[Validity of a complex soccer-specific field test and a non-specific sprint test-assessments for test and match performance]. / Validierung eines komplexen fußballspezifischen und fußballunspezifischen Tests-Leistungsdiagnostik im Spannungsfeld von Test- und Wettkampfleistung.

BACKGROUND: Soccer assessments often lack specificity and complexity. Examinations of validity for soccer assessments, based on the relation between test and match performance, are available although they are scarce. A complex soccer-specific field test which is validated cannot be found in the literature at all. OBJECTIVE: The aim of this follow-up study was to assess the validity of a soccer-specific complexity test (FBKT) and a repeated non-specific sprint test (ST) based on three gold standards: match performance, coach ranking, and league affiliation. MATERIALS AND METHODS: A German fourth league soccer team (n = 14) was assessed using FBKT and ST in the pre-season for the second half of the 2010/2011 season. Afterwards, their performance in 17 matches was evaluated using video analysis in order to compare them with the test parameters (e. g., pass/assist ratio, goals, duelling behaviour). Eighteen months later, the league affiliation of all players was identified and the coach evaluated the tested players. RESULTS: With regard to match performance, playing time was proved to be the most suitable parameter for validating the test performance (FBKT, ST). The total and minimum times of ST were the most powerful parameters in relation to playing time and explained 50 % and 46 % of the variance, respectively. Concerning the FBKT, the parameters "sum of all linear sprints" (24 %) and "total time of all activity series with penalty time in round two" (22 %) explained the highest amount of variance. Coach ranking generated significant odds ratios for the minimum time of ST (OR = 6.5; CI: 3.2 - 5.2 × 1015; p = 0.037), and total time of speed dribbling of the FBKT (OR = 1.3; CI: 1.2 - 199.5; p = 0.036) based on a proportional-odds model. With regard to league affiliation, significant odds ratios occurred with the following parameters: minimum time of ST (OR = 15.8; CI: 2.16 - 115.4; p = 0.007); total time of ST (OR = 3.28; CI: 1.31 - 8.21; p = 0.011); and, total time of speed dribbling for the FBKT (OR = 1.3; CI: 1.01 - 1.61; p = 0.044). CONCLUSIONS: This study showed that the larger logical validity of soccer-specific complex tests does not necessarily translate to a larger construct validity, as compared to non-specific tests. However, their value is not limited to performance evaluation. The FBKT provides valuable information concerning training process control. It is possible that its low validity is caused by the poor performance of the players in soccer-specific consequences of actions (centres, goals) due to the restricted differentiation of players.

[Longitudinal and specific analyses of physical performance in handball]. / Longitudinale, sportartspezifische Leistungsdiagnostik im Handball.

BACKGROUND: Sports-specific, biomechanical measuring stations and measuring-station trainings have become common practice in many forms of sports and are an essential element of the complex assessment of physical performance. In handball, however, there is still considerable research potential in this respect as well as in the systematic generation and acquisition of the requirements profile and progress of strain. OBJECTIVE: The prime objective of the longitudinal study was to determine the potential performance and development of handball players (3 rd league) in general and in terms of handball sport in particular. Another objective was to establish correlations between tests and indicators of performance in competitions. MATERIALS AND METHODS: 13 handball players (age: 26.5 ± 3.6 years) were tested three times (before and after the pre-season preparation phase and at the end of the first half of the season) on two test days each. The examination was composed of sprint test (ST, day 1), handball-specific complex test (HBKT, day 1) and assessment of treadmill diagnostics (LD, day 2). The surveyed parameters were lactate and heart rate (LD/HBKT) as well as time (ST, HBKT) and the number of errors (HBKT). RESULTS: The cardiac (Hfmax = 201 min-1) and metabolic strain (lactate = 17.8 mmol/L) in the HBKT were very high. In the preparatory phase, the average magnitudes of effect registered were at d = 0.31 (ST parameter), d = 0.68 (HBKT parameter) and d = 0.98 (LD parameter). The most significant improvements throughout the entire period of time were registered in the parameters v2 (LD; η2 = 0.371), total goal-throwing time (HBKT; η2 = 0.250), total penalty time (HBKT; η2 = 0.236) and total round 2 (HBKT; η2 = 0.227). In HBKT and LD, the performance level was stabilised by the end of the first half of the season. In terms of speed, however, there was a decline in performance abilities. The competition performance has its highest degree of correlation with cardial (defense: r = -0.656) and metabolic (offensive: r = -0.655) recuperativeness in HBKT. CONCLUSIONS: The findings of this longitudinal survey are on the one hand intended to make assessments of physical performance more efficient (isolated sprint test no longer required) and to improve data output (HBKT: throwing velocity; reference database). In this context, a more extensive consideration of indicators for competition performance and their correlation to specific parameters is recommendable. On the other hand, the applied training contents must be further optimised in terms of their severity and chronology.

