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von Stengel S, Fröhlich M, Ludwig O, Eifler C, Berger J, Kleinöder H, Micke F, Wegener B, Zinner C, Mooren FC, Teschler M, Filipovic A, Müller S, England K, Vatter J, Authenrieth S, Kohl M, Kemmler W. Revised contraindications for the use of non-medical WB-electromyostimulation. Evidence-based German consensus recommendations. Front Sports Act Living 2024; 6:1371723. [PMID: 38689869 PMCID: PMC11058671 DOI: 10.3389/fspor.2024.1371723] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/01/2024] [Indexed: 05/02/2024] Open
Abstract
Whole-body electromyostimulation has proven to be a highly effective alternative to conventional resistance-type exercise training. However, due to adverse effects in the past, very extensive contraindications have been put in place for the commercial, non-medical WB-EMS market. Considering recent positive innovations e.g., federal regulation, mandatory trainer education, revised guidelines, and new scientific studies on WB-EMS application, we believe that a careful revision of the very restrictive contraindications on WB-EMS is needed. This applies all the more because many cohorts with limited options for conventional exercise have so far been excluded. During a first meeting of an evidence-based consensus process, stakeholders from various backgrounds (e.g., research, education, application) set the priorities for revising the contraindications. We decided to focus on four categories of absolute contraindications: "Arteriosclerosis, arterial circulation disorders", "Diabetes mellitus" (DM), "Tumor and cancer" (TC), "Neurologic diseases, neuronal disorders, epilepsy". Based on scientific studies, quality criteria, safety aspects and benefit/risk assessment of the category, DM and TC were moved to the relative contraindication catalogue, while arteriosclerosis/arterial circulation disorders and neurologic diseases/neuronal disorders/epilepsy were still considered as absolute contraindications. While missing evidence suggests maintaining the status of neurologic diseases/neuronal disorders as an absolute contraindication, the risk/benefit-ratio does not support the application of WB-EMS in people with arteriosclerosis/arterial circulation diseases. Despite these very cautious modifications, countries with less restrictive structures for non-medical WB-EMS should consider our approach critically before implementing the present revisions. Considering further the largely increased amount of WB-EMS trials we advice regular updates of the present contraindication list.
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Affiliation(s)
- S. von Stengel
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - M. Fröhlich
- Department of Sports Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Kaiserslautern, Germany
| | - O. Ludwig
- Department of Sports Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Kaiserslautern, Germany
| | - C. Eifler
- German University for Prevention and Health Management, Saarbrücken, Germany
| | - J. Berger
- German University for Prevention and Health Management, Saarbrücken, Germany
| | - H. Kleinöder
- Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - F. Micke
- Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - B. Wegener
- Musculoskeletal University Center, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - C. Zinner
- Hessian College of Police and Administration, Wiesbaden, Germany
| | - F. C. Mooren
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - M. Teschler
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | | | | | - K. England
- Glucker Kolleg, Frankfurt, Germany
- Bundeswehr Medical Academy Munich, Munich, Germany
| | - J. Vatter
- Soccer Club Paderborn 07, Paderborn, Germany
- PT Lounge Cologne, Cologne, Germany
| | - S. Authenrieth
- Glucker Kolleg, Frankfurt, Germany
- EMS-Performance, Kornwestheim, Germany
| | - M. Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - W. Kemmler
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
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Vagedes J, Huber BM, Islam MOA, Vagedes K, Kohl M, von Schoen-Angerer T. Antibiotic Use in a Neonatal Intensive Care Unit Practicing Integrative Medicine-A Retrospective Analysis. J Integr Complement Med 2024; 30:394-402. [PMID: 37815790 PMCID: PMC11001955 DOI: 10.1089/jicm.2023.0001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Background: Antibiotic use in neonatal intensive care units (NICUs) remains high. Low antibiotic prescribing has been documented among physicians trained in complementary medicine. This study sought to identify if an NICU integrating complementary medicine has low antibiotic prescribing. Methods: We conducted a retrospective analysis at the level-2 NICU of the Filderklinik, an integrative medicine hospital in Southern Germany, to compare antibiotic use locally and internationally; to compare neonates with suspected infection, managed with and without antibiotics; and to describe use and safety of complementary medicinal products. Results: Among 7778 live births, 1086 neonates were hospitalized between 2014 and 2017. Two hundred forty-six were diagnosed with suspected or confirmed infection, their median gestational age was 40.3 weeks (range 29-42), 3.25% had a birthweight <2500 g, 176 were treated with antibiotics for a median duration of 4 days, 6 had culture-proven infection (0.77 per 1000 live births), and 2.26% of live births were started on antibiotics. A total of 866 antibiotic treatment days corresponded to 111 antibiotic days per 1000 live births and 8.8 antibiotic days per 100 hospital days. Neonates managed with antibiotics more often had fever and abnormal laboratory parameters than those managed without. Complementary medicinal products comprising 71 different natural substances were used, no side effect or adverse event were described. A subanalysis using the inclusion criteria of a recent analysis of 13 networks in Europe, North America, and Australia confirmed this cohort to be among the lowest prescribing networks. Conclusions: Antibiotic use was low in this NICU in both local and international comparison, while the disease burden was in the mid-range, confirming an association between integrative medicine practice and low antibiotic prescribing in newborns. Complementary medicinal products were widely used and well tolerated. Clinical Trial Registration number: NCT04893343.
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Affiliation(s)
- Jan Vagedes
- ARCIM Institute, Filderstadt, Germany
- Department of Pediatrics, Filderklinik, Filderstadt, Germany
- Department of Neonatology, University Hospital Tübingen, Tübingen, Germany
| | - Benedikt M. Huber
- Center for Integrative Pediatrics, Fribourg Cantonal Hospital, Fribourg, Switzerland
- Department of Community Health, Fribourg University, Fribourg, Switzerland
| | | | | | - Matthias Kohl
- Institute of Precision Medicine, University Furtwangen, Furtwangen, Germany
| | - Tido von Schoen-Angerer
- ARCIM Institute, Filderstadt, Germany
- Center for Integrative Pediatrics, Fribourg Cantonal Hospital, Fribourg, Switzerland
- Department of Community Health, Fribourg University, Fribourg, Switzerland
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Kemmler W, Kohl M, von Stengel S, Willert S, Kast S, Uder M. Effects of whole-body electromyostimulation with different impulse intensity on blood pressure changes in hyper- and normotensive overweight people. A pilot study. Front Physiol 2024; 15:1349750. [PMID: 38455842 PMCID: PMC10918690 DOI: 10.3389/fphys.2024.1349750] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Hypertension is a frequent condition in untrained middle-aged to older adults, who form the core group of whole-body electromyostimulation (WB-EMS) applicants. So far, the acute effects of varying impulse intensities on blood pressure responses have not been evaluated in normo- and hypertensive people. Thirteen hypertensive and twelve normotensive overweight WB-EMS novices, 40-70 years old, conducted the same WB-EMS protocol (20 min, bipolar, 85 Hz, 350 µs, 4 s impulse-4 s rest; combined with easy movements) with increasing impulse intensity (low, moderate, advanced) per session. Mean arterial blood pressure (MAP) as determined by automatic sphygmomanometry rose significantly (p < .001) from rest, 5 min pre-WB-EMS to immediately pre-WB-EMS assessment. Of importance, a 20-min WB-EMS application does not increase MAP further. In detail, maximum individual MAP does not exceed 128 mmHg (177 mmHg systolic or 110 mmHg diastolic) in any case. Two-min post-WB-EMS, MAP was significantly lower (p = .016) compared to immediately pre-WB-EMS. In contrast, heart rate increased significantly from immediately pre to immediately post-exercise (p < .001), though individual peak values did not exceed 140 beats/min-1 and heart rate decreased rapidly (p < .001) post-exercise. No significant differences in MAP and HR kinetics were observed for impulse intensity categories or hypertensive status. In summary, largely independently of impulse intensity and status, the acute effect of WB-EMS on MAP in novice applicants seem to be largely negligible. Although definite evidence might not have been provided by the present study, we conclude that hypertension, at least under treatment, should not be considered as a barrier for WB-EMS application in moderately old or older cohorts.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Radiology, University Hospital Nürnberg, Erlangen, Germany
- Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, Germany
| | - Simon von Stengel
- Institute of Radiology, University Hospital Nürnberg, Erlangen, Germany
| | - Sebastian Willert
- Institute of Radiology, University Hospital Nürnberg, Erlangen, Germany
| | - Stephanie Kast
- Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Nürnberg, Erlangen, Germany
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Kircher K, Chaudry O, Nagel AM, Ghasemikaram M, Uder M, Jakob F, Kohl M, Kemmler W, Engelke K. Effects of high-intensity training on fatty infiltration in paraspinal muscles in elderly males with osteosarcopenia - the randomized controlled FrOST study. BMC Geriatr 2024; 24:141. [PMID: 38326734 PMCID: PMC10851592 DOI: 10.1186/s12877-024-04736-5] [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] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Osteosarcopenia is a common geriatric syndrome with an increasing prevalence with age, leading to secondary diseases and complex consequences such as falls and fractures, as well as higher mortality and frailty rates. There is a great need for prevention and treatment strategies. METHODS In this analysis, we used magnetic resonance imaging (MRI) data from the randomised controlled FrOST trial, which enrolled community-dwelling osteosarcopenic men aged > 72 years randomly allocated to 16 months of twice-weekly high-intensity resistance training (HIRT) or a non-training control group. MR Dixon imaging was used to quantify the effects of HIRT on muscle fat infiltration in the paraspinal muscles, determined as changes in muscle tissue, fat faction and intermuscular adipose tissue (IMAT) in the erector spinae and psoas major muscles. Intention-to-treat analysis with multiple imputation was used to analyse the data set. RESULTS After 16 months of intervention, 15 men from the HIRT and 16 men from the CG were included in the MRI analysis. In summary, no positive effects on the fat infiltration of the erector spinae and psoas major muscles were observed. CONCLUSIONS The previously reported positive effects on lumbar spine bone mineral density (BMD) suggest that mechanotransduction induces tropic effects on bone, but that fat infiltration of the erector spinae and psoas major muscles are either irreversible or, for some unknown reason, resistant to exercise. Because of the beneficial effects on spinal BMD, HIRT is still recommended in osteosarcopenic older men, but further research is needed to confirm appropriate age-specific training exercises for the paraspinal muscles. The potential of different MRI sequences to quantify degenerative and metabolic changes in various muscle groups must be better characterized. TRIAL REGISTRATIONS FrOST was approved by the University Ethics Committee of the Friedrich-Alexander University of Erlangen-Nürnberg (number 67_15b and 4464b) and the Federal Office for Radiation Projection (BfS, number Z 5-2,246,212 - 2017-002). Furthermore, it fully complies with the Declaration of Helsinki and is registered at ClinicalTrials.gov: NCT03453463 (05/03/2018). JAMA 310:2191-2194, 2013.
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Affiliation(s)
- Kaja Kircher
- Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Henkestr. 91, 91052, Erlangen, Germany.
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.
- Institute of Radiology, Friedrich-Alexander-University of Erlangen-Nürnberg and University Hospital Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany.
| | - Oliver Chaudry
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Armin M Nagel
- Institute of Radiology, Friedrich-Alexander-University of Erlangen-Nürnberg and University Hospital Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Mansour Ghasemikaram
- Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Henkestr. 91, 91052, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, Friedrich-Alexander-University of Erlangen-Nürnberg and University Hospital Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Franz Jakob
- Bernhard-Heine-Center for Locomotion Research, University of Würzburg, Brettreichstrasse 11, 97074, Würzburg, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Neckarstrasse 1, 78054, Villingen-Schwenningen, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Henkestr. 91, 91052, Erlangen, Germany
- Institute of Radiology, Friedrich-Alexander-University of Erlangen-Nürnberg and University Hospital Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Klaus Engelke
- Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Henkestr. 91, 91052, Erlangen, Germany
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
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Beier M, Schoene D, Kohl M, von Stengel S, Uder M, Kemmler W. Non-Athletic Cohorts Enrolled in Longitudinal Whole-Body Electromyostimulation Trials-An Evidence Map. Sensors (Basel) 2024; 24:972. [PMID: 38339689 PMCID: PMC10857049 DOI: 10.3390/s24030972] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
Whole-body electromyostimulation (WB-EMS) can be considered as a time-efficient, joint-friendly, and highly customizable training technology that attracts a wide range of users. The present evidence map aims to provide an overview of different non-athletic cohorts addressed in WB-EMS research. Based on a comprehensive systematic search according to PRISMA, eighty-six eligible longitudinal trials were identified that correspond with our eligibility criteria. In summary, WB-EMS research sufficiently covers all adult age categories in males and females. Most cohorts addressed (58%) were predominately or exclusively overweight/obese, and in about 60% of them, diseases or conditions were inclusion criteria for the trials. Cohorts specifically enrolled in WB-EMS trials suffer from cancer/neoplasm (n = 7), obesity (n = 6), diabetes mellitus (n = 5), metabolic syndrome (n = 2), nervous system diseases (n = 2), chronic heart failure (n = 4), stroke (n = 1), peripheral arterial diseases (n = 2), knee arthrosis (n = 1), sarcopenia (n = 3), chronic unspecific low back pain (n = 4), and osteopenia (n = 3). Chronic kidney disease was an eligibility criterion in five WB-EMS trials. Finally, three studies included only critically ill patients, and two further studies considered frailty as an inclusion criterion. Of importance, no adverse effects of the WB-EMS intervention were reported. In summary, the evidence gaps in WB-EMS research were particular evident for cohorts with diseases of the nervous and cerebrovascular system.
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Affiliation(s)
- Miriam Beier
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Daniel Schoene
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, 78056 Villingen-Schwenningen, Germany;
| | - Simon von Stengel
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Wolfgang Kemmler
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany
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Cordoba-Caballero J, Perkins JR, García-Criado F, Gallego D, Navarro-Sánchez A, Moreno-Estellés M, Garcés C, Bonet F, Romá-Mateo C, Toro R, Perez B, Sanz P, Kohl M, Rojano E, Seoane P, Ranea JAG. Exploring miRNA-target gene pair detection in disease with coRmiT. Brief Bioinform 2024; 25:bbae060. [PMID: 38436559 PMCID: PMC10939301 DOI: 10.1093/bib/bbae060] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/14/2023] [Accepted: 01/10/2024] [Indexed: 03/05/2024] Open
Abstract
A wide range of approaches can be used to detect micro RNA (miRNA)-target gene pairs (mTPs) from expression data, differing in the ways the gene and miRNA expression profiles are calculated, combined and correlated. However, there is no clear consensus on which is the best approach across all datasets. Here, we have implemented multiple strategies and applied them to three distinct rare disease datasets that comprise smallRNA-Seq and RNA-Seq data obtained from the same samples, obtaining mTPs related to the disease pathology. All datasets were preprocessed using a standardized, freely available computational workflow, DEG_workflow. This workflow includes coRmiT, a method to compare multiple strategies for mTP detection. We used it to investigate the overlap of the detected mTPs with predicted and validated mTPs from 11 different databases. Results show that there is no clear best strategy for mTP detection applicable to all situations. We therefore propose the integration of the results of the different strategies by selecting the one with the highest odds ratio for each miRNA, as the optimal way to integrate the results. We applied this selection-integration method to the datasets and showed it to be robust to changes in the predicted and validated mTP databases. Our findings have important implications for miRNA analysis. coRmiT is implemented as part of the ExpHunterSuite Bioconductor package available from https://bioconductor.org/packages/ExpHunterSuite.
