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Friebe D, Hülsdünker T, Giesche F, Banzer W, Pfab F, Haser C, Vogt L. Reliability and Usefulness of the SKILLCOURT as a Computerized Agility and Motor-Cognitive Testing Tool. Med Sci Sports Exerc 2023; 55:1265-1273. [PMID: 36878188 DOI: 10.1249/mss.0000000000003153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
INTRODUCTION Agility and cognitive skills are essential in sports. However, standardized agility assessment tools often lack a reactive component, and cognitive assessments are performed using computer-based or paper-pencil tests. The SKILLCOURT is a newly developed testing and training device allowing agility and cognitive assessments in a more ecologically valid setting. This study evaluated the reliability and sensitivity to changes in performance (usefulness) of the SKILLCOURT technology. METHODS In a test-retest (7 d, 3 months) design, 27 healthy adults (♀ = 12; age, 24.9 ± 3.3 yr) performed three trials of agility (Star Run, Random Star Run) and motor-cognitive tests (1-back, 2-back, executive function). Absolute and relative intersession and intrasession reliability was determined using the intraclass coefficient (ICC) and coefficient of variation (CV). A repeated-measures ANOVA was applied to identify potential learning effects between trials and test sessions. The smallest worthwhile change and typical error (TE) were calculated to investigate the intrasession and intersession usefulness of the tests. RESULTS Agility tests revealed good relative and absolute intersession (ICC, 83-0.89; CV, 2.7%-4.1%) and intrasession (ICC, 7-0.84; CV, 2.4%-5.5%) reliability accompanied by adequate usefulness from test day 3 onward. Motor-cognitive tests showed good relative intersession reliability (ICC, 0.7-0.77) with marginal CV values (4.8%-8.6%). Adequate intrasession reliability and usefulness can be assumed from test day 2 (1-back test, executive function test) and day 3 (2-back test) onward. For all tests, learning effects were observed within and compared with test day 1. CONCLUSIONS The SKILLCOURT is a reliable diagnostic tool for assessing reactive agility and motor-cognitive performance. Because of learning effects, sufficient familiarization with the tests is required when used for diagnostic purposes.
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Affiliation(s)
- David Friebe
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Goethe University, Frankfurt, GERMANY
| | | | - Florian Giesche
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Goethe University, Frankfurt, GERMANY
| | | | - Florian Pfab
- Medical Department Eintracht Frankfurt, Frankfurt/Main, GERMANY
| | - Christian Haser
- Medical Department Eintracht Frankfurt, Frankfurt/Main, GERMANY
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt/Main, GERMANY
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Hülsdünker T, Friebe D, Giesche F, Vogt L, Pfab F, Haser C, Banzer W. Validity of the SKILLCOURT® technology for agility and cognitive performance assessment in healthy active adults. J Exerc Sci Fit 2023; 21:260-267. [PMID: 37497363 PMCID: PMC10366450 DOI: 10.1016/j.jesf.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 07/28/2023] Open
Abstract
Background/Objectives Agility and cognitive abilities are typically assessed separately by different motor and cognitive tests. While many agility tests lack a reactive decision-making component, cognitive assessments are still mainly based on computer-based or paper-pencil tests with low ecological validity. This study is the first to validate the novel SKILLCOURT technology as an integrated assessment tool for agility and cognitive-motor performance. Methods Thirty-two healthy adults performed agility (Star Run), reactive agility (Random Star Run) and cognitive-motor (executive function test, 1-back decision making) performance assessments on the SKILLCOURT. Cognitive-motor tests included lower limb responses in a standing position to increase the ecological validity when compared to computer-based tests. Test results were compared to established motor and agility tests (countermovement jump, 10 m linear sprint, T-agility tests) as well as computer-based cognitive assessments (choice-reaction, Go-NoGo, task switching, memory span). Correlation and multiple regression analyses quantified the relation between SKILLCOURT performance and motor and cognitive outcomes. Results Star Run and Random Star Run tests were best predicted by linear sprint (r = 0.68, p < 0.001) and T-agility performance (r = 0.77, p < 0.001), respectively. The executive function test performance was well explained by computer-based assessments on choice reaction speed and cognitive flexibility (r = 0.64, p < 0.001). The 1-back test on the SKILLCOURT revealed moderate but significant correlations with the computer-based assessments (r = 0.47, p = 0.007). Conclusion The results support the validity of the SKILLCOURT technology for agility and cognitive assessments in more ecologically valid cognitive-motor tasks. This technology provides a promising alternative to existing performance assessment tools.