[Development and evaluation of a soccer focused complexity test]. / Entwicklung und Evaluierung eines fußballspezifischen Komplextests.

BACKGROUND: Soccer has increasingly become a technical - tactical (speed of activity!) and athletic sport over the last years. Simultaneously the new training and contest conditions result in new challenges to sports science and sports medicine evaluation. Complex, sports specific field tests for soccer exist rarely and only in low quality. OBJECTIVE: Development and evaluation of a standardised complexity test in soccer (FBKT) for assessment of the complex sports specific and league specific physical performance. MATERIALS AND METHODS: Two regional German soccer teams (Verbandsliga [VL], Oberliga [OL]) (n = 27) were assessed with FBKT. The assessment included lactate levels, heart rate as well as time and error frequency (penalty time per error: 5 s) for defined activity series at defined time points (heart rate: rest, after round 1, prior to round 2, E 0, E 2, E 6, E 10, E 14; lactate: rest, E 2, E 6, E 10, E 14). RESULTS: The heart rate (hr (max) = 200 min (-1)) and metabolic rate (lactate (max) = 17.1 mmol/l) were very excessively high and did only partially differ between the groups (heart rate difference at rest p = 0.005, prior to round 2: p = 0.014, E 6: p = 0.042). Furthermore no significant differences occurred in the following parameters: recovery potential (hr (E0 - E14): p = 0.560; lactate (Max-Min): p = 0.448), technical error (p = 0.384), sprint (p = 0.499), slalom dribbling (p = 0.310), time round 1 (p = 0.119), shots on goal (p = 0.585) and crosses (p = 0.676). Significant difference were only found in the parameters time round 2 (p = 0.004), time round 1 and round 2 (p = 0.013), overall time (running)(time + penalty)(time) (p = 0.022) and speed dribbling (p = 0.005). CONCLUSIONS: Soccer specific complex loads generate very high physical demamds. Although complex, the FBKT proved to be a practical assessment tool with high standardising potential. The FBKT gives plentiful information under competition - like conditions such as technical skills, speed, speed endurance or anaerobe capacity.

[Diagnostic tools for endurance testing in handball players]. / Diagnostik der Ausdauerleistungsfähigkeit im Handball.

BACKGROUND: The physiological demands of handball players on international level has increased during the last years mainly due to rule changes. Therefore a scientific funded training method under sports medical supervision gets more and more important. Nevertheless any only limited data are available concerning adequate tests and methods on endurance and sports related assessment of physical performance in handball. OBJECTIVE: Goal of this experimental cross sectional study was to record the endurance of handball players (regional league) in general and related to their sport. This study was performed in conjunction with the development and testing of a new handball specific complexity test (HBKT) and the use of a new lactate analysis software wesp-analysis during a treadmill test (TT). METHODS: 16 semi-professional handball players (mean age: 27.5 +/- 6.78 years) of a regional team were investigated with TT and HBKT on two different days (time delay 72 h). The parameters lactate, heart rate (TT/HBKT) and the time and rate of faults in the HBKT were recorded. RESULTS: The players showed large deficits in basic endurance capacity. There was a great performance difference within the team, especially in the lower intensity regions (< or = 3 mmol/l). Whereas the maximal heart rate was significantly higher in the TT versus the HBKT (TT: 192 +/- 8.67 min (-1) versus HBKT: 180 +/- 9.23 min (-1); p < 0.001; eta(2) = 0.794). The maximum lactate levels showed directly the opposite (10.1 +/- 2.91 mmol/l for TT versus 12.8 +/- 1.99 mmol/l for HBKT; p < 0.001, eta(2) = 0.644). Maximal run velocity (TT) and general performance (HBKT) was related on a mean level (r = -0.566). CONCLUSIONS: The results show the necessity of individual heart rate dependant basic endurance training. The correlation between the tests is a further sign for the significant importance of endurance capacity for sports performance. A comparison of these results to a higher level handball team would yield further information regarding interpretation and grading of the data. HBKT und lactate analysis software wesp-analysis showed to be practical assessment tools.