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Affiliation(s)
- Jose Cordoba-Caballero
- Departamento de Biología Molecular y Bioquímica, Facultad de Ciencias, Universidad de Málaga, Bulevar Louis Pasteur, 31, Málaga, 29010, Spain
- Research Unit, Biomedical Research and Innovation Institute of Cádiz (INiBICA), Puerta del Mar University Hospital, Cádiz, Spain
| | - James R Perkins
- Departamento de Biología Molecular y Bioquímica, Facultad de Ciencias, Universidad de Málaga, Bulevar Louis Pasteur, 31, Málaga, 29010, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Plataforma BIONAND), C/ Severo Ochoa, 35, Parque Tecnológico de Andalucía (PTA), Campanillas, Málaga, 29590, Spain
| | - Federico García-Criado
- Departamento de Biología Molecular y Bioquímica, Facultad de Ciencias, Universidad de Málaga, Bulevar Louis Pasteur, 31, Málaga, 29010, Spain
| | - Diana Gallego
- CIBER de Enfermedades Raras (CIBERER), Avda. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, Madrid, 28029, Spain
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular-SO UAM-CSIC, Universidad Autónoma de Madrid, Campus de Cantoblanco, Madrid, Spain
- Instituto de Investigación Sanitaria IdiPaZ, Madrid, Spain
| | - Alicia Navarro-Sánchez
- CIBER de Enfermedades Raras (CIBERER), Avda. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, Madrid, 28029, Spain
- Departament de Fisiologia, Facultat de Medicina i Odontologia, Universitat de València, Av. Blasco Ibáñez 15, 46010, València, Spain
| | - Mireia Moreno-Estellés
- CIBER de Enfermedades Raras (CIBERER), Avda. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, Madrid, 28029, Spain
- Consejo Superior de Investigaciones Científicas, Instituto de Biomedicina de Valencia, Jaime Roig 11, 46010, Valencia, Spain
| | - Concepción Garcés
- CIBER de Enfermedades Raras (CIBERER), Avda. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, Madrid, 28029, Spain
- Departament de Fisiologia, Facultat de Medicina i Odontologia, Universitat de València, Av. Blasco Ibáñez 15, 46010, València, Spain
| | - Fernando Bonet
- Research Unit, Biomedical Research and Innovation Institute of Cádiz (INiBICA), Puerta del Mar University Hospital, Cádiz, Spain
- Medicine Department, School of Medicine, University of Cádiz, Cádiz, Spain
| | - Carlos Romá-Mateo
- CIBER de Enfermedades Raras (CIBERER), Avda. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, Madrid, 28029, Spain
- Departament de Fisiologia, Facultat de Medicina i Odontologia, Universitat de València, Av. Blasco Ibáñez 15, 46010, València, Spain
- Incliva Biomedical Research Institute, 46010, València, Spain
| | - Rocio Toro
- Research Unit, Biomedical Research and Innovation Institute of Cádiz (INiBICA), Puerta del Mar University Hospital, Cádiz, Spain
- Medicine Department, School of Medicine, University of Cádiz, Cádiz, Spain
| | - Belén Perez
- CIBER de Enfermedades Raras (CIBERER), Avda. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, Madrid, 28029, Spain
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular-SO UAM-CSIC, Universidad Autónoma de Madrid, Campus de Cantoblanco, Madrid, Spain
- Instituto de Investigación Sanitaria IdiPaZ, Madrid, Spain
| | - Pascual Sanz
- CIBER de Enfermedades Raras (CIBERER), Avda. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, Madrid, 28029, Spain
- Consejo Superior de Investigaciones Científicas, Instituto de Biomedicina de Valencia, Jaime Roig 11, 46010, Valencia, Spain
| | - Matthias Kohl
- Faculty of Medical and Life Sciences, Furtwangen University, Germany
| | - Elena Rojano
- Departamento de Biología Molecular y Bioquímica, Facultad de Ciencias, Universidad de Málaga, Bulevar Louis Pasteur, 31, Málaga, 29010, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Plataforma BIONAND), C/ Severo Ochoa, 35, Parque Tecnológico de Andalucía (PTA), Campanillas, Málaga, 29590, Spain
| | - Pedro Seoane
- Departamento de Biología Molecular y Bioquímica, Facultad de Ciencias, Universidad de Málaga, Bulevar Louis Pasteur, 31, Málaga, 29010, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Plataforma BIONAND), C/ Severo Ochoa, 35, Parque Tecnológico de Andalucía (PTA), Campanillas, Málaga, 29590, Spain
- CIBER de Enfermedades Raras (CIBERER), Avda. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, Madrid, 28029, Spain
| | - Juan A G Ranea
- Departamento de Biología Molecular y Bioquímica, Facultad de Ciencias, Universidad de Málaga, Bulevar Louis Pasteur, 31, Málaga, 29010, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Plataforma BIONAND), C/ Severo Ochoa, 35, Parque Tecnológico de Andalucía (PTA), Campanillas, Málaga, 29590, Spain
- CIBER de Enfermedades Raras (CIBERER), Avda. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, Madrid, 28029, Spain
- Instituto Nacional de Bioinformática (INB/ELIXIR-ES), Instituto de Salud Carlos III (ISCIII), C/ Sinesio Delgado, 4, Madrid, 28029, Spain
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Vagedes K, Kuderer S, Ehmann R, Kohl M, Wildhaber J, Jörres RA, Vagedes J. Effect of Buteyko breathing technique on clinical and functional parameters in adult patients with asthma: a randomized, controlled study. Eur J Med Res 2024; 29:42. [PMID: 38212823 PMCID: PMC10782792 DOI: 10.1186/s40001-023-01634-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The established therapy of asthma might be supported by additional non-pharmaceutical measures, such as the Buteyko breathing technique (BBT); however, the available data are mixed. To clarify the effects of BBT in patients with asthma, we investigated whether it led to clinical improvements with correlation to functional parameters. METHODS Using a randomized, controlled design, we studied two groups (n = 30 each) of patients with asthma under either BBT or usual therapy (UT) w/o BBT over a period of 3 months. The primary outcome comprised the voluntary control pause (CP) after 3 months, secondary outcomes an additional breathhold parameter, forced expiratory volume in 1 s (FEV1), capnovolumetry, exhaled nitric oxide (FeNO), Asthma Control Questionnaire (ACQ) and Nijmegen Questionnaire (NQ), and the use of medication (β2-agonists; inhaled corticosteroids, ICS). RESULTS CP showed significant time-by-group interaction [F(1,58.09) = 28.70, p < 0.001] as well as main effects for study group [F(1,58.27) = 5.91, p = 0.018] and time [F(1,58.36) = 17.67, p < 0.001]. ACQ and NQ scores were significantly (p < 0.05 each) improved with BBT. This was associated with reductions in the use of β2-agonists and ICS (p < 0.05 each) by about 20% each. None of these effects occurred in the UT group. While FEV1 and the slopes of the capnovolumetric expiratory phases 2 and 3 did not significantly change, the capnovolumetric threshold volume at tidal breathing increased (p < 0.05) with BBT by about 10 mL or 10%, compared to baseline, suggesting a larger volume of the central airways. No significant changes were seen for FeNO. CONCLUSIONS BBT was clinically effective, as indicated by the fact that the improvement in symptom scores and the small increase in bronchial volume occurred despite the significant reduction of respiratory pharmacotherapy. As the self-controlled Buteyko breathing therapy was well-accepted by the participants, it could be considered as supporting tool in asthma therapy being worth of wider attention in clinical practice. Trial registration Retrospectively registered on 10 March 2017 at ClinicalTrials.gov (NCT03098849).
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Affiliation(s)
- Katrin Vagedes
- ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Filderstadt, Germany
| | - Silja Kuderer
- ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Filderstadt, Germany
| | - Rainer Ehmann
- Asthma Center, Outpatient Pulmonology, Stuttgart, Germany
| | - Matthias Kohl
- Institute of Precision Medicine, University Furtwangen, Villingen-Schwenningen, Germany
| | | | - Rudolf A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, LMU Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Jan Vagedes
- ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Filderstadt, Germany.
- Department of Neonatology, University Hospital Tübingen, Tübingen, Germany.
- Department of Pediatrics, Filderklinik, Filderstadt, Germany.
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8
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Quint I, Simantzik J, Kaiser L, Laufer S, Csuk R, Smith D, Kohl M, Deigner HP. Ready-to-use nanopore platform for label-free small molecule quantification: Ethanolamine as first example. Nanomedicine 2024; 55:102724. [PMID: 38007066 DOI: 10.1016/j.nano.2023.102724] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/06/2023] [Accepted: 10/26/2023] [Indexed: 11/27/2023]
Abstract
In recent decades, nanopores have become a promising diagnostic tool. Protein and solid-state nanopores are increasingly used for both RNA/DNA sequencing and small molecule detection. The latter is of great importance, as their detection is difficult or expensive using available methods such as HPLC or LC-MS. DNA aptamers are an excellent detection element for sensitive and specific detection of small molecules. Herein, a method for quantifying small molecules using a ready-to-use sequencing platform is described. Taking ethanolamine as an example, a strand displacement assay is developed in which the target-binding aptamer is displaced from the surface of magnetic particles by ethanolamine. Non-displaced aptamer and thus the ethanolamine concentration are detected by the nanopore system and can be quantified in the micromolar range using our in-house developed analysis software. This method is thus the first to describe a label-free approach for the detection of small molecules in a protein nanopore system.
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Affiliation(s)
- Isabel Quint
- Institute of Precision Medicine, Furtwangen University, Jakob-Kienzle-Strasse 17, Villingen-Schwenningen 78054, Germany; Institute of Pharmaceutical Sciences, Department of Pharmacy and Biochemistry, Eberhard-Karls-University Tuebingen, Auf der Morgenstelle 8, Tuebingen 72076, Germany
| | - Jonathan Simantzik
- Institute of Precision Medicine, Furtwangen University, Jakob-Kienzle-Strasse 17, Villingen-Schwenningen 78054, Germany
| | - Lars Kaiser
- Institute of Precision Medicine, Furtwangen University, Jakob-Kienzle-Strasse 17, Villingen-Schwenningen 78054, Germany
| | - Stefan Laufer
- Institute of Pharmaceutical Sciences, Department of Pharmacy and Biochemistry, Eberhard-Karls-University Tuebingen, Auf der Morgenstelle 8, Tuebingen 72076, Germany; Tuebingen Center for Academic Drug Discovery & Development (TüCAD2), 72076 Tuebingen, Germany
| | - Rene' Csuk
- Institute of Organic Chemistry, Martin-Luther University Halle-Wittenberg, Kurt-Mothes-Str. 2, 06120 Halle (Saale), Germany
| | - David Smith
- Fraunhofer Institute IZI (Leipzig), Perlickstrasse 1, 04103 Leipzig, Germany
| | - Matthias Kohl
- Institute of Precision Medicine, Furtwangen University, Jakob-Kienzle-Strasse 17, Villingen-Schwenningen 78054, Germany.
| | - Hans-Peter Deigner
- Institute of Precision Medicine, Furtwangen University, Jakob-Kienzle-Strasse 17, Villingen-Schwenningen 78054, Germany; EXIM Department, Fraunhofer Institute IZI (Leipzig), Schillingallee 68, 18057 Rostock, Germany; Faculty of Science, Eberhard-Karls-University Tuebingen, Auf der Morgenstelle 8, Tuebingen, 72076, Germany.
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9
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Bollinger M, Frère N, Shapeton AD, Schary W, Kohl M, Kill C, Riße J. Does Prehospital Suspicion of Sepsis Shorten Time to Administration of Antibiotics in the Emergency Department? A Retrospective Study in One University Hospital. J Clin Med 2023; 12:5639. [PMID: 37685707 PMCID: PMC10488377 DOI: 10.3390/jcm12175639] [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] [Received: 08/08/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
Early treatment is the mainstay of sepsis therapy. We suspected that early recognition of sepsis by prehospital healthcare providers may shorten the time for antibiotic administration in the emergency department. We retrospectively evaluated all patients above 18 years of age who were diagnosed with sepsis or severe infection in our emergency department between 2018 and 2020. We recorded the suspected diagnosis at the time of presentation, the type of referring healthcare provider, and the time until initiation of antibiotic treatment. Differences between groups were calculated using the Kruskal-Wallis rank sum test. Of the 277 patients who were diagnosed with severe infection or sepsis in the emergency department, an infection was suspected in 124 (44.8%) patients, and sepsis was suspected in 31 (11.2%) patients by referring healthcare providers. Time to initiation of antibiotic treatment was shorter in patients where sepsis or infection had been suspected prior to arrival for both patients with severe infections (p = 0.022) and sepsis (p = 0.004). Given the well-described outcome benefits of early sepsis therapy, recognition of sepsis needs to be improved. Appropriate scores should be used as part of routine patient assessment to reduce the time to antibiotic administration and improve patient outcomes.
