pole force. Sixteen elite skiers performed a double-poling V(max) test while treadmill roller skiing. Pole forces and 3D kinematics of pole movement at a speed of 30 km/h were analyzed and related to V(max). The duration of the "preparation phase" showed the strongest relationship with V(max) (r=0.87, P<0.001). Faster skiers generated longer cycle lengths with longer swing and poling times, had less inclined pole angles at pole plant and a later peak pole force. Horizontal pole forces were not more highly related to V(max) compared with the resultant pole force. Impact force was not related to V(max). At high skiing speeds, skiers should aim to combine high pole forces with appropriate timing of pole forces and appropriate pole and body positions during the swing and poling phase. The emphasis in training should be on the development of specific strength capacities for pole force production and the utilization of these capacities in double-poling training sessions.

General strength and kinetics: fundamental to sprinting faster in cross country skiing?

To determine relationships between general strength, maximal skiing speed (V(max)), pole and leg kinetics and kinematics, 16 male elite skiers underwent three V(max) tests in double poling, diagonal stride and V2 on a treadmill. The analyzed skiing speeds and leg and arm kinetics were among the highest ever recorded. Relationships between general strength exercises and V(max) were technique dependent. Power output in bench press and bench pull were related to V(max) in DP and diagonal stride, whereas each 1 repetition maximum was related to V2. Isometric squats were not associated with V(max) in all three techniques, whereas jump height and rate of force development during squat jump were. Analysis of kinetics and kinematics revealed that it was not exclusively the magnitude of applied forces during skiing, but the timing and proper instant of force application were major factors discriminating between faster and slower skiers. For all techniques, the faster skiers used different skiing strategies when approaching V(max) when compared with the slower skiers. General strength and power per se seem not to be major determinants of performance in elite skiers, whereas coordination of these capacities within the different and complex skiing movements seems to be the discriminating factor.

Analysis of a simulated sprint competition in classical cross country skiing.

The objectives of this project were first to analyze the physiological response of a classical cross country (XC) skiing sprint competition, second, to examine the relationships of kinematic and physiological variables with sprint performance and third, to test the hypothesis that maximal speed in double poling (DP) and diagonal stride (DIAG) predicts sprint performance. Twelve elite skiers performed a treadmill-based simulation of a sprint competition that included two maximal speed tests (DP, DIAG), a test and three sprint heats over a 3.5-h period. VO(2), lactate, heart rate (HR) and kinematic variables were measured. Maximal DP and DIAG speed, the level of repeatedly produced lactate values and skiing technical aspects positively correlated with sprint performance. Fastest skiers produced longer cycle lengths in all techniques at equal poling frequency. VO(2) variables showed no correlation to sprint performance. VO(2), tidal volume (VT), and lactate decreased over the heats. XC-sprint performance in classical style depends on speed abilities, technique use, fatigue resistance, and anaerobic capacity. The relationship of maximal speed with sprint performance suggests (a) integrating maximal speed tests in XC sprint diagnostics and (b) emphasizing training models for XC skiing-specific speed abilities to improve performance in XC skiing sprint.