[Postural deficits and risk of falling in elderly persons with incipient osteoporosis]. / Posturale Defizite und Sturzrisiko bei älteren Personen mit Verdacht auf Osteoporose.

BACKGROUND: Falls and fall-dependent complications represent major problems in geriatrics. Approximately 80-90% of femoral neck fractures in postmenopausal women are caused by falls. STUDY QUESTION: The goal of this study was to evaluate a new posturographic measurement system (Interactive Balance System, IBS) regarding its potential to predict falls in osteoporotic patients. MATERIALS AND METHODS: A total of 228 patients admitted for osteodensitometry because of suspected osteoporosis were included in the study. During the baseline investigation, bone density and postural regulation were measured. Over a follow-up period of 12 months, all falls were recorded in a fall diary. Participants with more than two falls per year were classified as persons at high risk of falling. RESULTS: In patients with confirmed osteoporosis (n=139), the posturographic frequency range F(2-4) was found to be predictive for falls. The ROC analysis of the dependent fall index FIOR(F2-4) showed an AUC value of 0.88. CONCLUSION: IBS is an effective assessment for fall prediction in osteoporosis. Especially peripheral-vestibular regulation mechanisms seem to be of great importance in the evaluated patient group.

[The impact of different sports on posture regulation]. / Der Einfluss unterschiedlicher Sportarten auf die Haltungsregulation.

BACKGROUND: Previous work has suggested that both the level of activity and the type of sport may have a major impact on postural control. However, no systematic investigation has been performed regarding the various types of professional sports. Particularly, the impact of competitional sports on the postural subsystems has not been elucidated so far. OBJECTIVE: The aim of this study was to investigate the influence of the major professional sport types, such as handball, gymnastics, swimming, and shooting, on the subsystems of postural control. We also tested the hypothesis that specific types of sport have specific effects on postural regulation. METHODS: 155 competitive male and female athletes (handball: n = 30; gymnastics: n = 44; swimming: n = 50; shooting: n = 31), and 34 age- and gender-matched controls were investigated using the Interactive Balance System (IBS; Tetrax Inc., Ramat Gan, Israel). The following spectral and time-domain indices were determined: power in the following frequency bands: P(F1) (0.03 - 0.1 Hz), P(F)(2 - 4) (0.1 - 0.5 Hz), P(F)(5 - 6) (0.5 - 1.0 Hz), P(F)(7 - 8) (> 1.0 Hz), stability index (STABI), and synchronisation index (SYN). RESULTS: Shooting athletes exhibited significantly smaller values of P(F1) (p = 0.003), P(F)(2 - 4) (p < 0.001), and P(F)(7 - 8) (p = 0.002), respectively, than the other athletes investigated. Also, the shooting athletes exhibited the smallest STABI values (p = 0.002). In contrast, the gymnasts showed the largest SYN values (p = 0.002). CONCLUSIONS: Different types of competitive sports exert different effects on the various subsystems of posture control, where especially shooting competitors demonstrate a significantly better posture regulation. Those effects can be parameterised and quantified with the IBS which thus enables an efficient and purposeful training. Furthermore, the IBS is highly suitable for aptitude screening in sports with high posture regulatory demands (shooting competitions, gymnastics, diving etc.).

[Prospective comparison of assessments to evaluate fall risk in a nursing home population]. / Prospektiver Vergleich von Assessments zur Beurteilung der Sturzgefahr bei Pflegeheimbewohnern.

BACKGROUND: Falls represent the main health risk in the over-60 age group. Therefore, evaluation of the individual fall risk and assessment of fall mechanisms are important preventive tools. STUDY QUESTION: The goal of this study was to validate a new posturographic measurement system [Interactive Balance System (IBS)] in terms of fall prediction. MATERIALS AND METHODS: In all, 108 subjects (mean age: 81.9+/-9.5 years) were submitted to the IBS, as well as other fall risk assessment methods [FES-1, Timed-Up-and-Go Test, Performance Oriented Mobility Assessment (Tinetti-Test), Chair-Rising-Test, Tandem stance). The follow-up period of 6 months prospectively recorded all falls using a fall diary. RESULTS: Of the nursing home residents studied, 25 (23%) fell at least once. The posturographic fall index FI(F1&WDI) (sensitivity: 88%) and the Timed-Up-and-Go Test (PPV: 38%) showed the best results regarding sensitivity and positive prediction value (PPV). CONCLUSION: The IBS and the Timed-Up-and-Go Test proved to be the most powerful assessment tools for fall prediction. Furthermore, the IBS is able to provide a purposeful adaption of preventive sensomotoric interventions.