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Affiliation(s)
- Matthias Bollinger
- Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Schwarzwald-Baar Hospital, Klinikstrasse 11, 78052 Villingen-Schwenningen, Germany
- Department of Anesthesiology I, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Nadja Frère
- Center of Emergency Medicine, University Hospital Essen, 45147 Essen, Germany
| | - Alexander Daniel Shapeton
- Department of Anesthesia, Critical Care and Pain Medicine, Boston Veterans Affairs Healthcare System, West Roxbury, MA 02132, USA
- Tufts University School of Medicine, Boston, MA 02111, USA
| | - Weronika Schary
- Institute of Precision Medicine, Faculty of Medical and Life Sciences, Furtwangen University, 78054 Villingen-Schwenningen, Germany
| | - Matthias Kohl
- Institute of Precision Medicine, Faculty of Medical and Life Sciences, Furtwangen University, 78054 Villingen-Schwenningen, Germany
| | - Clemens Kill
- Center of Emergency Medicine, University Hospital Essen, 45147 Essen, Germany
| | - Joachim Riße
- Center of Emergency Medicine, University Hospital Essen, 45147 Essen, Germany
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10
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Fischer C, Jakob F, Kohl M, Kast S, Von Stengel S, Kerschan-Schindl K, Lange U, Thomasius F, Peters S, Uder M, Kemmler W. Additive Effects of Exercise and Vitamin D Supplementation (with and without Calcium) on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis. J Osteoporos 2023; 2023:5570030. [PMID: 37588008 PMCID: PMC10427236 DOI: 10.1155/2023/5570030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 08/18/2023] Open
Abstract
Exercise is a recognized component in the prevention and therapy of osteoporosis. The present systematic review and meta-analysis aimed to determine the effect of Vitamin D (Vit-D) added to exercise versus exercise alone on bone mineral density (BMD) at the lumbar spine (LS) or hip in older adults. A systematic review based on six literature databases according to PRISMA included (a) exercise trials, with an exercise (EX) and a combined exercise + Vit-D group (EX + Vit-D), (b) intervention ≥ 6 months, and (c) BMD assessments at LS or hip. Effects sizes (MD) and 95%-confidence intervals (95%-CI) were calculated using a random-effect model that includes the inverse heterogeneity model (IVhet). Five studies with 281 participants in the EX and 279 participants in the EX + Vit-D were included. No significant differences between EX versus EX + Vit-D were observed for BMD-LS (MD: 0.002, 95%-CI: -0.033 to 0.036) or BMD-hip (MD: 0.003, 95%-CI: -0.035 to 0.042). Heterogeneity between the trial results was moderate-substantial for LS (I2 = 0%) and moderate for hip-BMD (I2 = 35%). The funnel plot analysis suggests evidence for a publication/small study bias for BMD-LS and hip results. In summary, this present systematic review and meta-analysis were unable to determine significant positive interaction of exercise and Vit-D on LS- or hip-BMD. We predominately attribute this finding to (1) the less bone-specific exercise protocols of at least two of the five studies and (2) the inclusion criteria of the studies that did not consequently focus on Vit-D deficiency. This issue should be addressed in more detail by adequately powered exercise trials with promising exercise protocols and participants with Vit-D deficiency. This trial is registered with the International Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42022309813.
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Affiliation(s)
- Cecilie Fischer
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Franz Jakob
- Bernhard-Heine-Centrum für Bewegungsforschung, University of Würzburg, Würzburg, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - Stephanie Kast
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Simon Von Stengel
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | | | - Uwe Lange
- German Society for Physical and Rehabilitative Medicine, Ulm, Germany
| | | | - Stefan Peters
- German Association for Health-Related Fitness and Exercise Therapy (DVGS) e.V., Hürth-Efferen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Wolfgang Kemmler
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
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11
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Jason LA, Behrends U, Blitshteyn S, Gerner P, Grande B, Grande T, Hammer S, Hoffmann K, Kohl M, Renz-Polster H, Scheibenbogen C, Stingl M, Untersmayr E, Vink M, Westermeier F, Hughes BM. [The overview of the current evidence ignores the current evidence]. Nervenarzt 2023; 94:736-737. [PMID: 37368011 DOI: 10.1007/s00115-023-01515-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/28/2023]
Affiliation(s)
- Leonard A Jason
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Suite 3119, 60614, Chicago, IL, USA
| | - Uta Behrends
- Zentrum für Kinder- und Jugendmedizin, Klinikum rechts der Isar der Technischen Universität München und München Klinik Schwabing, Kölner Platz 1, 80804, München, Deutschland
| | - Svetlana Blitshteyn
- Department of Neurology, University at Buffalo, Jacobs School of Medicine, Buffalo, NY, USA
| | - Patrick Gerner
- Klinik für Kinder- und Jugendmedizin, Ortenau Klinikum Offenburg, Ebertplatz 12, 77654, Offenburg, Deutschland
| | - Bettina Grande
- Psychotherapie und Psychoanalyse, Hauptstr. 48, 69117, Heidelberg, Deutschland.
| | - Tilman Grande
- Psychotherapie und Psychoanalyse, Hauptstr. 48, 69117, Heidelberg, Deutschland
| | - Sabine Hammer
- Fachbereich Gesundheit & Soziales, Hochschule Fresenius/Idstein, 65510, Idstein, Deutschland
| | - Kathryn Hoffmann
- Department of Primary Care Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Österreich
| | - Matthias Kohl
- Institute of Precision Medicine, Furtwangen University, Furtwangen im Schwarzwald, Deutschland
| | - Herbert Renz-Polster
- Zentrum für Präventivmedizin und Digitale Gesundheit, Abteilung Allgemeinmedizin, Universitätsmedizin Mannheim, Universität Heidelberg, Heidelberg, Deutschland
| | - Carmen Scheibenbogen
- Institute for Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Michael Stingl
- Facharztzentrum Votivpark, Garnisongasse 7/13, 1090, Wien, Österreich
| | - Eva Untersmayr
- Institut für Pathophysiologie und Allergieforschung, Zentrum für Pathophysiologie, Infektiologie und Immunologie, Medizinische Universität Wien, Waehringer Guertel 18-20, 1090, Wien, Österreich
| | - Mark Vink
- Independent researcher, 1096 HZ, Amsterdam, Niederlande
| | - Francisco Westermeier
- Institute of Biomedical Science, Department of Health Studies, FH, Joanneum University of Applied Sciences, Graz, Österreich
| | - Brian M Hughes
- School of Psychology, University of Galway, H91 TK33, Galway, Irland
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12
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Käärmelahti SA, Temmink RJM, van Dijk G, Prager A, Kohl M, Gaudig G, Koks AHW, Liu W, Vroom RJE, Gerwing K, Peters CJH, Krebs M, Fritz C. Nutrient dynamics of 12 Sphagnum species during establishment on a rewetted bog. Plant Biol (Stuttg) 2023. [PMID: 37186018 DOI: 10.1111/plb.13534] [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] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/11/2023] [Indexed: 05/17/2023]
Abstract
Peatland degradation through drainage and peat extraction have detrimental environmental and societal consequences. Rewetting is a mitigation option to restore lost ecosystem functions, such as carbon uptake, water retention, biodiversity and nutrient sequestration. Peat mosses (Sphagnum) are the most important peat-forming species in bogs. Most Sphagnum species occur in nutrient-poor habitats, however, high growth rates have been reported in artificial nutrient-rich conditions with optimal water supply. Here, we demonstrate the differences in nutrient dynamics of 12 Sphagnum species during their establishment in a one-year field experiment at a Sphagnum paludiculture area in NW Germany. The 12 species are categorized in three groups (slower, medium and fast-growing). Rapid establishment of the peat mosses is facilitated by constant and sufficient supply of nutrient-rich, low pH, and low alkalinity surface water. Our study shows that slower-growing species (S. papillosum, S. magellancium, S. fuscum, S. rubellum, S. austinii; often forming hummocks) displayed signs of nutrient imbalance. These species accumulated higher amounts of nitrogen, phosphorus, magnesium and calcium in their capitula, and had an elevated stem N:K quotient (> 3). Additionally, this group sequestered less carbon and potassium per m2 than the fast and medium growing species (S. denticulatum, S. fallax, S. riparium, S. fimbriatum, S. squarrosum, S. palustre, S. centrale). Lower lawn thickness may have amplified negative effects of flooding in slower-growing species. We conclude that nutrient dynamics and carbon/nutrient sequestration rates are species-specific. For optimal outcomes of bog restoration, generating ecosystem services or choosing suitable donor material for Sphagnum paludiculture, it is crucial to consider their compatibility with existing environmental conditions.
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Affiliation(s)
- S A Käärmelahti
- Aquatic Ecology and Environmental Biology, Radboud Institute for Biological and Environmental Sciences, Radboud University, Heyendaalseweg 135, 6525, AJ, Nijmegen, the Netherlands
| | - R J M Temmink
- Aquatic Ecology and Environmental Biology, Radboud Institute for Biological and Environmental Sciences, Radboud University, Heyendaalseweg 135, 6525, AJ, Nijmegen, the Netherlands
- Environmental Sciences, Copernicus Institute of Sustainable Development, Utrecht University, Princetonlaan 8a, 3584, CB, Utrecht, the Netherlands
| | - G van Dijk
- Aquatic Ecology and Environmental Biology, Radboud Institute for Biological and Environmental Sciences, Radboud University, Heyendaalseweg 135, 6525, AJ, Nijmegen, the Netherlands
- B-WARE Research Centre, Toernooiveld 1, Nijmegen, 6525, ED, the Netherlands
| | - A Prager
- Institute of Botany and Landscape Ecology, University of Greifswald, partner in the Greifswald Mire Centre, Soldmannstr. 15, 17487, Greifswald, Germany
| | - M Kohl
- Institute of Botany and Landscape Ecology, University of Greifswald, partner in the Greifswald Mire Centre, Soldmannstr. 15, 17487, Greifswald, Germany
| | - G Gaudig
- Institute of Botany and Landscape Ecology, University of Greifswald, partner in the Greifswald Mire Centre, Soldmannstr. 15, 17487, Greifswald, Germany
| | - A H W Koks
- Aquatic Ecology and Environmental Biology, Radboud Institute for Biological and Environmental Sciences, Radboud University, Heyendaalseweg 135, 6525, AJ, Nijmegen, the Netherlands
- B-WARE Research Centre, Toernooiveld 1, Nijmegen, 6525, ED, the Netherlands
| | - W Liu
- Integrated Research on Energy, Environment and Society, University of Groningen, Nijenborgh 6, 9747, AG, Groningen, the Netherlands
| | - R J E Vroom
- Aquatic Ecology and Environmental Biology, Radboud Institute for Biological and Environmental Sciences, Radboud University, Heyendaalseweg 135, 6525, AJ, Nijmegen, the Netherlands
| | - K Gerwing
- Biology and Environmental Sciences, Carl von Ossietzky University of Oldenburg, Ammerländer Heerstraße 114-118, 26129, Oldenburg, Germany
| | - C J H Peters
- Aquatic Ecology and Environmental Biology, Radboud Institute for Biological and Environmental Sciences, Radboud University, Heyendaalseweg 135, 6525, AJ, Nijmegen, the Netherlands
| | - M Krebs
- Institute of Botany and Landscape Ecology, University of Greifswald, partner in the Greifswald Mire Centre, Soldmannstr. 15, 17487, Greifswald, Germany
| | - C Fritz
- Aquatic Ecology and Environmental Biology, Radboud Institute for Biological and Environmental Sciences, Radboud University, Heyendaalseweg 135, 6525, AJ, Nijmegen, the Netherlands
- Integrated Research on Energy, Environment and Society, University of Groningen, Nijenborgh 6, 9747, AG, Groningen, the Netherlands
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13
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Wagner GE, Dabernig-Heinz J, Lipp M, Cabal A, Simantzik J, Kohl M, Scheiber M, Lichtenegger S, Ehricht R, Leitner E, Ruppitsch W, Steinmetz I. Real-Time Nanopore Q20+ Sequencing Enables Extremely Fast and Accurate Core Genome MLST Typing and Democratizes Access to High-Resolution Bacterial Pathogen Surveillance. J Clin Microbiol 2023; 61:e0163122. [PMID: 36988494 PMCID: PMC10117118 DOI: 10.1128/jcm.01631-22] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/17/2023] [Indexed: 03/30/2023] Open
Abstract
Next-generation whole-genome sequencing is essential for high-resolution surveillance of bacterial pathogens, for example, during outbreak investigations or for source tracking and escape variant analysis. However, current global sequencing and bioinformatic bottlenecks and a long time to result with standard technologies demand new approaches. In this study, we investigated whether novel nanopore Q20+ long-read chemistry enables standardized and easily accessible high-resolution typing combined with core genome multilocus sequence typing (cgMLST). We set high requirements for discriminatory power by using the slowly evolving bacterium Bordetella pertussis as a model pathogen. Our results show that the increased raw read accuracy enables the description of epidemiological scenarios and phylogenetic linkages at the level of gold-standard short reads. The same was true for our variant analysis of vaccine antigens, resistance genes, and virulence factors, demonstrating that nanopore sequencing is a legitimate competitor in the area of next-generation sequencing (NGS)-based high-resolution bacterial typing. Furthermore, we evaluated the parameters for the fastest possible analysis of the data. By combining the optimized processing pipeline with real-time basecalling, we established a workflow that allows for highly accurate and extremely fast high-resolution typing of bacterial pathogens while sequencing is still in progress. Along with advantages such as low costs and portability, the approach suggested here might democratize modern bacterial typing, enabling more efficient infection control globally.
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Affiliation(s)
- Gabriel E. Wagner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Johanna Dabernig-Heinz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Michaela Lipp
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Adriana Cabal
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Jonathan Simantzik
- Medical and Life Sciences Faculty, Furtwangen University, Villingen-Schwenningen, Germany
| | - Matthias Kohl
- Medical and Life Sciences Faculty, Furtwangen University, Villingen-Schwenningen, Germany
| | - Martina Scheiber
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Sabine Lichtenegger
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Ralf Ehricht
- InfectoGnostics Research Campus, Centre for Applied Research, Jena, Germany
- Leibniz-Institute of Photonic Technology (Leibniz-IPHT), Jena, Germany
- Friedrich Schiller University Jena, Institute of Physical Chemistry, Jena, Germany
| | - Eva Leitner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | | | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
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14
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Schinzel E, Kast S, Kohl M, von Stengel S, Jakob F, Kerschan-Schindl K, Kladny B, Lange U, Peters S, Thomasius F, Clausen J, Uder M, Kemmler W. The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis. Front Physiol 2023; 14:1135663. [PMID: 36994417 PMCID: PMC10042290 DOI: 10.3389/fphys.2023.1135663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 02/28/2023] [Indexed: 03/14/2023] Open
Abstract
Introduction: Aquatic or water-based exercise is a very popular type of exercise in particular for people with physical limitations, joint problems and fear of falling. The present systematic review and meta-analysis aimed to provide evidence for the effect of aquatic exercise on Bone Mineral Density (BMD) in adults.Methods: A systematic literature search of five electronic databases (PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science and CINAHL) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted until 2022/01/30, with an update to 2022/10/07. We included controlled trials with a duration of more than 6 months and at least two study groups, aquatic exercise (EG) versus non-training controls (CG) with no language restrictions. Outcome measures were standardized mean differences (SMD) with 95%-confidence intervals (95%-CI) for BMD changes at the lumbar spine (LS) and femoral neck (FN). We applied a random-effects meta-analysis and used the inverse heterogeneity (IVhet) model to analyze the data.Results: Excluding an outlier study with an exceptionally high effect size for LS-BMD, we observed a statistically significant (p = .002) effect (EG vs. CG) of aquatic exercise for the LS-BMD (n = 10; SMD: 0.30; 95%-CI: 0.11–0.49). In parallel, the effect of aquatic exercise on FN-BMD was statistically significant (p = .034) compared to the CG (n = 10; SMD: 0.76, 95%-CI: 0.06–1.46). Of importance, heterogeneity between the trial results was negligible for LS (I2: 7%) but substantial for FN-BMD (I2: 87%). Evidence for risks of small study/publication bias was low for LS-BMD and considerable for FN-BMD.Discussion: In summary, the present systematic review and meta-analysis provides further evidence for the favorable effect of exercise on bone health in adults. Due to its safety and attractiveness, we particularly recommend water-based exercise for people unable, afraid or unmotivated to conduct intense land-based exercise programs.