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Affiliation(s)
- Thorben Hülsdünker
- Department of Exercise and Sport Science, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
- Luxembourg Health & Sport Sciences Research Institute (LHSSRI), Differdange, Luxembourg
| | - David Friebe
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Goethe University, Frankfurt, Germany
| | - Florian Giesche
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Goethe University, Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt/Main, Germany
| | - Florian Pfab
- Medical Department Eintracht Frankfurt, Frankfurt, Germany
| | | | - Winfried Banzer
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Goethe University, Frankfurt, Germany
- Medical Department Eintracht Frankfurt, Frankfurt, Germany
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Giesche F, Rink J, Füzéki E, Banzer W. Health-promotion Counseling And Offers For Parents Of Children With Disabilities. A Public Health Pilot Project. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000878740.26230.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ashigbi EYK, Giesche F, Niederer D, Weßler L, Friebe D, Groneberg DA, Banzer W. Anterior Cruciate Ligament Reconstruction And Alterations In Biomechanical Landing-stability And Decision-making Quality During Unanticipated Jump-landings. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000877620.35760.3d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Friebe D, Fischer M, Giesche F, Füzéki E, Banzer W. Auswirkungen des COVID-19-Lockdowns auf physische Leistungsparameter im professionellen Fußball. Zbl Arbeitsmed 2022; 72:89-97. [PMID: 35095213 PMCID: PMC8785923 DOI: 10.1007/s40664-022-00455-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 11/27/2022]
Abstract
Zusammenfassung
Hintergrund
Die staatlichen Maßnahmen zur Eindämmung des Coronavirus SARS-CoV‑2 im Jahr 2020 brachten den Trainings- und Wettkampfbetrieb im professionellen Fußball in vielen Ländern zum zeitweiligen Erliegen. In Folge des Lockdowns waren die Trainingsmöglichkeiten zumeist auf unspezifische heimbasierte Trainingsmethoden begrenzt. Es ist unklar, ob sich die fehlenden sportspezifischen Belastungsreize negativ auf die physische Leistungsfähigkeit der Fußballspielenden auswirkten.
Methodik
Im Rahmen eines narrativen Reviews wurde mittels einer selektiven Literaturrecherche in den Datenbanken PubMed, Google Scholar und BISp-Surf nach Studien gesucht, welche die Auswirkungen des Lockdowns auf physische Leistungsparameter bei erwachsenen professionellen Fußballspielenden untersuchten.
Ergebnisse
In die Übersichtsarbeit wurden sechs prospektive Längsschnittstudien eingeschlossen. In allen Studien kam während der Quarantäne ein heimbasiertes Ersatztraining zum Einsatz. Vier Studien verglichen die Leistungsfähigkeit der Fußballer/-innen mit Leistungsdaten aus vorherigen Spielzeiten. Zwei Studien ermittelten die Leistungsfähigkeit der Sportler/-innen unmittelbar vor und nach der Lockdownperiode.
Diskussion
Während die allgemeine Kraft- und Ausdauerleistung durch heimbasierte Ersatztrainingsprogramme erhalten werden kann, weisen die Studien darauf hin, dass sich die fehlenden spezifischen Belastungsreize vor allem negativ auf die Schnelligkeits- und Schnellkraftleistung der Fußballspielenden auswirken könnten. Bei Rückkehr in den regulären Trainingsbetrieb sollte daher auf eine progressive Belastungssteuerung insbesondere im Schnelligkeitstraining geachtet werden, um das Risiko für Verletzungen zu senken.
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Affiliation(s)
- D. Friebe
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Arbeitsbereich Präventiv- und Sportmedizin, Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt/Main, Deutschland
| | - M. Fischer
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Arbeitsbereich Präventiv- und Sportmedizin, Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt/Main, Deutschland
| | - F. Giesche
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Arbeitsbereich Präventiv- und Sportmedizin, Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt/Main, Deutschland
| | - E. Füzéki
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Arbeitsbereich Präventiv- und Sportmedizin, Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt/Main, Deutschland
| | - W. Banzer
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Arbeitsbereich Präventiv- und Sportmedizin, Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt/Main, Deutschland
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Friebe D, Giesche F, Niederer D, Ashigbi EYK, Groneberg DA, Banzer W. Acute effects of an injury preventive warmup programme on unanticipated jump-landing-task performance in adult football players: A crossover trial. Eur J Sport Sci 2021; 22:1630-1639. [PMID: 34334102 DOI: 10.1080/17461391.2021.1963322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
HIGHLIGHTS Adapting movements rapidly to unanticipated external stimuli (e.g. unexpected landings) is crutial to prevent injuries in footballIt is unclear wether popular neuromuscular injury preventive warmup programmes (e.g. Prevent injury and Enhance Performance (PEP)) adaquatly prepare athletes for these situationsOur study shows that the PEP warm up programme has acute effects on anticipated landing stability, but no influence on unanticipated landings or decision making qualityClassic neuromuscular warm up programmes may not be the optimal choice to prepare athletes properly for the upcoming motor-cognitive demands in a football match.
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Affiliation(s)
- David Friebe
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt, Germany
| | - Florian Giesche
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt, Germany
| | - Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Goethe University, Frankfurt, Germany
| | - Evans Y K Ashigbi
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt, Germany.,Department of Physiotherapy and Rehabilitation Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Hohoe, Ghana
| | - David A Groneberg
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt, Germany
| | - Winfried Banzer
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt, Germany
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Giesche F, Stief F, Groneberg DA, Wilke J. Effect of unplanned athletic movement on knee mechanics: a systematic review with multilevel meta-analysis. Br J Sports Med 2021; 55:1366-1378. [PMID: 34344709 DOI: 10.1136/bjsports-2021-103933] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To compare the effects of pre-planned and unplanned movement tasks on knee biomechanics in uninjured individuals. DESIGN Systematic review with meta-analysis. DATA SOURCES Five databases (PubMed, Google Scholar, Cochrane Library, ScienceDirect and Web of Science) were searched from inception to November 2020. Cross-sectional, (randomised) controlled/non-controlled trials comparing knee angles/moments of pre-planned and unplanned single-leg landings/cuttings were included. Quality of evidence was assessed using the tool of the Grading of Recommendations Assessment, Development and Evaluation working group. METHODS A multilevel meta-analysis with a robust random-effects meta-regression model was used to pool the standardised mean differences (SMD) of knee mechanics between pre-planned and unplanned tasks. The influence of possible effect modifiers (eg, competitive performance level) was examined in a moderator analysis. RESULTS Twenty-five trials (485 participants) with good methodological quality (Downs and Black) were identified. Quality of evidence was downgraded due to potential risk of bias (eg, confounding). Moderate-quality evidence indicates that unplanned tasks evoked significantly higher external knee abduction (SMD: 0.34, 95% CI: 0.16 to 0.51, 14 studies) and tibial internal rotation moments (SMD: 0.51, 95% CI: 0.23 to 0.79, 11 studies). No significant between-condition differences were detected for sagittal plane mechanics (p>0.05). According to the moderator analysis, increased abduction moments particularly occurred in non-professional athletes (SMD: 0.55, 95% CI: 0.14 to 0.95, 5 studies). CONCLUSION Unplanned movement entails higher knee abduction and tibial internal rotation moments, which could predispose for knee injury. Exercise professionals designing injury-prevention protocols, especially for non-elite athletes, should consider the implementation of assessments and exercises requiring time-constrained decision-making. PROSPERO REGISTRATION NUMBER CRD42019140331.