[Impact of therapeutic riding on gait and posture regulation]. / Der Einfluss des Therapeutischen Reitens auf den Gang und die Haltungsregulation.

BACKGROUND: Hippotherapy has become an important therapeutic option in patients suffering from motoric dysfunction. The physiologic basis of this approach is the three-dimensional transmission of the horse's motion onto the patients body. These motion stimuli are believed to exert possitve effects on the patients's postural control systems. AIM: To test the hypothesis that hippotherapy has both positive short- and lang-term effects on gait and posture control of persons suffering from motoric disabilities. METHODS: Twenty-two children and adolescents aged 9.69 +/- 4.01 years (range: 9.69 +/- 4.01 years) with motoric dysfunctions were included in a prospective matched control study. In each participant, gait and posture control were investigated on four different occasions (O1 - O4) using the Interactive balance system (IBS; Tetrax Inc., Ramat Gan, Israel) and the portable gait analysis sytem RehaWatch (Hasomed, Magdeburg, Germany). The dates of gait and posture analysis were defined as follows: O 1: immediately prior to first therapeutic riding session (TRS); O 2: immediately after first TRS; O 3: after the last day of an eight weeks period of daily TRS; O 4: seven weeks later after a TRS free interval. RESULTS: The following parameters were slightly improved (adjusted significance level of p < 0.003) after eight weeks of therapeutic riding: (O1 vs. O 3): (1) walking distance (p = 0.009, eta(2) = 0.339); (2) pace frequency (p = 0.007, eta(2) = 0.358); (3) walking speed (p = 0.006, eta(2) = 0.367), and (4) time of attachment (p = 0.007, eta(2) = 0.360). The only short-term effect observed was a significant decrease of the attachment phase (p = 0.002, eta(2) = 0.387). Interestingly, gait symmetry remained unaffected. Posturography (adjusted significance level of p < 0.01) at O 1 versus O 2 (short-term) showed a significant decrease of the performance of both the visual-nigrostriatal subsystem (p < 0.001) and the somato-sensory subsystem (p = 0.001). At O 1 versus O 3 (long-term), the following parameters were sharply decreased: (1) postural stability (p = 0.011), and (2) somatosensory performance (p = 0.011). CONCLUSIONS: In the individuals investigated, an eight weeks series of therapeutic riding did not improve posture control and had only a small positive effect on gait performance. The reasons for these rather disappointing results could have been the low number of therapeutic riding sessions (0.5 sessions per week), and the relatively short duration (30 min) of each session. It remains to be seen, whether a higher density and longer duration of therapeutic riding sessions yields better results.

[Immediate post-operative advantages of minimally invasive hip replacement - results of symmetry and load from the measurement of ground reaction force]. / Frühfunktionelle Vorteile von minimalinvasiv implantierten Hüfttotalendoprothesen - Ganganalytische Befunde zur Symmetrie und Belastung aus der Messung der Bodenreaktionskraft.

AIM: The purpose of this clinical study is to evaluate the postoperative walking ability after total hip replacement (THR) in terms of different surgical approaches by means of an evaluation of gait velocity. METHODS: 21 patients underwent a total hip replacement using an anterolateral minimally invasive modified Watson-Jones approach (MIS group). 20 other patients received a THR using a transgluteal approach (standard group). Differences in functional indices of ground reaction forces and symmetry indices were measured one day pre-operatively, and at 6 and 13 weeks postoperatively on the walkway. The intervention of gait velocity was done by means of a digital metronome. The given step frequences were 70, 90 and 110 steps/minute. The results were compared to an age-matched control group (n = 20). RESULTS: There are significantly reduced pain symptoms in both surgical groups at 6 weeks post-operatively. The MIS group has a higher functional ability, improved symmetry indices of stance time, loading rate and single limb stance compared to the control group at 6 weeks postoperatively. At 13 weeks postoperatively there are no differences between the two surgical groups, except for the parameter "loading rate". The patients in the MIS group had an increasing improvement already at 6 weeks after THR. From 6 to 13 weeks after surgery there were important changes in the control group. CONCLUSION: Obviously, the early postoperative advantages of the minimal invasive approach provide for an improved re-establishment of symmetry and load. In this clinical course study, the proof is validated because the trends in the biomechanical gait parameters are comparable by means of gait velocity standardisation.