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Affiliation(s)
- Eileen Schinzel
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
| | - Stephanie Kast
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
| | - Matthias Kohl
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - Simon von Stengel
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
| | - Franz Jakob
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Bernhard-Heine-Centrum für Bewegungsforschung, University of Würzburg, Würzburg, Germany
| | - Katharina Kerschan-Schindl
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Austrian Society for Bone and Mineral Research, Vienna, Austria
| | - Bernd Kladny
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- German Society for Orthopaedics and Trauma (DGOU), Berlin, Germany
| | - Uwe Lange
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- German Society for Physical and Rehabilitative Medicine, Leipzig, Germany
| | - Stefan Peters
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- German Association for Health-Related Fitness and Exercise Therapy (DVGS), Hürth, Germany
| | - Friederike Thomasius
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Osteology Umbrella Association Germany, Austria, Switzerland
- Frankfurt Center of Bone Health, Frankfurt, Germany
| | - Jürgen Clausen
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Deutsche Rheuma-Liga Bundesverband eV, Bonn, Germany
| | - Michael Uder
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
| | - Wolfgang Kemmler
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
- *Correspondence: Wolfgang Kemmler,
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Mohebbi R, Shojaa M, Kohl M, von Stengel S, Jakob F, Kerschan-Schindl K, Lange U, Peters S, Thomasius F, Uder M, Kemmler W. Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators. Osteoporos Int 2023:10.1007/s00198-023-06682-1. [PMID: 36749350 DOI: 10.1007/s00198-023-06682-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/20/2023] [Indexed: 02/08/2023]
Abstract
The aim of this systematic review and meta-analysis was (1) to determine exercise effects on bone mineral density (BMD) in postmenopausal women and (2) to address the corresponding implication of bone and menopausal status or supervision in postmenopausal women. A comprehensive search of eight electronic databases according to the PRISMA statement up to August 9, 2022, included controlled exercise trials ≥ 6 months. BMD changes (standardized mean differences: SMD) at the lumbar spine (LS), femoral neck (FN), and total hip (TH) were considered as outcomes. Study group comparisons were conducted for osteopenia/osteoporosis versus normal BMD, early versus late postmenopausal women, and predominantly supervised versus predominantly non-supervised study arms. We applied an inverse heterogeneity (IVhet) model. In summary, 80 studies involving 94 training and 80 control groups with a pooled number of 5581 participants were eligible. The IVhet model determined SMDs of 0.29 (95% CI: 0.16-0.42), 0.27 (95% CI: 0.16-0.39), and 0.41 (95% CI: 0.30-0.52) for LS, FN, and THBMD, respectively. Heterogeneity between the trial results varied from low (I2 = 20%, TH BMD) to substantial (I2 = 68%, LS-BMD). Evidence for publication bias/small study effects was negligibly low (FN-, TH-BMD) to high (LSBMD). We observed no significant differences (p > .09) for exercise effects on LS-, FN-, or TH-BMD-LS between studies/study arms with or without osteopenia/osteoporosis, early versus late postmenopausal women, or predominantly supervised versus non-supervised exercise programs. Using robust statistical methods, the present work provides further evidence for a positive effect of exercise on BMD in postmenopausal women. Differences in bone status (osteopenia/osteoporosis versus normal bone), menopausal status (early versus late postmenopausal), and supervision (yes versus no) did not significantly affect the exercise effects on BMD at LS or proximal femur.
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Affiliation(s)
- Ramin Mohebbi
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Mahdieh Shojaa
- Department Population-Based Medicine, Institute of Health Science, University Hospital Tübingen, Tübingen, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Simon von Stengel
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Franz Jakob
- Bernhard-Heine-Centrum Für Bewegungsforschung, University of Würzburg, Würzburg, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Katharina Kerschan-Schindl
- Austrian Society for Bone and Mineral Research, Vienna, Austria
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Uwe Lange
- German Society for Physical and Rehabilitative Medicine, Dresden, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Stefan Peters
- German Association for Health-Related Fitness and Exercise Therapy (DVGS), Hürth-Efferen, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Friederike Thomasius
- Osteology Umbrella Association Germany, Austria, Switzerland
- Frankfurt Center of Bone Health, Frankfurt, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany.
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany.
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany.
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16
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Kast S, Jakob F, Kohl M, von Stengel S, Kerschan-Schindl K, Lange U, Thomasius F, Kemmler W. Exercise effects on glucocorticoid-induced bone loss in adults: a systematic review and meta-analysis. Rheumatol Adv Pract 2023; 7:rkad019. [PMID: 36844918 PMCID: PMC9945849 DOI: 10.1093/rap/rkad019] [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: 12/12/2022] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
Objectives Due to their pronounced anti-inflammatory and immunosuppressive effects, glucocorticoids (GCs) are widely used in inflammatory conditions and organ transplants. Unfortunately, GC-induced osteoporosis is one of the most common causes of secondary osteoporosis. The aim of the present systematic review and meta-analysis was to determine the effect of exercise added to GC therapy on BMD at the lumbar spine or femoral neck in people on GC therapy. Methods A systematic literature search of five electronic databases included controlled trials with a duration of >6 months and at least two study arms [glucocorticoids (GCs) and GCs and exercise (GC + EX)] were conducted up to 20 September 2022. Studies involving other pharmaceutical therapies with relevant effects on bone metabolism were excluded. We applied the inverse heterogeneity model. Outcome measures were standardized mean differences (SMDs) with 95% CIs for BMD changes at the lumbar spine (LS) and femoral neck (FN). Results We identified three eligible trials with a total of 62 participants. In summary, the GC + EX intervention indicated statistically significantly higher SMDs for LS-BMD [SMD 1.50 (95% CI 0.23, 2.77)] but not for FN-BMD [0.64 (95% CI -0.89, 2.17)] compared with GC treatment alone. We observed substantial heterogeneity (LS-BMD I 2 = 71%, FN-BMD I 2 = 78%) between the study results. Conclusion Although more well-designed exercise studies are needed to address the issue of exercise effects on GC-induced osteoporosis (GIOP) in more detail, upcoming guidelines should pay more attention to the aspect of exercise for bone strengthening in GIOP. Registration number PROSPERO: CRD42022308155.
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Affiliation(s)
- Stephanie Kast
- Institute of Radiology, FAU-Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Franz Jakob
- Bernhard-Heine-Centrum für Bewegungsforschung, University of Würzburg, Würzburg, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - Simon von Stengel
- Institute of Radiology, FAU-Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | | | - Uwe Lange
- Department of Rheumatology, Osteology und Physical Medicine, Justus-Liebig-University Gießen, Gießen, Germany
| | | | - Wolfgang Kemmler
- Correspondence to: Wolfgang Kemmler, Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestrasse 91, 91052 Erlangen, Germany. E-mail:
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Knauer K, Chaudry O, Uder M, Kohl M, Kemmler W, Bickelhaupt S, Engelke K. Effects of High-Intensity Resistance Training on Visceral Adipose Tissue and Abdominal Aortic Calcifications in Older Men with Osteosarcopenia - Results from the FrOST Study. Clin Interv Aging 2023; 18:71-80. [PMID: 36700164 PMCID: PMC9869795 DOI: 10.2147/cia.s388026] [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: 09/10/2022] [Accepted: 12/06/2022] [Indexed: 01/20/2023] Open
Abstract
Purpose To evaluate the effect of a high-intensity resistance training (HIT-RT) on visceral adipose tissue (VAT) and abdominal aortic calcifications (AAC). Patients and Methods We conducted a post hoc analysis of the Franconian Osteopenia and Sarcopenia Trial (FrOST). 43 community-dwelling men with osteosarcopenia aged 72 years and older were randomly allocated to a supervised high-intensity resistance training (HIT-RT) twice weekly for 18 months (EG; n=21) and a non-training control group (CG; n=22). Non-contrast enhanced 2-point Dixon MRI scans covering mid L2 to mid L3 were acquired to measure VAT volume inside the abdominal cavity. Volume of AAC and hard plaques in renal arteries, truncus celiacus and superior mesenteric artery was measured by computed tomography (CT) scans covering mid T12 to mid L3. Intention-to-treat analysis with imputation for missing data was used to determine longitudinal changes in VAT and AAC volume. Correlations were used to determine associations between VAT and AAC. Results Significant reduction of VAT volume in the EG (-7.7%; p<0.001) combined with no change in the CG (-1.3%; p=0.46) resulted in a significant 6.4% between group effect (p=0.022). We observed a significant increase of AAC volume in EG (+10.3%; p<0.001) and CG (12.0%; p<0.001). AAC differences between groups were not significant (p=0.57). In vascular outlets increases in volume of the hard plaques were observed in both groups, however, not all of them were significant. There was no significant correlation between changes in VAT and AAC volumes. Conclusion The study confirmed a positive impact of HIT-RT on the metabolic and cardiovascular risk profile with respect to reduction of VAT volume. No positive exercise effect on AAC was observed. However, there was a further progression of AAC volume independent of group affiliation. Whether different exercise regimen may show a positive effect on AAC remains subject to further studies.
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Affiliation(s)
- Kira Knauer
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, 91054, Germany,Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91052, Germany,Correspondence: Kira Knauer, Institute of Radiology, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Maximiliansplatz 3, Erlangen, 91054, Germany, Tel +49 9131/85-36065, Email
| | - Oliver Chaudry
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91052, Germany,Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, 91054, Germany
| | - Michael Uder
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, 91054, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, 78054, Germany
| | - Wolfgang Kemmler
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, 91054, Germany,Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91052, Germany
| | - Sebastian Bickelhaupt
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, 91054, Germany
| | - Klaus Engelke
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91052, Germany,Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, 91054, Germany
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18
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Jungmann S, Hettchen M, Kohl M, Kemmler W. Impact of 3 months of detraining after high intensity exercise on menopause-related symptoms in early postmenopausal women - results of the randomized controlled actlife project. Front Sports Act Living 2023; 4:1039754. [PMID: 36685065 PMCID: PMC9849881 DOI: 10.3389/fspor.2022.1039754] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Regular exercise might reduce postmenopausal symptoms, however even short-moderate periods of absence from exercise training might significantly reduce these positive effects. The aim of the study was thus to determine detraining effects on postmenopausal symptoms after a 3-month detraining period in early post-menopausal women. After 13 months, the exercise group (EG: n = 27; 54.6 ± 2.0; 23.6 ± 3.3 kg/m2) had to abruptly stop their supervised, facility-based, high intensity aerobic and resistance group exercise conducted three times per week due to the COVID-19 pandemic and the corresponding lockdown of all training facilities in Germany. In parallel, the control group (CG: n = 27; 55.6 ± 1.6 years, 25.2 ± 5.2 kg/m2) had to terminate their low-intensity exercise program performed once per week. Study endpoint as determined after 3 months of detraining was menopausal symptoms as determined by the Menopausal Rating Scale II (MRS II). The intention to treat principle with multiple imputation was applied. After 13 months of intense multicomponent exercise and significant exercise-induced effects on menopausal symptoms, a further 3 months of detraining resulted in non-significant deteriorations (p = .106) in the exercise group, while non-significant improvements were observed in the control group (p = .180). Corresponding group differences were significant (p = .036) after detraining. Of importance, self-reported individual outdoor activities increased by about 40% in both groups during the three-month lock-down period. Three months of absence from a supervised high-intensity group exercise protocol resulted in detraining effects on postmenopausal symptoms even when outdoor physical activity was increased significantly. Trial registration number ClinicalTrials.gov: NCT03959995.
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Affiliation(s)
- Sophia Jungmann
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Hettchen
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany,Institute of Radiology, University-Hospital Erlangen, Erlangen, Germany,Correspondence: Wolfgang Kemmler
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Hoffmann I, Kohl M, von Stengel S, Jakob F, Kerschan-Schindl K, Lange U, Peters S, Schoene D, Sieber C, Thomasius F, Bischoff-Ferrari HA, Uder M, Kemmler W. Exercise and the prevention of major osteoporotic fractures in adults: a systematic review and meta-analysis with special emphasis on intensity progression and study duration. Osteoporos Int 2023; 34:15-28. [PMID: 36355068 PMCID: PMC9813248 DOI: 10.1007/s00198-022-06592-8] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022]
Abstract
UNLABELLED The role of exercise in preventing osteoporotic fractures is vague, and further recommendations for optimized exercise protocols are very rare. In the present work, we provided positive evidence for exercise effects on the number of osteoporotic fractures in adults, albeit without observing any significant relevance of intensity progression or study duration. INTRODUCTION Osteoporotic fractures are a major challenge confronting our aging society. Exercise might be an efficient agent for reducing osteoporotic fractures in older adults, but the most promising exercise protocol for that purpose has yet to be identified. The present meta-analysis thus aimed to identify important predictors of the exercise effect on osteoporotic fractures in adults. METHODS We conducted a systematic search of six literature databases according to the PRISMA guideline that included controlled exercise studies and reported the number of low-trauma major osteoporotic fractures separately for exercise (EG) and control (CG) groups. Primary study outcome was incidence ratio (IR) for major osteoporotic fractures. Sub-analyses were conducted for progression of intensity (yes vs. no) during the trial and the study duration (≤ 12 months vs. > 12 months). RESULTS In summary, 11 studies with a pooled number of 9715 participant-years in the EG and 9592 in the CG were included. The mixed-effects conditional Poisson regression revealed positive exercise effects on major osteoporotic fractures (RR: 0.75, 95% CI: 0.54-0.94, p = .006). Although studies with intensity progression were more favorable, our subgroup analysis did not determine significant differences for diverging intensity progression (p = .133) or study duration (p = .883). Heterogeneity among the trials of the subgroups (I2 ≤ 0-7.1%) was negligible. CONCLUSION The present systematic review and meta-analysis provided significant evidence for the favorable effect of exercise on major osteoporotic fractures. However, diverging study and exercise characteristics along with the close interaction of exercise parameters prevented the derivation of reliable recommendations for exercise protocols for fracture reductions. PROSPERO ID CRD42021250467.