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Affiliation(s)
- Florian Giesche
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Felix Stief
- University Hospital Frankfurt, Department of Orthopedics (Friedrichsheim), Movement Analysis Lab, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - David A Groneberg
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jan Wilke
- Division of Health and Performance, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
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Giesche F, Vieluf S, Wilke J, Engeroff T, Niederer D, Banzer W. Cortical Motor Planning and Biomechanical Stability During Unplanned Jump-Landings in Males With ACL-Reconstruction. J Athl Train 2021; 57:547-556. [PMID: 35969662 PMCID: PMC9387379 DOI: 10.4085/1062-6050-0544.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Athletes with anterior cruciate ligament (ACL) reconstruction exhibit increased cortical motor planning during simple sensorimotor tasks compared to healthy controls. This may interfere with proper decision-making during time-constrained movements elevating the re-injury risk. OBJECTIVE To compare cortical motor planning and biomechanical stability during jump-landings between participants with ACL-reconstruction and healthy individuals. DESIGN Cross-sectional exploratory study. SETTING Laboratory patients or other participants: Ten males with ACL-reconstruction (28±4 yrs., 63±35 months post-surgery) and 17 healthy males (28±4 yrs.) completed pre-planned (landing leg shown before take-off; n=43±4) and unplanned (visual cue during flight; n=51±5) countermovement-jumps with single-leg-landings. MAIN OUTCOME MEASURES Movement-related cortical potentials (MRCP) and frontal theta frequency power before the jump were analyzed using electroencephalography. MRCP were subdivided into three successive 0.5 sec epochs (readiness potential 1 and 2; RP and negative slope; NS) relative to movement onset (higher values indicative of more motor planning). Theta power was calculated for the last 0.5 sec prior to movement onset (higher values indicative of more focused attention). Biomechanical landing stability was measured via vertical peak ground reaction force, time to stabilization, and center of pressure. RESULTS Both conditions evoked MRCP at all epochs in both groups. During the unplanned condition, the ACL-reconstructed group exhibited slightly, but not significantly higher MRCP (RP-1:p=0.651, d=0.44, RP-2:p=0.451, d=0.48; NS:p=0.482, d=0.41). The ACL-reconstructed group also showed slightly higher theta power values during the pre-planned (p=0.175, d=0.5) and unplanned condition (p=0.422, d=0.3) reaching small to moderate effect sizes. In none of the biomechanical outcomes, both groups differed significantly (p>0.05). No significant condition and group interactions occurred (p>0.05). CONCLUSIONS Our jump-landing task evoked MRCP. Although not significant between groups, the observed effect sizes provide first indication that males with ACL-reconstruction may persistently rely on more cortical motor planning associated with unplanned jump-landings. Confirmatory studies with larger sample sizes are warranted. TRIAL REGISTRY clinicalTrials.gov (NCT03336060).
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Affiliation(s)
| | | | - Jan Wilke
- *Goethe University, Frankfurt am Main, Germany
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Friebe D, Engeroff T, Giesche F, Niederer D. Effects of Open Skill Visuomotor Choice Reaction Time Training on Unanticipated Jump-Landing Stability and Quality: A Randomized Controlled Trial. Front Hum Neurosci 2021; 15:683909. [PMID: 34393739 PMCID: PMC8358675 DOI: 10.3389/fnhum.2021.683909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/09/2021] [Indexed: 11/30/2022] Open
Abstract
Adapting movements rapidly to unanticipated external stimuli is paramount for athletic performance and to prevent injuries. We investigated the effects of a 4-week open-skill choice-reaction training intervention on unanticipated jump-landings. Physically active adults (n = 37; mean age 27, standard deviation 2.7 years, 16 females, 21 males) were randomly allocated to one of two interventions or a control group (CG). Participants in the two intervention groups performed a 4-week visuomotor open skill choice reaction training, one for the upper and one for the lower extremities. Before and after the intervention, two different types of countermovement jumps with landings in split stance position were performed. In the (1) pre-planned condition, we informed the participants regarding the landing position (left or right foot in front position) before the jump. In the (2) unanticipated condition, this information was displayed after take-off (350–600 ms reaction time before landing). Outcomes were landing stability [peak vertical ground reaction force (pGRF) and time to stabilization (TTS)], and landing-related decision-making quality (measured by the number of landing errors). To measure extremity-specific effects, we documented the number of correct hits during the trained drills. A two-factorial (four repeated measures: two conditions, two time factors; three groups) ANCOVA was carried out; conditions = unanticipated versus pre-planned condition, time factors = pre versus post measurement, grouping variable = intervention allocation, co-variates = jumping time and self-report arousal. The training improved performance over the intervention period (upper extremity group: mean of correct choice reaction hits during 5 s drill: +3.0 hits, 95% confidence interval: 2.2–3.9 hits; lower extremity group: +1.6 hits, 0.6–2.6 hits). For pGRF (F = 8.4, p < 0.001) and landing errors (F = 17.1, p < 0.001) repeated measures effect occurred. Significantly more landing errors occurred within the unanticipated condition for all groups and measurement days. The effect in pGRF is mostly impacted by between-condition differences in the CG. No between-group or interaction effect was seen for these outcomes: pGRF (F = 0.4, p = 0.9; F = 2.3, p = 0.1) landing errors (F = 0.5, p = 0.6; F = 2.3, p = 0.1). TTS displayed a repeated measures (F = 4.9, p < 0.001, worse values under the unanticipated condition, improvement over time) and an interaction effect (F = 2.4, p = 0.03). Healthy adults can improve their choice reaction task performance by training. As almost no transfer to unanticipated landing successfulness or movement quality occurred, the effect seems to be task-specific. Lower-extremity reactions to unanticipated stimuli may be improved by more specific training regimens.