[Minimally invasive vs. transgluteal total hip replacement. A 3-month follow-up of a prospective randomized clinical study]. / Minimal-invasiver vs. transglutealer Hüftgelenkersatz. 3-Monats-Follow-up einer prospektiv randomisierten klinischen Studie.

BACKGROUND: The aim of this prospective randomized study was to compare the results after total hip replacement (THR) using an MIS approach versus a regular transgluteal approach (Bauer approach). METHOD: We compared 20 THRs using a modified Watson-Jones minimally invasive approach (MIS group) with 20 conventionally performed THRs using a Bauer approach (control group). In all cases, the same implants (Trilogy cup, MAYO stem) were used. The Harris Hip Score (HHS), the visual analogue scale, myoglobin level, and creatinine kinase level were measured preoperatively and up to 3 months postoperatively. RESULTS: Advantages of the MIS group were evaluated using the HHS in the categories of activity and range of motion 6 weeks postoperatively. In terms of function, gait, and total HHS, we found benefits in the MIS group 6 and 12 weeks postoperatively. Up to 48 h postoperatively, patients in the MIS group had lower myoglobin blood levels. No differences were found in creatinine kinase levels, pain sensation as measured by visual analogue scale, or implant positioning. CONCLUSION: Use of the minimally invasive Watson-Jones approach shows advantages compared with the transgluteal Bauer approach 6 and 12 weeks postoperatively. Up to now there has been no prospective randomized clinical study that has definitely shown the superiority of the minimally invasive procedure. For that reason, the conventional approaches in THR are still the gold standard.

[Measurement of ground reaction forces after total hip arthroplasty using different surgical approaches]. / Ergebnisse aus Messungen der Bodenreaktionskraft vor und nach Implantation einer Hüfttotalendoprothese bei unterschiedlichen Operationszugängen.

AIM: Benefits of less damage of soft tissues and muscles in minimally invasive hip replacement lead to expectations of better results in gait rehabilitation. The aim of the study is to evaluate post-operative walking ability in terms of different surgical approaches. METHOD: 16 patients underwent a minimally invasive total hip replacement (MIS group) and 16 other patients got a THA using a transgluteal approach (standard group). Differences in functional indices of ground reaction forces and symmetry indices were measured one day pre-operatively as well as 8, 14 and 28 weeks post-operatively. The results were compared between the surgical approaches and to an age-matched healthy control group. RESULTS: There are significantly reduced pain symptoms and a higher functional ability in both surgical groups 8 weeks post-operatively. There are no differences in gait parameters between the surgical groups after 28 weeks. Trends in gait velocity, temporal parameters and in functional indices of ground reaction forces show advantages for the minimally invasive group 8 and 14 weeks post-operatively. Patients do not reach the age-matched control group. CONCLUSION: Obviously the immediate post-operative advantages of minimally invasive hip replacement provide better chances for gait rehabilitation compared to the transgluteal approach. Due to the complexity of the problem clinical and gait analysis studies should be linked more closely.

[Coordinative treatment and quality of life - a randomised trial of nurses with back pain]. / Koordinationstraining und Lebensqualität - Eine Längsschnittuntersuchung bei Pflegepersonal mit Rückenschmerzen.

BACKGROUND DATA: The influence of strength training on back conditions has been demonstrated quite well, whereas coordinative training being a major component of physical therapy regarding preventive and rehabilitative treatment of back pain is used only occasionally and has been evaluated even more rarely. One has to consider this fact regarding the still growing number of musculo-skeletal diseases. AIM OF STUDY: The influence of several preventive therapies (coordination training in spacecurl, kinaesthetics/back protective patient transfer) has been investigated with regard to coordination, back pain and quality of life in a randomised controlled study. METHODS: We used an assessment-set consisting of a specially devised questionnaire regarding job demands, sports activity and back pain and the WHOQOL-BREF for control of quality of life. These methods were combined with body surface electromyography and posturography. Those methods enabled us to determine parameters such as coordination, back pain and quality of life at 3 different stages (untrained individuals) and 4 points (trained individuals) respectively. RESULTS: Trained individuals showed a significant reduction of back pain frequency (p = 0.016) before and after training. In comparison there was no difference in untrained individuals. Furthermore trained individuals showed an increase in quality of life of 5.4 % (p = 0.028), whereas again there was no difference in untrained individuals. Somatic diagnostics (body surface electromyography, posturography) showed significant changes only in the trained group. CONCLUSION: The used coordination training program is enhancing coordination and reducing back pain whilst having a positive effect upon the quality of life of an individual.