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Affiliation(s)
- Isabelle Hoffmann
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
| | - Matthias Kohl
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
- Department of Medicine and Life Sciences, University of Furtwangen, Schwenningen, Germany
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Franz Jakob
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- Bernhard-Heine-Center Movement Science, University of Würzburg, Würzburg, Germany
| | - Katharina Kerschan-Schindl
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- Austrian Society for Bone and Mineral Research, Vienna, Austria
| | - Uwe Lange
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- German Society for Physical and Rehabilitative Medicine, Ulm, Germany
| | - Stefan Peters
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- German Association for Health-Related Fitness and Exercise Therapy (DVGS E.V.), Hürth-Efferen, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Cornel Sieber
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- European Geriatric Medicine Society (EuGMS), Institute for Biomedicine of Aging, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Friederike Thomasius
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- Osteology Umbrella Association Austria, Germany, Switzerland
| | - Heike A Bischoff-Ferrari
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
- Department of Geriatrics and Aging Research, University Hospital of Zurich, City Hospital of Zurich-Waid and University of Zurich, Zurich, Switzerland
- Centre On Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Michael Uder
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- Research and Writing Group On Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention" (Bone Division), Erlangen, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany.
- Department of Aging Medicine, University Hospital Zurich and City Hospital Zurich, Zurich, Switzerland.
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany.
- Research and Writing Group On Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention" (Bone Division), Erlangen, Germany.
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Paskali F, Simantzik J, Dieterich A, Kohl M. Specification of Neck Muscle Dysfunction through Digital Image Analysis Using Machine Learning. Diagnostics (Basel) 2022; 13:diagnostics13010007. [PMID: 36611299 PMCID: PMC9818408 DOI: 10.3390/diagnostics13010007] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/17/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
Everyone has or will have experienced some degree of neck pain. Typically, neck pain is associated with the sensation of tense, tight, or stiff neck muscles. However, it is unclear whether the neck muscles are objectively stiffer with neck pain. This study used 1099 ultrasound elastography images (elastograms) obtained from 38 adult women, 20 with chronic neck pain and 18 asymptomatic. For training machine learning algorithms, 28 numerical characteristics were extracted from both the original and transformed shear wave velocity color-coded images as well as from respective image segments. Overall, a total number of 323 distinct features were generated from the data. A supervised binary classification was performed, using six machine-learning algorithms. The random forest algorithm produced the most accurate model to distinguish the elastograms of women with chronic neck pain from asymptomatic women with an AUC of 0.898. When evaluating features that can be used as biomarkers for muscle dysfunction in neck pain, the region of the deepest neck muscles (M. multifidus) provided the most features to support the correct classification of elastograms. By constructing summary images and associated Hotelling's T2 maps, we enabled the visualization of group differences and their statistical confirmation.
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Affiliation(s)
- Filip Paskali
- Institute of Precision Medicine, Medical and Life Sciences, Hochschule Furtwangen, 78054 Villingen-Schwenningen, Germany
| | - Jonathan Simantzik
- Institute of Precision Medicine, Medical and Life Sciences, Hochschule Furtwangen, 78054 Villingen-Schwenningen, Germany
| | - Angela Dieterich
- Physiotherapie, Fakultät Gesundheit, Sicherheit, Gesellschaft, Hochschule Furtwangen, Studienzentrum Freiburg, 79110 Freiburg, Germany
| | - Matthias Kohl
- Institute of Precision Medicine, Medical and Life Sciences, Hochschule Furtwangen, 78054 Villingen-Schwenningen, Germany
- Correspondence:
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Hettchen M, Willert S, von Stengel S, Kohl M, Kemmler W. Effects of the "Spinomed active" orthosis on chronic back pain in kyphotic women with osteoporotic vertebral fractures three months and older: A randomized controlled study. Front Pain Res (Lausanne) 2022; 3:1038269. [PMID: 36618579 PMCID: PMC9811681 DOI: 10.3389/fpain.2022.1038269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022]
Abstract
Vertebral fractures are frequent clinical consequences of osteoporosis. Considering the demographic change in Europe, the number of vertebral fractures will quite likely increase during the next decades. Apart from pharmaceutic agents and physiotherapy, spinal orthoses are established elements of conservative therapy for vertebral (body) fractures. Recent studies on acute vertebral fractures reported positive effects on back pain, kyphosis and functional disabilities, but the efficacy of active strengthening spinal orthoses in vertebral fractures ≥6 months remains to be established. Eighty hyperkyphotic, community-dwelling women ≥65 years with chronic back pain and vertebral fractures occurred ≥3 months ago were randomly allocated to a group which wore the "Spinomed active" orthoses 2 × 2-3 h/d for 16 weeks (SOG: n = 40) or an untreated control group (CG: n = 40). Study outcomes were back pain intensity, kyphosis angle, trunk strength, back pain induced- and general function and disability, functional ability (chair-rise test) and respiratory function. We applied an intention-to-treat analysis; data were consistently adjusted for baseline values applying an ANCOVA. Observing a compliance of 82 ± 14% with the wearing protocol, we determined large and significant favorable effects for back pain (p = .008), back pain-induced physical disability (p < .001) and kyphosis angle (p < .001). We also demonstrated positive effects on trunk strength (p = .049), functional ability (p = .062) and general function and disability (p = .057), although not all of the parameters reach significance. No relevant changes were observed for respiratory function. After a few further individual adjustments of the orthosis (n = 2), no adverse effects were reported. In summary, the present study provided evidence for the efficacy of an active strengthening spinal orthosis ("Spinomed active") in people with vertebral fractures ≥6 months. Based on our results, we recommend expanding the application of the "Spinomed active" orthosis, which was previously validated for acute vertebral fractures, also to older hyperkyphotic women with osteoporotic vertebral fractures ≥3 months.
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Affiliation(s)
- Matthias Hettchen
- Institute of Medical Physics,Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Sebastian Willert
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Simon von Stengel
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Matthias Kohl
- Department of Medicine and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics,Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany,Institute of Radiology, University Hospital Erlangen, Erlangen, Germany,Correspondence: Wolfgang Kemmler
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22
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Vink M, Grande T, Kohl M. Letter to the Editor Regarding Fleischer et al. Neurological Study Does Not Provide Any Evidence that Long COVID is Psychosomatic. Neurol Ther 2022; 12:329-332. [PMID: 36508159 PMCID: PMC9744047 DOI: 10.1007/s40120-022-00426-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/10/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- Mark Vink
- Independent Researcher, Amsterdam, The Netherlands.
| | | | - Matthias Kohl
- Institute of Precision Medicine, Furtwangen University, Furtwangen im Schwarzwald, Germany
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Saemann L, Kohl M, Veres G, Korkmaz‐Icöz S, Großkopf A, Karck M, Simm A, Wenzel F, Szabó G. Prediction Model for Contractile Function of Circulatory Death Donor Hearts Based on Microvascular Flow Shifts During Ex Situ Hypothermic Cardioplegic Machine Perfusion. J Am Heart Assoc 2022; 11:e027146. [PMID: 36382941 PMCID: PMC9851462 DOI: 10.1161/jaha.122.027146] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Hearts procured from circulatory death donors (DCD) are predominantly maintained by machine perfusion (MP) with normothermic donor blood. Currently, DCD heart function is evaluated by lactate and visual inspection. We have shown that MP with the cardioplegic, crystalloid Custodiol-N solution is superior to blood perfusion to maintain porcine DCD hearts. However, no method has been developed yet to predict the contractility of DCD hearts after cardioplegic MP. We hypothesize that the shift of microvascular flow during continuous MP with a cardioplegic preservation solution predicts the contractility of DCD hearts. Methods and Results In a pig model, DCD hearts were harvested and maintained by MP with hypothermic, oxygenated Custodiol-N for 4 hours while myocardial microvascular flow was measured by Laser Doppler Flow (LDF) technology. Subsequently, hearts were perfused with blood for 2 hours, and left ventricular contractility was measured after 30 and 120 minutes. Various novel parameters which represent the LDF shift were computed. We used 2 combined LDF shift parameters to identify bivariate prediction models. Using the new prediction models based on LDF shifts, highest r2 for end-systolic pressure was 0.77 (P=0.027), for maximal slope of pressure increment was 0.73 (P=0.037), and for maximal slope of pressure decrement was 0.75 (P=0.032) after 30 minutes of reperfusion. After 120 minutes of reperfusion, highest r2 for end-systolic pressure was 0.81 (P=0.016), for maximal slope of pressure increment was 0.90 (P=0.004), and for maximal slope of pressure decrement was 0.58 (P=0.115). Identical prediction models were identified for maximal slope of pressure increment and for maximal slope of pressure decrement at both time points. Lactate remained constant and therefore was unsuitable for prediction. Conclusions Contractility of DCD hearts after continuous MP with a cardioplegic preservation solution can be predicted by the shift of LDF during MP.
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Affiliation(s)
- Lars Saemann
- Department of Cardiac Surgery, University Hospital Halle (Saale)University of HalleHalle (Saale)Germany,Department of Cardiac SurgeryUniversity Hospital HeidelbergHeidelbergGermany
| | - Matthias Kohl
- Faculty Medical and Life SciencesFurtwangen UniversityVillingen‐SchwenningenGermany
| | - Gábor Veres
- Department of Cardiac Surgery, University Hospital Halle (Saale)University of HalleHalle (Saale)Germany,Department of Cardiac SurgeryUniversity Hospital HeidelbergHeidelbergGermany
| | - Sevil Korkmaz‐Icöz
- Department of Cardiac Surgery, University Hospital Halle (Saale)University of HalleHalle (Saale)Germany,Department of Cardiac SurgeryUniversity Hospital HeidelbergHeidelbergGermany
| | - Anne Großkopf
- Department of Cardiac Surgery, University Hospital Halle (Saale)University of HalleHalle (Saale)Germany
| | - Matthias Karck
- Department of Cardiac SurgeryUniversity Hospital HeidelbergHeidelbergGermany
| | - Andreas Simm
- Department of Cardiac Surgery, University Hospital Halle (Saale)University of HalleHalle (Saale)Germany
| | - Folker Wenzel
- Faculty Medical and Life SciencesFurtwangen UniversityVillingen‐SchwenningenGermany
| | - Gábor Szabó
- Department of Cardiac Surgery, University Hospital Halle (Saale)University of HalleHalle (Saale)Germany,Department of Cardiac SurgeryUniversity Hospital HeidelbergHeidelbergGermany
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24
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Münch F, Purbojo A, Wenzel F, Kohl M, Dittrich S, Rauh M, Zimmermann R, Kwapil N. [Improved quality of stored packed red blood cells by mechanical rinsing]. Anaesthesiologie 2022; 71:882-892. [PMID: 35969253 PMCID: PMC9636120 DOI: 10.1007/s00101-022-01189-6] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 07/03/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The transfusion of packed red blood cells (PRBC) is associated with various side effects, including storage damage to PRBCs. The cells change their structure, releasing potassium as well as lactate. Mechanical rinsing, available in many hospitals, is able to remove toxic substances and possibly minimizes the negative side effects of transfusion. OBJECTIVE The primary aim of our study was to improve the quality of PRBCs before transfusion. The effects of different washing solutions on PRBC quality were analyzed. MATERIAL AND METHODS This in vitro study compares 30 mechanically washed PRBCs. They were either processed with standard normal saline 0.9% (n = 15, N group) or a hemofiltration solution containing 4 mmol/l potassium (n = 15, HF group) by a mechanical rinsing device (Xtra, LivaNova, Munich, Germany). A subgroup analysis was performed based on the storage duration of the processed PRBCs (7, 14, 37 days). Samples were taken before washing (EKprä), immediately after washing (EKpost) and 10 h later (EKpost10h), after storage in the "wash medium" at room temperature. Concentrations of ATP (probability of survival in transfused erythrocytes), lactate, citrate and electrolytes (potassium, sodium, chloride, calcium) were tested. RESULTS AND CONCLUSION Mechanical rinsing improves pretransfusion quality of PRBC. Washing with a hemofiltration solution results in a more physiological electrolyte composition. Even 10 h after mechanical rinsing with a hemofiltration solution, the quality of 37-day-old PRBC is comparable to young PRBC that have been stored for 7 days and have not been washed. Washing stored PRBC increases the ATP content, which subsequently leads to an increased probability of survival of red cells after transfusion.
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Affiliation(s)
- F Münch
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Loschgestraße 15, 91054, Erlangen, Deutschland.