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Affiliation(s)
- David Friebe
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Tobias Engeroff
- Department of Health and Performance, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Florian Giesche
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Frankfurt, Germany
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Giesche F, Niederer D, Banzer W, Vogt L. Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-related and self-reported knee function: A systematic review. PLoS One 2020; 15:e0240192. [PMID: 33112865 PMCID: PMC7592749 DOI: 10.1371/journal.pone.0240192] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 09/22/2020] [Indexed: 12/26/2022] Open
Abstract
Study design Systematic review. Background and objectives Preoperative neuromuscular function is predictive for knee function and return to sports (RTS) after reconstruction of the anterior cruciate ligament (ACL). The aim of this review was to examine the potential benefits of prehabilitation on pre-/postoperative objective, self-reported and RTS-specific outcomes. Methods A systematic search was conducted within three databases. From the 1.071 studies screened, two randomized control trials (RCTs), two control trials (CTs) and two cohort studies (CS) met the inclusion criteria. Methodological quality rating adopted the PEDro- (RCT, CT) or Newcastle-Ottawa-Scale (CS). Results and conclusions Methodological quality of the included studies was moderate (PEDro score: 6.5 ± 1.7; range 4 to 9). Two studies reported higher increases of the maximal quadriceps torque from baseline to pre-reconstruction: one study in the limb symmetry index (LSI), and one in both legs of the prehabilitation group compared to the controls. At 12-weeks post-reconstruction, one study (from two) indicated that the prehabilitation group had a lesser post-operative decline in the single-leg-hop for distance LSI (clinically meaningful). Similar findings were found in terms of quadriceps strength LSI (one study). At both pre-reconstruction (three studies) and two-year post-surgery (two studies), the prehabilitation groups reached significantly higher self-reported knee function (clinically meaningful) than the controls. RTS tended to be faster (one study). At two years post-surgery, RTS rates (one study) were higher in the prehabilitation groups. The results provide evidence for the relevance of prehabilitation prior to ACL-reconstruction to improve neuromuscular and self-reported knee function as well as RTS. More high quality confirmatory RCTs are warranted. Registration number PROSPERO 2017: CRD42017065491.
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Affiliation(s)
- Florian Giesche
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt/Main, Germany
- * E-mail:
| | - Daniel Niederer
- Department of Sports Medicine & Exercise Physiology, Institute of Sports Sciences, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Winfried Banzer
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine & Exercise Physiology, Institute of Sports Sciences, Goethe University Frankfurt, Frankfurt/Main, Germany
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Giesche F, Vieluf S, Wilke J, Engeroff T, Niederer D, Banzer W. Does ACL-reconstruction Lead To Higher Use Of Neural Resources To Prepare & Initiate Challenging Jump-landings? Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000681008.34970.a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Engeroff T, Giesche F, Friebe D, Wilke J, Vogt L, Banzer W, Niederer D. Lower Extremity Open Skill Training Effects on Perception of Visual Stimuli, Cognitive Processing, and Performance. J Mot Behav 2020; 53:324-333. [PMID: 32536289 DOI: 10.1080/00222895.2020.1776674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This study investigates if lower extremity open-skill training impacts perception and cognitive processing abilities or just influences task related motor abilities. Twenty-two participants (24.7 ± 2.4years; 11 males, 11 females) were randomly allocated either into the group that trained on a computerized device or to the control group. Prior to and following the 4-week study period, motor performance was assessed using drop jump, hexagon test, postural control and lower extremity choice reaction. Perception, cognitive processing and task inhibition were captured using validated neurocognitive tests. Repeated measurements analyses of co-variances (ANCOVAs) were performed. They revealed a time (before and after intervention) × group (training vs. control) effect on lower extremity choice reaction and hexagon (p < .05). No effects on group differences or between groups in cognitive performance were found. A detrimental effect of training on accuracy of task inhibition (lower percentage of correct inhibitions) was detected. Computerized open skill training affects specific movement patterns without increasing task-relevant cognitive or perceptual abilities. Indicated by the lower percentage of correct inhibitions, the training might further detrimentally influence the risk-taking behavior during choice reaction tasks.
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Affiliation(s)
- Tobias Engeroff
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Florian Giesche
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - David Friebe
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Jan Wilke
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Winfried Banzer
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Frankfurt, Germany
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Wilke J, Giesche F, Klier K, Vogt L, Herrmann E, Banzer W. Acute Effects of Resistance Exercise on Cognitive Function in Healthy Adults: A Systematic Review with Multilevel Meta-Analysis. Sports Med 2020; 49:905-916. [PMID: 30838520 DOI: 10.1007/s40279-019-01085-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Recent research has revealed a beneficial impact of chronic resistance exercise (RE) on brain function. However, it is unclear as to whether RE is also effective in an acute setting. OBJECTIVE To investigate the immediate effects of a single RE session on cognitive performance in healthy adults. METHODS A multilevel meta-analysis with random effects meta-regression model was used to pool the standardized mean differences (SMD) between RE and no-exercise (NEX) as well as between RE and aerobic exercise (AE). In addition to global cognitive function, effects on reported sub-domains (inhibitory control, cognitive flexibility, working memory, attention) were examined. RESULTS Twelve trials with fair methodological quality (PEDro scale) were identified. Compared to NEX, RE had a positive effect on global cognition (SMD: 0.56, 95% CI 0.22-0.90, p = 0.004), but was not superior to AE (SMD: - 0.10, 95% CI 0.01 to - 0.20, p = 0.06). Regarding cognitive sub-domains, RE, compared to NEX, improved inhibitory control (SMD: 0.73, 95% CI 0.21-1.26, p = 0.01) and cognitive flexibility (SMD: 0.36, 95% CI 0.17-0.55, p = 0.004). In contrast, working memory (SMD: 0.35, 95% CI - 0.05 to 0.75, p = 0.07) and attention (SMD: 0.79, 95% CI - 0.42 to 2.00, p = 0.16) remained unaffected. No significant differences in sub-domains were found between RE and AE (p > 0.05). CONCLUSION RE appears to be an appropriate method to immediately enhance cognitive function in healthy adults. Further studies clearly elucidating the impact of effect modifiers such as age, training intensity, or training duration are warranted.
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Affiliation(s)
- Jan Wilke
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt/Main, Germany.
| | - Florian Giesche
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Kristina Klier
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Winfried Banzer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt/Main, Germany
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Niederer D, Giesche F, Janko M, Niemeyer P, Wilke J, Engeroff T, Stein T, Frank J, Banzer W, Vogt L. Unanticipated jump-landing quality in patients with anterior cruciate ligament reconstruction: How long after the surgery and return to sport does the re-injury risk factor persist? Clin Biomech (Bristol, Avon) 2020; 72:195-201. [PMID: 31901699 DOI: 10.1016/j.clinbiomech.2019.12.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/05/2019] [Accepted: 12/23/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Inadequate reactions to unforeseen external stimuli are regarded as a major cause for non-contact anterior cruciate ligament (ACL) injuries. We aimed to delineate a potential deficit in the ability to perform unanticipated jump-landing manoeuvres, its sustainability and potential as a new outcome measure after ACL-reconstruction. METHODS Physically active adults (n = 27, 13 females, 14 males, 29.7 standard deviation 3.1 years) with a history of unilateral ACL rupture and subsequent reconstruction (6 months to 7 years ago), cleared for return to sports, were included. All participants performed counter-movement jumps with unanticipated single leg landings. Visual information shown after jump take-off indicated the required landing leg. Jump time [s] and successfulness [yes/no], vertical peak ground reaction forces at landing [N], as well as time to stabilisation after landing [s] and path length of the centre of pressure (CoP, [mm]) were calculated. Limb symmetry ratios were determined and analysed for their association with the time since surgery. FINDINGS Time since ACL reconstruction was logarithmically (basis 10) associated with side symmetry improvements in peak ground reaction force (R2 = 0.23, p < .01) and time to stabilisation (R2 = 0.18, p < .01) during and after landing in unanticipated/unpredictable single-leg jump landing tasks. The asymmetry found persists up to 18-26 months post-surgery. INTERPRETATION A deficit in unanticipated jump-landing ability seems to persist far beyond surgical restoration of mechanical stability and resumption of initial physical activities levels. The assessment of the ability to suddenly adapt movements to unanticipated visual stimuli may be a relevant complementary component within current functional testing canon in monitoring therapy success and return to sport testing.
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Affiliation(s)
- Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Germany.