| | - A Purbojo
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Loschgestraße 15, 91054, Erlangen, Deutschland
| | - F Wenzel
- Fakultät Medical and Life Science, Hochschule Furtwangen University Campus Villingen-Schwenningen, Jakob-Kienzle-Str. 17, 78054, Villingen-Schwenningen, Deutschland
| | - M Kohl
- Fakultät Medical and Life Science, Hochschule Furtwangen University Campus Villingen-Schwenningen, Jakob-Kienzle-Str. 17, 78054, Villingen-Schwenningen, Deutschland
| | - S Dittrich
- Kinderkardiologische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Loschgestraße 15, 91054, Erlangen, Deutschland
| | - M Rauh
- Klinisches Labor der Kinder- und Jugendklinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Loschgestraße 15, 91054, Erlangen, Deutschland
| | - R Zimmermann
- Transfusionsmedizinische und Hämostaseologische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Deutschland
| | - N Kwapil
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Loschgestraße 15, 91054, Erlangen, Deutschland
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25
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Hoffmann I, Shojaa M, Kohl M, von Stengel S, Becker C, Gosch M, Jakob F, Kerschan-Schindl K, Kladny B, Clausen J, Lange U, Middeldorf S, Peters S, Schoene D, Sieber C, Tholen R, Thomasius F, Bischoff-Ferrari HA, Uder M, Kemmler W. Exercise Reduces the Number of Overall and Major Osteoporotic Fractures in Adults. Does Supervision Make a Difference? Systematic Review and Meta-Analysis. J Bone Miner Res 2022; 37:2132-2148. [PMID: 36082625 DOI: 10.1002/jbmr.4683] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 02/06/2022] [Revised: 07/14/2022] [Accepted: 08/14/2022] [Indexed: 11/07/2022]
Abstract
The purpose of this systematic review and meta-analysis (PROSPERO ID: CRD42021250467) was to evaluate the effects of exercise on low-trauma overall and major osteoporotic fractures (hip, spine, forearm, or humerus fractures) and to determine the corresponding effect of supervision of the exercise program. Our systematic search of six literature databases according to the PRISMA guideline was conducted from January 1, 2013 (ie, date of our last search) to May 22, 2021, and included controlled clinical exercise trials with (i) individuals aged ≥45 years, (ii) cohorts without therapies/diseases related to fractures, (iii) observation periods of ≥3 months, and (iv) the number of low-trauma fractures listed separately for the exercise (EG) and control (CG) groups. We included 20 intervention studies with 21 EGs and 20 CGs comprising a pooled number of participant-years of n = 11.836 in the EG and n = 11.275 in the CG. The mixed-effects conditional Poisson regression revealed significant effects of exercise on low-trauma overall incidence (rate) ratio (IR 0.67, 95% confidence interval [95% CI] 0.51-0.87) and major osteoporotic fractures IR (0.69, 95% CI 0.52-0.92). Heterogeneity between the trials was moderate for low-trauma overall (I2 = 40%) and negligible (I2 < 1%) for major osteoporotic fractures. Supervision of the exercise program plays a significant role in the reductions of overall and major osteoporotic fractures with IR about twice as favorable in the predominately supervised (IR 0.44; 95% CI 0.27-0.73 and 0.38; 0.19-0.76) versus the predominately non-supervised exercise trials (IR 0.83; 95% CI 0.60-1.14 and 0.82; 0.64-1.05). In summary, the present study provides evidence for the positive effect of exercise on low-trauma overall and major osteoporotic fractures in middle aged to older adults. Supervision of the exercise program is a crucial aspect in exercise programs on fracture reduction. Thus, home-based exercise protocols should increasingly implement online classes to ensure widely consistent supervision and monitoring of the exercise program. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Isabelle Hoffmann
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Mahdieh Shojaa
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Institute of Health Science, Department of Population-Based Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Clemens Becker
- Robert-Bosch-Hospital, Geriatrics and Geriatric Rehabilitation, Stuttgart, Germany
| | - Markus Gosch
- Paracelsus Medical University Nürnberg and General Hospital Nürnberg, Nuremberg, Germany
| | - Franz Jakob
- Bernhard Heine Centre of Movement Science, University of Würzburg, Würzburg, Germany
| | | | - Bernd Kladny
- German Society for Orthopaedics and Trauma, Frankfurt, Germany
| | | | - Uwe Lange
- German Society for Physical and Rehabilitative Medicine, Ulm, Germany
| | | | - Stefan Peters
- German Association for Health-Related Fitness and Exercise Therapy (DVGS) e.V, Hürth-Efferen, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Cornel Sieber
- European Geriatric Medicine Society (EuGMS), Institute for Biomedicine of Aging, FAU Erlangen-Nürnberg, Nürnberg, Germany
| | - Reina Tholen
- Deutscher Verband für Physiotherapie (ZVK) e.V, Köln, Germany
| | | | - Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University Hospital of Zurich, City Hospital of Zurich-Waid and University of Zurich, Centre on Aging and Mobility, University of Zurich, Zürich, Switzerland
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
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26
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Bollinger M, Saile P, Shapeton AD, Kohl M, Kumle B. Sensitivity of severe acute respiratory syndrome coronavirus type 2 rapid antigen point-of-care tests in vaccinated patients. Eur J Emerg Med 2022; 29:285-290. [PMID: 35413034 PMCID: PMC9241555 DOI: 10.1097/mej.0000000000000928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/08/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND IMPORTANCE Rapid antigen point-of-care tests (antigen POC tests) are frequently used to detect COVID-19 infections. Based on clinical impressions, we suspected that the sensitivity of antigen POC tests might be lower in vaccinated patients. OBJECTIVE To evaluate the sensitivity of antigen POC tests in vaccinated patients. DESIGN, SETTING AND PARTICIPANTS We retrospectively evaluated all patients over 18 years of age that tested positive for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) in November 2021 at our institution, whose antigen POC test result had been recorded. We considered patients who were either fully vaccinated or unvaccinated, as well as whether they were symptomatic. OUTCOME MEASURE AND ANALYSIS We calculated the sensitivity of antigen POC tests in vaccinated and unvaccinated as well as in symptomatic and asymptomatic patients and compared the results. RESULTS A total of 4080 reverse transcription PCR tests were performed in our institution in November 2021, of which 360 patients tested positive for SARS-CoV-2. Of those, 234 patients met inclusion criteria and were further evaluated. The sensitivity of the antigen POC test was only 39.4% [95% confidence interval (CI), 31.3-48.1%] in vaccinated patients and differed significantly from the sensitivity of 53.3% (95% CI, 43.9-62.4%) in unvaccinated patients (difference of sensitivities, 13.9%; 95% CI, 1.1-26.1%). In symptomatic patients, the sensitivity increased by only 11.8% from 45.7% in all patients (95% CI, 39.5-52.1%) to 57.5% in symptomatic patients (95% CI, 49.9-64.7%). In asymptomatic patients, the antigen POC test was only able to detect SARS-CoV-2 positive patients in 16.4% of the cases (95% CI, 9.4-27.1%). CONCLUSION Point-of-care antigen tests are likely not useful for ruling out SARS-CoV-2 infection, especially in vaccinated and asymptomatic patients, potentially due to lower viral load. Moreover, the use of these tests might lead to a false sense of security, especially when used by the public as part of a public health testing strategy.
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Affiliation(s)
- Matthias Bollinger
- Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Schwarzwald-Baar Hospital, Villingen-Schwenningen
- Witten/Herdecke University, Faculty of Health, School of Medicine, Witten
| | - Petra Saile
- Central Laboratory, Schwarzwald-Baar Hospital, Villingen-Schwenningen, Germany
| | - Alexander D. Shapeton
- Boston Veterans Affairs Healthcare System
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Matthias Kohl
- Furtwangen University, Faculty of Medical and Life Sciences
| | - Bernhard Kumle
- Furtwangen University, Faculty of Medical and Life Sciences
- Department of Emergency Medicine, Schwarzwald-Baar Hospital, Villingen-Schwenningen, Germany
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27
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Kast S, Shojaa M, Kohl M, von Stengel S, Gosch M, Jakob F, Kerschan-Schindl K, Kladny B, Klöckner N, Lange U, Middeldorf S, Peters S, Schoene D, Sieber C, Thomasius F, Uder M, Kemmler W. Effects of different exercise intensity on bone mineral density in adults: a comparative systematic review and meta-analysis. Osteoporos Int 2022; 33:1643-1657. [PMID: 35304613 PMCID: PMC9499891 DOI: 10.1007/s00198-022-06329-7] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/31/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE The primary objective of the present systematic review and meta-analysis was to determine the effect of differing exercise intensity on (areal) bone mineral density (BMD) at lumbar spine and hip in adults by a comparative meta-analysis. METHODS A systematic review of the literature according to the PRISMA statement included: (a) exercise trials, (b) with ≥two study arms that compared different exercise intensities, (c) intervention ≥6 months, (d) BMD assessments at lumbar spine (LS) or hip. Five electronic databases were scanned without language restrictions up to July 2021. The present analysis of exercise intensity was conducted as a mixed-effect meta-analysis and applied "type of exercise" and "study duration" as moderator in subgroup analyses. Outcome measures were standardized mean differences (SMD) for BMD changes at the LS, and hip. RESULTS Eleven exercise studies with 26 study arms were included. Although the effect of high-intensity exercise was more pronounced on LS-BMD (SMD: 0.19, 95%-CI: 0.61 to -0.23) and hip-ROI (0.17, 0.38 to -0.04), we did not observe significant differences between the groups (LS-BMD: p=0.373 and hip-BMD: p=0.109). We observed a substantial level of heterogeneity between the trials for LS- but not for hip-BMD. Applying "type of exercise" and "study duration" as moderators did not significantly modify the differences between low and high exercise intensity on BMD at LS or hip. CONCLUSION There is insufficient evidence for a superior effect of high-intensity exercise on areal BMD at lumbar spine and hip in people aged 50 years and older. Varying exercise intensity with periods of lower exercise intensity intermitted by higher intensity might be a promising option to address the issue of exercise intensities in intervention studies.
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Affiliation(s)
- S Kast
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
| | - M Shojaa
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Institute of Health Science, Department Population-Based Medicine, University Hospital Tübingen, Tübingen, Germany
| | - M Kohl
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Department of Med. and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - S von Stengel
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
| | - M Gosch
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Paracelsus Medical University Nürnberg and General Hospital Nürnberg, Nürnberg, Germany
| | - F Jakob
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Bernhard Heine Zentrum für Bewegungsforschung, University of Würzburg, Würzburg, Germany
| | - K Kerschan-Schindl
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Austrian Society for Bone and Mineral Research, Vienna, Austria
| | - B Kladny
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- German Society for Orthopaedics and Trauma, Berlin, Germany
| | - N Klöckner
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Deutsche Rheuma-Liga Bundesverband e.V., Bonn, Germany
| | - U Lange
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- German Society for Physical and Rehabilitative Medicine, Dresden, Germany
| | - S Middeldorf
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- International Musculoskeletal Pain Society, Berlin, Germany
| | - S Peters
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- German Association for Health-Related Fitness and Exercise Therapy, Hürth-Efferen, Germany
| | - D Schoene
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
| | - C Sieber
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- European Geriatric Medicine Society (EuGMS), Institute for Biomedicine of Aging, FAU Erlangen-Nürnberg, Nürnberg, Germany
| | - F Thomasius
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Osteology Umbrella Association Germany, Austria, Switzerland, Frankfurt, Germany
| | - M Uder
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
| | - W Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany.
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany.
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Kuderer S, Vagedes K, Szöke H, Kohl M, Joos S, Gündling PW, Vagedes J. Do ginger footbaths improve symptoms of insomnia more than footbaths with warm water only? - A randomized controlled study. Complement Ther Med 2022; 67:102834. [PMID: 35439548 DOI: 10.1016/j.ctim.2022.102834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To compare the effects between warm water (WW) and ginger footbaths (WW+ginger) on sleep quality and warmth regulation in adults with self-reported insomnia symptoms. METHODS A prospective randomized-controlled study in which 28 participants (mean age 50.9 years, 64.3% women, insomnia symptom duration 11.4 years) were randomized to receive WW (n = 13) or WW+ginger (n = 15) daily for 2 weeks. Treatment involved nightly footbaths (12 liters of 38-42 °C warm tap water, maximum duration 20 min) with and without topical ginger (80 g of powdered ginger rhizomes). MAIN OUTCOME MEASURES The primary outcome measure was self-reported sleep quality (global score from Pittsburgh Sleep Quality Index, PSQI) at 2 weeks. Secondary outcomes included measures of insomnia severity (Insomnia Severity Index, ISI) and warmth regulation (Herdecke Warmth Perception Questionnaire, HWPQ and 24-hour distal-proximal skin temperature gradient, DPG). RESULTS WW+ginger had no greater effect on PSQI (mean between-difference 0.0 [95% CI -3.0 to 2.9], Cohen's d=0.0) or ISI (-0.2 [-3.9 to 3.4], 0.0) than WW. Nor were there any significant differences in HWPQ perceived warmth (0.1 ≥d≥0.5) or DPG (0.1 ≥d≥0.4) between WW and WW+ginger. Both groups improved over time in PSQI (WW+ginger: d=0.7, WW: d=1.3) and ISI (WW+ginger: d=0.8, WW: d=1.0). Perceived warmth of the feet increased only in WW+ginger over time (d=0.6, WW: d=0.0). CONCLUSIONS This dose of ginger (6.67 g/liter) did not have greater effects on sleep quality, insomnia severity or warmth regulation than WW. Considering effect sizes, costs and risks, the use of WW would be recommended over WW+ginger in this patient population.
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Affiliation(s)
- Silja Kuderer
- Research Department, ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Im Haberschlai 7, 70794 Filderstadt, Germany
| | - Katrin Vagedes
- Research Department, ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Im Haberschlai 7, 70794 Filderstadt, Germany
| | - Henrik Szöke
- Department of Integrative Medicine, University of Pécs, Vörösmarty utca 3, 7623 Pécs, Hungary
| | - Matthias Kohl
- Institute of Precision Medicine, University Furtwangen, Jakob-Kienzle-Straße 17, 78054 VS-Schwenningen, Germany
| | - Stefanie Joos
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Osianderstraße 5, 72076 Tübingen, Germany
| | - Peter W Gündling
- Hochschule Fresenius, University of Applied Sciences, Limburger Str. 2, 65510 Idstein, Germany
| | - Jan Vagedes
- Research Department, ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Im Haberschlai 7, 70794 Filderstadt, Germany; Department of Neonatology, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany; Department of Pediatrics, Filderklinik, Im Haberschlai 7, 70794 Filderstadt, Germany.
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29
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Born C, Jakob F, Shojaa M, Kohl M, von Stengel S, Kerschan-Schindl K, Lange U, Thomasius F, Kemmler W. Effects of Hormone Therapy and Exercise on Bone Mineral Density in Healthy Women-A Systematic Review and Meta-analysis. J Clin Endocrinol Metab 2022; 107:2389-2401. [PMID: 35325147 DOI: 10.1210/clinem/dgac180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT There is some evidence that an adequate "anabolic hormonal milieu" is essential for the mechanosensitivity/transduction/response of bone tissue. OBJECTIVE This work aimed to determine whether enhancing hormone therapy (HT) with exercise increases the isolated effect of HT on bone mineral density (BMD) at the lumbar spine (LS) and femoral neck (FN). METHODS A comprehensive search of 6 electronic databases according to the PRISMA statement up to April 28, 2021, included controlled trials longer than 6 months with 3 study arms: (a) HT, (b) exercise, and (c) HT plus exercise (HT + E). Apart from HT, no pharmaceutic therapy or diseases with relevant osteoanabolic or osteocatabolic effect on bone metabolism were included. The present analysis was conducted as a random-effects meta-analysis. Outcome measures were standardized mean differences (SMD) for BMD changes at the LS and FN. RESULTS Our search identified 6 eligible studies (n = 585). Although the effect of HT + E was more pronounced in the LS (SMD: 0.19; 95% C,: -0.15 to 0.53) and FN-BMD (0.18; -0.09 to 0.44) compared to the HT group, we did not observe significant differences between the 2 groups. We observed a low (I2: 29%) or moderate (I2: 49%) level of heterogeneity between the trials for FN or LS. CONCLUSION We do not observe a significant effect of HT + E vs HT alone. We largely attribute this result to varying HT supplementation and hormonal status. Bearing in mind that synergistic/additive effects between HT and mechanical stimulation can only be expected in situations of hormonal insufficiency, further clinical studies should consider baseline endogenous estrogen production but also HT dosing more carefully.