| | - Florian Giesche
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Maren Janko
- Department of Trauma- Hand and Reconstructive Surgery, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Philipp Niemeyer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Germany
| | - Jan Wilke
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Germany
| | - Tobias Engeroff
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Germany
| | - Thomas Stein
- Department of Sport Traumatology-, Knee- and Shoulder-Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Germany
| | - Johannes Frank
- Department of Trauma- Hand and Reconstructive Surgery, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Winfried Banzer
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Germany
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Giesche F, Wilke J, Engeroff T, Niederer D, Hohmann H, Vogt L, Banzer W. Are biomechanical stability deficits during unplanned single-leg landings related to specific markers of cognitive function? J Sci Med Sport 2020; 23:82-88. [DOI: 10.1016/j.jsams.2019.09.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 09/02/2019] [Accepted: 09/04/2019] [Indexed: 01/13/2023]
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Niemeyer P, Niederer D, Giesche F, Janko M, Frank J, Vogt L, Banzer W. Unanticipated jump-landing after anterior cruciate ligament reconstruction: Does unanticipated jump-landing testing deliver additional return to sport information to traditional jump performance tests? Clin Biomech (Bristol, Avon) 2019; 70:72-79. [PMID: 31408765 DOI: 10.1016/j.clinbiomech.2019.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/01/2019] [Accepted: 08/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND We aimed to delineate if unanticipated jump-landing assessments delivers complementary information to those of commonly used hop and jump tests after anterior cruciate ligament reconstruction. METHODS Eleven participants (5 males) performed a series of unanticipated jump-landings and traditional hop and jump performance tests (single leg hops for distance, triple crossover hops for distance and drop jumps). The number of mistrials, time to stabilization and peak ground reaction force (pGRF) at landing and jump/hop distance were measured. Pearson correlations to find potential associations between the unanticipated jump-landing-values and the traditional jump/hop performance tests were calculated twice: once for the affected and once for the unaffected legs. t-Tests for dependent samples were used to detect differences between affected and unaffected leg within each test condition. FINDINGS The pGRF at unanticipated landing significantly correlated to the pGRF at drop jump landing (r = 0.68) and the hopping distance after the triple crossover hops (r = 0.71, each p < .05). No other significant correlation occurred (p > .05). Hopping distance after single leg hops (mean: 110.2 cm vs. 95.5 cm) and triple crossover hops for distance (mean: 315.3 cm vs. 294.2 cm) showed significant differences between the unaffected and the reconstructed leg (p < .05). Other parameters showed no significant between-legs differences (p > .05). INTERPRETATION Both, the reconstructed and the contralateral leg seems to be affected. Unanticipated jump landing tasks deliver information beyond those of commonly used jump and hop tests, the thereby assessed abilities may thus be a complementary aspect of dynamic knee function than those assessed with classic tests.
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Affiliation(s)
- Philipp Niemeyer
- Department of Sports Medicine, Goethe University Frankfurt am Main, Germany.
| | - Daniel Niederer
- Department of Sports Medicine, Goethe University Frankfurt am Main, Germany; Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Germany
| | - Florian Giesche
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Germany
| | - Maren Janko
- Department of Trauma- Hand and Reconstructive Surgery, Hospital of the Goethe-University Frankfurt am Main, Germany
| | - Johannes Frank
- Department of Trauma- Hand and Reconstructive Surgery, Hospital of the Goethe-University Frankfurt am Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University Frankfurt am Main, Germany
| | - Winfried Banzer
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Germany
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Niederer D, Willberg C, Kruse A, Exler N, Giesche F, Vogt L, Banzer W. Acute effects of preventive warm-up exercises on modifiable risk factors for anterior cruciate ligament injuries: a three-arm randomized-controlled crossover trial. J Sports Med Phys Fitness 2019; 60:92-101. [PMID: 31663311 DOI: 10.23736/s0022-4707.19.09949-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND We aimed to compare the potential acute effects of single bouts of a classic prevention and a risk factor-focus training aiming to target modifiable anterior cruciate ligament (ACL) rupture risk factors and the impact of neuromuscular fatigue on relevant ACL rupture risk factors. METHODS Two preventive warm-up (standard and ACL rupture risk factor training) and one inactive arm were compared; each of these were followed by a standardized neuromuscular fatigue protocol. The assessments included two Trail making tests (TMT-A; TMT-B, time to complete), drop jump landings (knee separation distance, normalized at hip width), as well as unanticipated counter movement jump landings (time to stabilization and peak ground reaction force). RESULTS We included 18 participants (25±2years). No differences were found between times and conditions for TMT (P>0.05). A significant time effect occurred in time to stabilization (F=2.6; P<0.05) and a significant time*baseline-value*jumping time interaction was seen in peak ground reaction force (F=3.1; P<0.05). No time effect was found for any knee separation distance (F=.1-2.4; P>0.05); but a significant time*baseline-value*jumping time interaction was seen at initial ground contact (F=2.8; P<0.05), and lowest point (F=4.2; P<0.01). CONCLUSIONS Risk factor-focus and classic warm-up may not differ in their acute effects on modifiable functional ACL (re-)injury risks factors.
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Affiliation(s)
- Daniel Niederer
- Department of Sports Medicine, Goethe University, Frankfurt, Germany -
| | - Christina Willberg
- Department of Sports Medicine, Goethe University, Frankfurt, Germany.,Department of Movement and Training Science, Goethe University, Frankfurt, Germany
| | - Adele Kruse
- Department of Sports Medicine, Goethe University, Frankfurt, Germany
| | - Nicola Exler
- Department of Sports Medicine, Goethe University, Frankfurt, Germany
| | - Florian Giesche
- Department of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University, Frankfurt, Germany
| | - Winfried Banzer
- Department of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt, Germany
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Niederer D, Plaumann U, Seitz T, Wallner F, Wilke J, Engeroff T, Giesche F, Vogt L, Banzer W. How does a 4-week motor-cognitive training affect choice reaction, dynamic balance and cognitive performance ability? A randomized controlled trial in well-trained, young, healthy participants. SAGE Open Med 2019; 7:2050312119870020. [PMID: 31448120 PMCID: PMC6693023 DOI: 10.1177/2050312119870020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/25/2019] [Indexed: 12/27/2022] Open
Abstract
Background: We aimed to investigate the potential effects of a 4-week motor–cognitive
dual-task training on cognitive and motor function as well as exercise
motivation in young, healthy, and active adults. Methods: A total of 26 participants (age 25 ± 2 years; 10 women) were randomly
allocated to either the intervention group or a control group. The
intervention group performed a motor–cognitive training (3×/week), while the
participants of the control group received no intervention. Before and after
the intervention period of 4 weeks, all participants underwent cognitive
(d2-test, Trail Making Test) and motor (lower-body choice reaction test and
time to stabilization test) assessments. Following each of the 12 workouts,
self-reported assessments (rating of perceived exertion, enjoyment and
pleasant anticipation of the next training session) were done. Analyses of
covariances and 95% confidence intervals plotting for between group and time
effects were performed. Results: Data from 24 participants were analysed. No pre- to post-intervention
improvement nor a between-group difference regarding motor outcomes
(choice-reaction: F = 0.5; time to stabilization test: F = 0.7; p > 0.05)
occurred. No significant training-induced changes were found in the
cognitive tests (D2: F = 0.02; Trail Making Test A: F = 0.24; Trail Making
Test B: F = 0.002; p > 0.05). Both enjoyment and anticipation of the next
workout were rated as high. Discussion: The neuro-motor training appears to have no significant effects on motor and
cognitive function in healthy, young and physically active adults. This
might be explained in part by the participants’ very high motor and
cognitive abilities, the comparably low training intensity or the programme
duration. The high degree of exercise enjoyment, however, may qualify the
training as a facilitator to initiate and maintain regular physical
activity. The moderate to vigorous intensity levels further point towards
potential health-enhancing cardiorespiratory effects.
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Affiliation(s)
- Daniel Niederer
- Department of Sports Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Ulrike Plaumann
- Department of Sports Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Tanja Seitz
- Department of Sports Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Franziska Wallner
- Department of Sports Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Jan Wilke
- Department of Sports Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Tobias Engeroff
- Department of Sports Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Florian Giesche
- Department of Sports Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Winfried Banzer
- Department of Sports Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
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Giesche F, Wilke J, Engeroff T, Niederer D, Vogt L, Banzer W. Cognition Matters: Brain Function May Explain Deficiencies In Unanticipated Single-leg Landing Quality. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000561308.27348.f6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Wilke J, Giesche F, Niederer D, Engeroff T, Barabas S, Tröller S, Vogt L, Banzer W. Is Visual-Cognitive Loading During Jumping A Potential Risk Factor For Sports Injuries? Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000562328.32242.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Giesche F, Krause F, Niederer D, Wilke J, Engeroff T, Vogt L, Banzer W. Visual and instrumental diagnostics using chromokinegraphics: Reliability and validity for low back pain stratification. J Back Musculoskelet Rehabil 2019; 32:345-353. [PMID: 30412482 DOI: 10.3233/bmr-181203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low back pain patients have been suggested to exhibit dysfunctional spinal movement patterns. However, there is a lack of clinically applicable but valid and reliable assessment tools, helping to discriminate normal and pathologically altered movement. OBJECTIVE We aimed to examine whether kinematic parameters determined with an ultrasound-based motion analysis and thereof derived chromokinegraphical angle-time matrices (CATMAs) are able to discriminate between non-symptomatic and symptomatic movement behaviour in individuals with non-specific chronic (CLBP), specific low back pain (SLBP), and controls. METHODS Thoracic and lumbar spine range of motion (ROM [∘]); angular velocity (V [∘/sec]) and side-to-side differences [%] during a lateral flexion movement were assessed in 17 healthy participants, 16 individuals with CLBP and 11 SLBP patients. CATMAs ratings of two investigators (6-item Likert scale) were dichotomised, classifying the observed movement as physiological or non-physiological. Intrarater and interrater reliability were estimated using kappa statistics and Cronbach's Alpha. T-tests and a ROC analysis to determine optimal cut-offs for the separation of the collectives as well as contingency tables for selectivity of the cut-offs (motor outcomes) were calculated. RESULTS CATMA ratings displayed partly moderate to good (rater B; i.e. CLBP vs. controls) and partly insufficient discriminant validity (rater A). Due to this, inter-rater reliability was poor (k= 0.061 to 0.135), while intra-rater-reliability was moderate to good for both raters (k= 0.329 to 0.625) except for SLBP vs. controls (rater A; k=-0.18). Regarding kinematics, group differences occurred neither in ROM nor in V (p> 0.05), but in terms of the relative side comparison between CLBP and controls (p<0.05). ROC analysis (CLBP vs. controls) revealed an optimal cut-off at side asymmetries of 16.9% (ROM) and 28.9% (V). Between SLBP patients and controls, no significant differences were observed neither in terms of the absolute values nor the relative side differences of both kinematic variables. CONCLUSIONS Side asymmetries of V and ROM may be used to differentiate between controls and individuals with CLBP. CATMAs appear to be of limited diagnostic value for the identification of pathological spine movement.
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Engeroff T, Giesche F, Niederer D, Gerten S, Wilke J, Vogt L, Banzer W. Explaining Upper or Lower Extremity Crossover Effects of Visuomotor Choice Reaction Time Training. Percept Mot Skills 2019; 126:675-693. [DOI: 10.1177/0031512519841755] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Current evidence indicates a strong relation between improved visuomotor choice reaction time (VMRT) and a reduced risk of lower extremity injury, making both lower- and upper extremity VMRT training paradigms valuable to athletes. This investigation studied as yet unconfirmed crossover effects of upper extremity training on lower extremity performance; and we evaluated underlying relevant perceptual and cognitive adaptations. In this three-armed, randomized, controlled intervention, we used a computerized training device to compare participants receiving four weeks of upper ( n = 12) and lower ( n = 12) extremity VMRT training with a control group ( n = 13) of healthy participants. Collectively, our participants had a mean age of 24.6 years ( SD = 2.2), a mean height of 173 cm ( SD = 10), and a mean weight of 69.6 kg ( SD = 12.1); 57% ( n = 21) were female and 43% ( n = 16) were male. We assessed participants’ upper and lower extremity VMRT performance and domain-specific perceptual and cognitive abilities before and after intervention and analyzed differences between their before and after performances. Lower extremity training enhanced VMRT performances for both lower extremity and crossover upper extremity. Upper extremity training improved VMRT for upper extremity and increased cognitive choice reaction performance but yielded no crossover effects to lower extremity. We found no effects of VMRT training on other domain-specific cognitive performance markers (attention, executive function, memory, or working memory). VMRT training modulated only task-specific cognitive performance and induced crossover effects from lower extremity training to upper extremity performance but not vice versa.