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Affiliation(s)
- Clara Born
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Franz Jakob
- Bernhard-Heine-Centrum für Bewegungsforschung, University of Würzburg, 97074 Würzburg, Germany
| | - Mahdieh Shojaa
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, 91052 Erlangen, Germany
- University Hospital Tübingen, Institute of Health Science, Department Population-Based Medicine, 72076 Tübingen, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, 78056 Villingen-Schwenningen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, 91052 Erlangen, Germany
| | | | - Uwe Lange
- German Society for Physical and Rehabilitative Medicine, 01067 Dresden, Germany
| | - Friederike Thomasius
- Osteology Umbrella Association Germany, Austria ,Switzerland; Frankfurt Center of Bone Health, 60306 Frankfurt, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, 91052 Erlangen, Germany
- Institute of Radiology, FAU-Erlangen-Nürnberg, University Hospital Erlangen, 91054 Erlangen, Germany
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Salem AA, Trares K, Kohl M, Jansen E, Brenner H, Schöttker B. Long-term effects of smoking on serum concentrations of oxidative stress biomarkers: Results of a large, population-based cohort study. Environ Res 2022; 204:111923. [PMID: 34428452 DOI: 10.1016/j.envres.2021.111923] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Cross-sectional studies have consistently shown an association between current smoking and oxidative stress biomarkers. However, no longitudinal studies have been performed so far. METHODS The oxidative stress biomarkers "total thiol groups of serum proteins" (TTP), and "derivatives of reactive oxygen metabolites" (D-ROM) were measured in serum samples of 3835 participants of a population-based, German cohort study of older adults (age: 60-84 years) with repeated measurements for 2834 participants three years later. Multivariable linear regression models were applied and β-coefficients with 95% confidence intervals were obtained. RESULTS In both cross-sectional and longitudinal analysis, current smoking was statistically significantly associated with increased D-ROM levels, and a dose-response relationship between the amount of daily tobacco consumption and the D-ROM concentrations was observed that plateaued at ≥15 g of tobacco consumption per day. Former smoking was also associated with D-ROM levels. Only former smokers who quitted smoking more than 10 years ago had no increased D-ROM levels compared to never smokers. There was neither a cross-sectional nor longitudinal association between any of the smoking variables and TTP levels. CONCLUSION This large population-based cohort of older German adults suggests that smoking has long-term effects on the oxidative stress burden. The further increasing D-ROM levels of current smokers at an older age and the observation that it may take more than 10 years until the redox balance is restored are solid arguments for quitting smoking as soon as possible at any age.
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Affiliation(s)
- Ahmed Abdelraouf Salem
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Medical and Life Science, Furtwangen University, Germany
| | - Kira Trares
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research, Heidelberg University, Germany
| | - Matthias Kohl
- Department of Medical and Life Science, Furtwangen University, Germany
| | - Eugène Jansen
- Centre for Health Protection, National Institute of Public Health and the Environment, Bilthoven, the Netherlands
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research, Heidelberg University, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research, Heidelberg University, Germany.
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Zitzmann AL, Shojaa M, Kast S, Kohl M, von Stengel S, Borucki D, Gosch M, Jakob F, Kerschan-Schindl K, Kladny B, Lange U, Middeldorf S, Peters S, Schoene D, Sieber C, Thomasius F, Uder M, Kemmler W. The effect of different training frequency on bone mineral density in older adults. A comparative systematic review and meta-analysis. Bone 2022; 154:116230. [PMID: 34624560 DOI: 10.1016/j.bone.2021.116230] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 12/22/2022]
Abstract
Exercise frequency is a key aspect of exercise protocols. In this systematic review and meta-analysis, we determined the effect of training frequency on (areal) bone mineral density (BMD) at lumbar spine (LS) and hip. Reviewing seven electronic databases up to April 2021, we conducted a systematic review of the literature according to the PRISMA statement. Inclusion criteria were (a) controlled exercise trials (b) with at least two study arms that compared low versus high exercise frequency, (c) an intervention ≥6 months and (d) BMD assessments at lumbar spine (LS) or hip. The analysis was conducted as a mixed-effect meta-analysis and used "type of exercise" and "study duration" as moderators in subgroup analyses. Standardized mean differences (SMD) for LS- and hip-BMD changes were defined as outcome measures. Seven studies with 17 exercise groups were included in the analysis. We observed significantly higher effects of high (≥2 sessions/week) vs. low net training frequency (1-<2 sessions/week) exercise on LS- (SMD 0.55, 95%-CI: 0.20-0.90) but not hip-BMD (0.19, -0.06 to 0.45). Study duration was found to be a significant moderator for the effect of training frequency at LS- but not hip-BMD. In parallel, the type of exercise moderately influences the effect of training frequency on LS- but not on hip-BMD. We observed a superior effect of higher net training frequency on BMD. Longer exercise exposition increases this effect. Considering e.g. holidays, indisposition or other temporary absence, exercise programs on osteoporosis should provide at least 3 sessions/week/year to allow a net training frequency of more than two sessions/week. STUDY REGISTRATION: PROSPERO (CRD42021246804).
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Affiliation(s)
- Anna-Lena Zitzmann
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Mahdieh Shojaa
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany; University Hospital Tübingen, Institute of Health Science, Department Population-Based Medicine, Tübingen, Germany
| | - Stephanie Kast
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Diana Borucki
- Deutsche Rheuma-Liga Bundesverband e.V., Bonn, Germany
| | - Markus Gosch
- Paracelsus Medical University Nürnberg and General Hospital Nürnberg, Germany
| | - Franz Jakob
- Bernhard-Heine-Centrum für Bewegungsforschung, University of Würzburg, Germany
| | | | - Bernd Kladny
- German Society for Orthopaedics and Trauma (DGOU), Germany
| | - Uwe Lange
- German Society for Physical and Rehabilitative Medicine, Germany
| | | | - Stefan Peters
- German Association for Health-Related Fitness and Exercise Therapy (DVGS), Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Cornel Sieber
- European Geriatric Medicine Society (EuGMS), Institute for Biomedicine of Aging, FAU Erlangen-Nürnberg, Germany
| | - Friederike Thomasius
- Osteology umbrella association Germany, Austria, Switzerland; Frankfurt Center of Bone Health, Frankfurt, Germany
| | - Michael Uder
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany; Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Germany.
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Abou Mehrem A, Al Awad E, Anninck K, Au-Young S, Aydinol N, Bartmann P, Benders M, Benlamri A, Bolderheij L, Celik Y, Chan N, Chau C, Chau V, Chen X, Chetcuti Ganado C, Coetser A, Cools F, Da Rocha G, Deigner HP, Dereymaeker A, Deshmukh L, Domonoske R, Dossani S, Dsouza JM, El Gamal M, Eshemokhai P, Esser M, Fiedrich E, Franz A, Ghosh A, Groenendaal F, Grunau RE, Venkata SKRG, Hamitoglu S, Hellström-Westas L, Irvine L, Jansen K, Javadyan A, Jenkin G, Kamanga N, Kaur N, Keles E, Keller M, Kelly E, Kesting SJ, Kgwadi D, Kim B, Kohl M, Kowal D, Kricitober JD, Leijser L, LePine M, Lim YP, Lodha A, Londhe A, Ly L, Maes E, Malhotra A, Marlow N, Mathew JL, McDonald C, McLean M, Metcalfe C, Meyer R, Miller SP, Miller S, Mogajane T, Mohammad K, Momin S, Montpetit J, Mukiza N, Murthy P, Scott JN, Nakibuuka V, Nakwa F, Naulaers G, Noort J, Ntuli N, Ondongo-Ezhet C, Paul R, Pepper M, Plum A, Rombough B, Saugstad O, Scotland J, Scott J, Seake K, Sebunya R, Selvanathan T, Sepeng L, Simsek H, Steins-Rang C, Stonestreet B, Tang S, Taskin E, Thewissen L, Thomas S, Thomas R, van Kwawegen A, van Rensburg J, Velaphi S, Wu Y, Yaman A, Yapicioglu-Yildizdas H, Yawno T, Zaki P, Zein H, Zhou L. Proceedings of the 13th International Newborn Brain Conference: Neuroprotection strategies in the neonate. J Neonatal Perinatal Med 2022; 15:427-439. [PMID: 35431186 DOI: 10.3233/npm-229003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Vagedes J, Kuderer S, Helmert E, Vagedes K, Kohl M, Szőke H, Beissner F, Joos S, Andrasik F. The Immediate Effect of Sinapis nigra and Zingiber officinale as Thermogenic Substances during Footbaths: A Randomized Controlled Crossover Trial. Complement Med Res 2021; 29:213-222. [PMID: 34933309 PMCID: PMC9677831 DOI: 10.1159/000521590] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/19/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Warm footbaths infused with Sinapis nigra (mustard, or MU) or Zingiber officinale (ginger, or GI) are used for various thermoregulatory conditions, but little is known about how they are perceived by individuals, both short- and long-term. We analyzed the immediate and long-term effects of MU and GI on warmth and stimulus perception in healthy adults. METHODS Seventeen individuals (mean age 22.1±2.4 years; 11 female) received three footbaths (mean temperature was 40 ± 0.2°C, administered between 1:30 and 6:30 p.m.) in a randomized order with a crossover design: 1. with warm water only (WA), 2. with warm water and MU, and 3. with warm water and GI. Warmth and stimulus perception at the feet were assessed at the 1st, 5th, 10th, 15th, and 20th minute of the footbaths, in the late evening (EVE), and the following morning (MG). We further assessed well-being (at EVE and MG) and sleep quality (at MG). The primary outcome measure was the warmth perception at the feet at the 10th minute of the footbath. RESULTS At the 10th minute of the footbath, warmth perception at the feet was significantly higher with MU and GI compared to WA. The immediate thermogenic effects pointed to a quick increase in warmth and stimulus perception with MU, a slower increase with GI, and a gradual decrease with WA. Regarding the long-term effects, warmth and stimulus perception were still higher after GI compared to WA at EVE and MG. No differences were seen for general well-being and sleep quality. CONCLUSION Thermogenic substances can significantly alter the dynamics of warmth and stimulus perception when added to footbaths. The different profiles in the application of GI and MU could be relevant for a more differentiated and specific use of both substances in different therapeutic indications.
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Affiliation(s)
- Jan Vagedes
- ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Filderstadt, Germany
- Department of Neonatology, University Hospital Tübingen, Tübingen, Germany
| | - Silja Kuderer
- ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Filderstadt, Germany
| | - Eduard Helmert
- ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Filderstadt, Germany
| | - Katrin Vagedes
- ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Filderstadt, Germany
| | - Matthias Kohl
- Institute of Precision Medicine, University Furtwangen, Villingen-Schwenningen, Germany
| | - Henrik Szőke
- Department of Integrative Medicine, University of Pécs, Pécs, Hungary
| | - Florian Beissner
- Insula Institute for Integrative Therapy Research, Hannover, Germany
| | - Stefanie Joos
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Frank Andrasik
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
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Vagedes J, Kuderer S, Vagedes K, Szoeke H, Kohl M, Wolf U. Chest Compresses with Ginger or Mustard Affect Warmth Regulation in Healthy Adults - A Randomized Co. Eur J Integr Med 2021. [DOI: 10.1016/j.eujim.2021.102076] [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: 10/19/2022]
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Zink-Rückel C, Chaudry O, Engelke K, Ghasemikaram M, Kohl M, Uder M, Kemmler W. Once Weekly Whole-Body Electromyostimulation Enhances Muscle Quality in Men: Data of the Randomized Controlled Franconian Electromyostimulation and Golf Study. Front Physiol 2021; 12:700423. [PMID: 34366890 PMCID: PMC8335588 DOI: 10.3389/fphys.2021.700423] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/02/2021] [Indexed: 12/29/2022] Open
Abstract
Whole-body electromyostimulation (WB-EMS) is commercially advertised as a time-efficient resistance-type exercise technology. Indeed, the commercial, non-medical setting applies 20 min of WB-EMS only once a week. However, this setting conflicts with the approved scientific approach of higher training frequencies. Using data from an ongoing study on WB-EMS and golf performance as a vehicle, we evaluate the effect of once weekly WB-EMS on changes of fatty muscle infiltration, as a crucial parameter of muscle quality. Fifty-four moderately physically active male amateur golfers 18-70 years old were randomly allocated to a WB-EMS (n = 27) with a standard setting of once weekly 20 min and a non-WB-EMS control group (CG, n = 27). Intermuscular adipose tissue (IMAT) volume and intrafascial muscle tissue (MT) volume per unit of intrafascial volume as determined by magnetic resonance imaging were used to characterize muscle quality. Intention to treat analysis with multiple imputation was applied. WB-EMS was conducted at the participants' homes; thus, the attendance rate was close to 100%. After 16 weeks of intervention, we observed increases in volume-adjusted IMAT (p = 0.040) and decreases in MT (p = 0.206) in the CG. IMAT decreased in the WB-EMS group (p = 0.215), while MT increased significantly (p = 0.032). Of importance, group difference (i.e., "effects") for intra-group changes in volume-adjusted IMAT (effect size: d´ = 0.66; p = 0.028) and MT (d´ = 0.70; p = 0.020) was significant for both parameters. Once weekly WB-EMS application significantly affects muscle quality of the mid-thigh in moderately active, healthy men 18-70 years old.
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Affiliation(s)
- Carina Zink-Rückel
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Oliver Chaudry
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Medizinische Klinik III, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Klaus Engelke
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Medizinische Klinik III, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Mansour Ghasemikaram
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, Germany
| | - Michael Uder
- Institute of Radiology, FAU Erlangen-Nürnberg and University Hospital, Erlangen, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Institute of Radiology, FAU Erlangen-Nürnberg and University Hospital, Erlangen, Germany
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Muehlbrandt S, Harter T, Füllner C, Ummethala S, Wolf S, Bacher A, Hahn L, Kohl M, Freude W, Koos C. Field-effect silicon-plasmonic photodetector for coherent T-wave reception. Opt Express 2021; 29:21586-21602. [PMID: 34265943 DOI: 10.1364/oe.425158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/18/2021] [Indexed: 06/13/2023]
Abstract
Plasmonic internal photoemission detectors (PIPED) have recently been shown to combine compact footprint and high bandwidth with monolithic co-integration into silicon photonic circuits, thereby opening an attractive route towards optoelectronic generation and detection of waveforms in the sub-THz and THz frequency range, so-called T-waves. In this paper, we further expand the PIPED concept by introducing a metal-oxide-semiconductor (MOS) interface with an additional gate electrode that allows to control the carrier dynamics in the device and the degree of internal photoemission at the metal-semiconductor interfaces. We experimentally study the behavior of dedicated field-effect (FE-)PIPED test structures and develop a physical understanding of the underlying principles. We find that the THz down-conversion efficiency of FE-PIPED can be significantly increased when applying a gate potential. Building upon the improved understanding of the device physics, we further perform simulations and show that the gate field increases the carrier density in the conductive channel below the gate oxide to the extent that the device dynamics are determined by ultra-fast dielectric relaxation rather than by the carrier transit time. In this regime, the bandwidth can be increased to more than 1 THz. We believe that our experiments open a new path towards understanding the principles of internal photoemission in plasmonic structures, leading to PIPED-based optoelectronic signal processing systems with unprecedented bandwidth and efficiency.