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Affiliation(s)
- Tobias Engeroff
- Department of Sports Medicine, Goethe University Frankfurt, Germany
| | - Florian Giesche
- Department of Sports Medicine, Goethe University Frankfurt, Germany
| | - Daniel Niederer
- Department of Sports Medicine, Goethe University Frankfurt, Germany
| | - Sina Gerten
- Neurocognition and Action—Biomechanics Research Group, Faculty of Psychology and Sport Science, Bielefeld University, Germany
- Center of Excellence “Cognitive Interaction Technology,” Research Institute for Cognition and Robotics, Bielefeld University, Germany
| | - Jan Wilke
- Department of Sports Medicine, Goethe University Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University Frankfurt, Germany
| | - Winfried Banzer
- Department of Sports Medicine, Goethe University Frankfurt, Germany
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Niederer D, Kalo K, Vogel J, Wilke J, Giesche F, Vogt L, Banzer W. Quadriceps Torque, Peak Variability and Strength Endurance in Patients after Anterior Cruciate Ligament Reconstruction: Impact of Local Muscle Fatigue. J Mot Behav 2019; 52:22-32. [PMID: 30732548 DOI: 10.1080/00222895.2019.1570909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We tested if ACL-reconstructed participants show a decreased quadriceps torque, a lower muscle endurance capacity and a higher peak torque variability compared to unimpaired control participants prior to and following local muscle fatigue. Participants (n = 19, 10 women; 25 ± 5yrs.) with unilateral hamstrings autograft ACL-reconstruction and a matched unimpaired control group were recruited. Participants performed two maximal isometric voluntary force (MIVF) contractions of the knee extensors. In between, standardized local muscle fatigue was induced. ACL-reconstructed knees display a lower peak torque of the knee extensors in comparison to the contralateral limb (3.2 ± .3Nm/kg vs. 3.5 ± .3 Nm/kg). Peak torque variability and fatigue resistance were not affected by local muscle fatigue (p > .05). Participants with ACL-reconstructed knees show a persistent quadriceps muscle dysfunction. This dysfunction and lower limb side asymmetries might be risk factors for ACL re-ruptures.
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Affiliation(s)
- Daniel Niederer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Kristin Kalo
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Johanna Vogel
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jan Wilke
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Florian Giesche
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Winfried Banzer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
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Giesche F, Engeroff T, Wilke J, Niederer D, Vogt L, Banzer W. Neurophysiological correlates of motor planning and movement initiation in ACL-reconstructed individuals: a case-control study. BMJ Open 2018; 8:e023048. [PMID: 30232114 PMCID: PMC6150139 DOI: 10.1136/bmjopen-2018-023048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Current evidence suggests that the loss of mechanoreceptors after anterior cruciate ligament (ACL) tears might be compensated by increased cortical motor planning. This occupation of cerebral resources may limit the potential to quickly adapt movements to unforeseen external stimuli in the athletic environment. To date, studies investigating such neural alterations during movement focused on simple, anticipated tasks with low ecological validity. This trial, therefore, aims to investigate the cortical and biomechanical processes associated with more sport-related and injury-related movements in ACL-reconstructed individuals. METHODS AND ANALYSIS ACL-reconstructed participants and uninjured controls will perform repetitive countermovement jumps with single leg landings. Two different conditions are to be completed: anticipated (n=35) versus unanticipated (n=35) successful landings. Under the anticipated condition, participants receive the visual information depicting the requested landing leg prior to the jump. In the unanticipated condition, this information will be provided only about 400 msec prior to landing. Neural correlates of motor planning will be measured using electroencephalography. In detail, movement-related cortical potentials, frequency spectral power and functional connectivity will be assessed. Biomechanical landing quality will be captured via a capacitive force plate. Calculated parameters encompass time to stabilisation, vertical peak ground reaction force, and centre of pressure path length. Potential systematic differences between ACL-reconstructed individuals and controls will be identified in dependence of jumping condition (anticipated/ unanticipated, injured/uninjured leg and controls) by using interference statistics. Potential associations between the cortical and biomechanical measures will be calculated by means of correlation analysis. In case of statistical significance (α<0.05.) further confounders (cofactors) will be considered. ETHICS AND DISSEMINATION The independent Ethics Committee of the University of Frankfurt (Faculty of Psychology and Sports Sciences) approved the study. Publications in peer-reviewed journals are planned. The findings will be presented at scientific conferences. TRIAL STATUS At the time of submission of this manuscript, recruitment is ongoing. TRIAL REGISTRATION NUMBER NCT03336060; Pre-results.
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Affiliation(s)
- Florian Giesche
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Tobias Engeroff
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Jan Wilke
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Daniel Niederer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Winfried Banzer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt, Germany
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