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Kemmler W, Hettchen M, Kohl M, Murphy M, Bragonzoni L, Julin M, Risto T, von Stengel S. Detraining Effects on Musculoskeletal Parameters in Early Postmenopausal Osteopenic Women: 3-Month Follow-Up of the Randomized Controlled ACTLIFE Study. Calcif Tissue Int 2021; 109:1-11. [PMID: 33712920 PMCID: PMC7954366 DOI: 10.1007/s00223-021-00829-0] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/19/2021] [Indexed: 12/20/2022]
Abstract
Periods of absence from supervised group exercise while maintaining physical activity might be a frequent pattern in adults' exercise habits. The aim of the present study was to determine detraining effects on musculoskeletal outcomes after a 3-month detraining period in early post-menopausal, osteopenic women. Due to the COVID-19 pandemic, we terminated the 18-month randomized controlled ACTLIFE exercise intervention immediately after the 13-month follow-up assessment. This put an abrupt stop to the high-intensity aerobic and resistance group exercise sessions undertaken three times per week by the exercise group (EG: n = 27) and the gentle exercise program performed once per week for the attention control group (CG: n = 27); but both groups were permitted to conduct individual outdoor activity for the 3-month lock-down period. Study endpoints were lean body mass (LBM), bone mineral density (BMD) at the lumbar spine (LS), maximum hip-/leg extension strength and power. Detraining-induced reductions of LBM, hip/leg strength and power (but not BMD-LS) were significantly greater (p < 0.001 to p = 0.044) compared with the CG. Significant exercise effects, i.e. differences between EG and CG, present after 13 months of exercise, were lost after 3 months of detraining for LBM (p = 0.157) and BMD-LS (p = 0.065), but not for strength (p < 0.001) and power (p < 0.001). Of note, self-reported individual outdoor activities and exercise increased by about 40% in both groups during the lock-down period. Three months' absence from a supervised group exercise protocol resulted in considerable detraining effects for musculoskeletal parameters. Thus, exercise programs for adults should be continuous rather than intermittent.Trial registration number: ClinicalTrials.gov: NCT04420806, 06.05.2020.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Henkestrasse 91, 91052, Erlangen, Germany.
| | - Michael Hettchen
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Henkestrasse 91, 91052, Erlangen, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - Marie Murphy
- Doctoral College, Ulster University, Newtownabbey, Co. Antrim, Northern Ireland, UK
| | | | - Mikko Julin
- Laurea University of Applied Sciences, Espoo, Finland
| | - Tapani Risto
- Laurea University of Applied Sciences, Espoo, Finland
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Henkestrasse 91, 91052, Erlangen, Germany
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Zink-Rückel C, Kohl M, Willert S, von Stengel S, Kemmler W. Once-Weekly Whole-Body Electromyostimulation Increases Strength, Stability and Body Composition in Amateur Golfers. A Randomized Controlled Study. Int J Environ Res Public Health 2021; 18:ijerph18115628. [PMID: 34070315 PMCID: PMC8197524 DOI: 10.3390/ijerph18115628] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 12/12/2022]
Abstract
Whole-body electromyostimulation (WB-EMS), an innovative training technology, is considered as a joint-friendly, highly customizable and particularly time-effective option for improving muscle strength and stability, body composition and pain relief. The aim of the present study was to determine the effect of 16 weeks of once-weekly WB-EMS on maximum isometric trunk (MITS), leg extensor strength (MILES), lean body mass (LBM) and body-fat content. A cohort of 54 male amateur golfers, 18 to 70 years old and largely representative for healthy adults, were randomly assigned to a WB-EMS (n = 27) or a control group (CG: n = 27). Bipolar low-frequency WB-EMS combined with low-intensity movements was conducted once per week for 20 min at the participants’ locations, while the CG maintained their habitual activity. The intention to treat analysis with multiple imputation was applied. After 16 weeks of once-weekly WB-EMS application with an attendance rate close to 100%, we observed significant WB-EMS effects on MITS (p < 0.001), MILES (p = 0.001), LBM (p = 0.034), but not body-fat content (p = 0.080) and low-back pain (LBP: p ≥ 0.078). In summary, the commercial setting of once-weekly WB-EMS application is effective to enhance stability, maximum strength, body composition and, to a lower extent, LBP in amateur golfers widely representative for a healthy male cohort.
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Affiliation(s)
- Carina Zink-Rückel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany; (C.Z.-R.); (S.W.); (S.v.S.)
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, 78056 Villingen-Schwenningen, Germany;
| | - Sebastian Willert
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany; (C.Z.-R.); (S.W.); (S.v.S.)
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany; (C.Z.-R.); (S.W.); (S.v.S.)
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany; (C.Z.-R.); (S.W.); (S.v.S.)
- Correspondence: ; Tel.: +49-9131-8523999
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Bernauer JC, Schmidt A, Henderson BS, Ice LD, Khaneft D, O'Connor C, Russell R, Akopov N, Alarcon R, Ates O, Avetisyan A, Beck R, Belostotski S, Bessuille J, Brinker F, Calarco JR, Carassiti V, Cisbani E, Ciullo G, Contalbrigo M, De Leo R, Diefenbach J, Donnelly TW, Dow K, Elbakian G, Eversheim PD, Frullani S, Funke C, Gavrilov G, Gläser B, Görrissen N, Hasell DK, Hauschildt J, Hoffmeister P, Holler Y, Ihloff E, Izotov A, Kaiser R, Karyan G, Kelsey J, Kiselev A, Klassen P, Krivshich A, Kohl M, Lehmann I, Lenisa P, Lenz D, Lumsden S, Ma Y, Maas F, Marukyan H, Miklukho O, Milner RG, Movsisyan A, Murray M, Naryshkin Y, Perez Benito R, Perrino R, Redwine RP, Rodríguez Piñeiro D, Rosner G, Schneekloth U, Seitz B, Statera M, Thiel A, Vardanyan H, Veretennikov D, Vidal C, Winnebeck A, Yeganov V. Measurement of the Charge-Averaged Elastic Lepton-Proton Scattering Cross Section by the OLYMPUS Experiment. Phys Rev Lett 2021; 126:162501. [PMID: 33961478 DOI: 10.1103/physrevlett.126.162501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
We report the first measurement of the average of the electron-proton and positron-proton elastic scattering cross sections. This lepton charge-averaged cross section is insensitive to the leading effects of hard two-photon exchange, giving more robust access to the proton's electromagnetic form factors. The cross section was extracted from data taken by the OLYMPUS experiment at DESY, in which alternating stored electron and positron beams were scattered from a windowless gaseous hydrogen target. Elastic scattering events were identified from the coincident detection of the scattered lepton and recoil proton in a large-acceptance toroidal spectrometer. The luminosity was determined from the rates of Møller, Bhabha, and elastic scattering in forward electromagnetic calorimeters. The data provide some selectivity between existing form factor global fits and will provide valuable constraints to future fits.
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Affiliation(s)
- J C Bernauer
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Schmidt
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - B S Henderson
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - L D Ice
- Arizona State University, Tempe, Arizona 85287, USA
| | - D Khaneft
- Johannes Gutenberg-Universität, Mainz, Germany
| | - C O'Connor
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - R Russell
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - N Akopov
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | - R Alarcon
- Arizona State University, Tempe, Arizona 85287, USA
| | - O Ates
- Hampton University, Hampton, Virginia 23668, USA
| | - A Avetisyan
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | - R Beck
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - S Belostotski
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - J Bessuille
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - F Brinker
- Deutsches Elektronen-Synchrotron, Hamburg, Germany
| | - J R Calarco
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - V Carassiti
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - E Cisbani
- Istituto Nazionale di Fisica Nucleare sezione di Roma and Istituto Superiore di Sanità, Rome, Italy
| | - G Ciullo
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - M Contalbrigo
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - R De Leo
- Istituto Nazionale di Fisica Nucleare sezione di Bari, Bari, Italy
| | - J Diefenbach
- Hampton University, Hampton, Virginia 23668, USA
| | - T W Donnelly
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - K Dow
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - G Elbakian
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | - P D Eversheim
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - S Frullani
- Istituto Nazionale di Fisica Nucleare sezione di Roma and Istituto Superiore di Sanità, Rome, Italy
| | - Ch Funke
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - G Gavrilov
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - B Gläser
- Johannes Gutenberg-Universität, Mainz, Germany
| | - N Görrissen
- Deutsches Elektronen-Synchrotron, Hamburg, Germany
| | - D K Hasell
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J Hauschildt
- Deutsches Elektronen-Synchrotron, Hamburg, Germany
| | - Ph Hoffmeister
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - Y Holler
- Deutsches Elektronen-Synchrotron, Hamburg, Germany
| | - E Ihloff
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Izotov
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - R Kaiser
- University of Glasgow, Glasgow, United Kingdom
| | - G Karyan
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | - J Kelsey
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Kiselev
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - P Klassen
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - A Krivshich
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - M Kohl
- Hampton University, Hampton, Virginia 23668, USA
| | - I Lehmann
- University of Glasgow, Glasgow, United Kingdom
| | - P Lenisa
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - D Lenz
- Deutsches Elektronen-Synchrotron, Hamburg, Germany
| | - S Lumsden
- University of Glasgow, Glasgow, United Kingdom
| | - Y Ma
- Johannes Gutenberg-Universität, Mainz, Germany
| | - F Maas
- Johannes Gutenberg-Universität, Mainz, Germany
| | - H Marukyan
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | - O Miklukho
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - R G Milner
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Movsisyan
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - M Murray
- University of Glasgow, Glasgow, United Kingdom
| | - Y Naryshkin
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | | | - R Perrino
- Istituto Nazionale di Fisica Nucleare sezione di Bari, Bari, Italy
| | - R P Redwine
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | | | - G Rosner
- University of Glasgow, Glasgow, United Kingdom
| | | | - B Seitz
- University of Glasgow, Glasgow, United Kingdom
| | - M Statera
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - A Thiel
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - H Vardanyan
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | | | - C Vidal
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Winnebeck
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - V Yeganov
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
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Micke F, Weissenfels A, Wirtz N, von Stengel S, Dörmann U, Kohl M, Kleinöder H, Donath L, Kemmler W. Similar Pain Intensity Reductions and Trunk Strength Improvements Following Whole-Body Electromyostimulation vs. Whole-Body Vibration vs. Conventional Back-Strengthening Training in Chronic Non-specific Low Back Pain Patients: A Three-Armed Randomized Controlled Trial. Front Physiol 2021; 12:664991. [PMID: 33927646 PMCID: PMC8076746 DOI: 10.3389/fphys.2021.664991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/06/2021] [Accepted: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this multicenter trial was to compare the effects of whole-body electromyostimulation (WB-EMS) and whole-body vibration (WBV) with conventional back-strengthening training (CT) on changes in mean back pain intensity (MPI) and trunk strength in patients suffering from chronic non-specific low back pain (CNLBP). Two-hundred and forty CNLBP patients (40–70 years; 62% female) were randomly assigned to three intervention arms (WB-EMS: n = 80 vs. WBV: n = 80 vs. CT: n = 80). All training intervention programs were performed for 12 weeks in their usual commercial training setting. Before and during the last 4 weeks of the intervention, MPI was recorded using a 4-week pain diary. Additionally, maximal isometric trunk extension and -flexion strength was assessed on the BackCheck® machine. A moderate but significant decrease of MPI was observed in all groups (WB-EMS: 29.7 ± 39.1% (SMD 0.50) vs. WBV: 30.3 ± 39.3% (SMD 0.57) vs. CT: 30.5 ± 39.6% (SMD 0.59); p < 0.001). Similar findings were observed for maximal isometric strength parameters with a significant increase in all groups (extension: WB-EMS: 17.1 ± 25.5% vs. WBV: 16.2 ± 23.6% vs. CT: 21.6 ± 27.5%; p < 0.001; flexion: WB-EMS: 13.3 ± 25.6% vs. WBV: 13.9 ± 24.0% vs. CT: 13.9 ± 25.4%; p < 0.001). No significant interaction effects for MPI (p = 0.920) and strength parameters (extension: p = 0.436; flexion: p = 0.937) were observed. WB-EMS, WBV, and CT are comparably effective in improving MPI and trunk strength. However, training volume of WB-EMS was 43 or 62% lower, compared with CT and WBV.
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Affiliation(s)
- Florian Micke
- Department of Intervention Research in Exercise Training, Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Anja Weissenfels
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Nicolas Wirtz
- Central Library for Sport Science, German Sport University Cologne, Cologne, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Ulrike Dörmann
- Department of Intervention Research in Exercise Training, Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, Germany
| | - Heinz Kleinöder
- Department of Intervention Research in Exercise Training, Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Lars Donath
- Department of Intervention Research in Exercise Training, Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
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Kemmler W, Schoene D, Kohl M, von Stengel S. Changes in Body Composition and Cardiometabolic Health After Detraining in Older Men with Osteosarcopenia: 6-Month Follow-Up of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST) Study. Clin Interv Aging 2021; 16:571-582. [PMID: 33854307 PMCID: PMC8039436 DOI: 10.2147/cia.s299867] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/31/2020] [Accepted: 02/20/2021] [Indexed: 12/11/2022] Open
Abstract
Purpose Temporary cessation of exercise but maintenance of habitual physical activity might be a frequent situation in older people’s lives. Particularly the COVID-19 induced lockdown of exercise training facilities with individual outdoor activities still being allowed might be a blueprint for this potentially harmful scenario. Thus, the aim of the present study was to determine the effects of 6 months of detraining after 18 months of high-intensity resistance exercise (HIT-RT) on body composition and cardiometabolic outcomes in predominately obese older men with osteosarcopenia. Materials and Methods Community-dwelling predominately obese men 72–91 years old with low muscle and bone mass (n=43) were randomly assigned to an 18-month HIT-RT (EG: n=21) or a non-training control group (CG, n=22). After the intervention, participants of the EG discontinued HIT-RT for 6 months, but increased their habitual physical activity. Study outcomes were group differences in detraining changes (“effects”) for lean body mass (LBM), total and abdominal body fat rate (determined by dual-energy x-ray absorptiometry) and the Metabolic Syndrome Z-Score (MetSZ). We applied an intention-to-treat analysis with multiple imputation to analyze the data. Results After the 18-month HIT-RT, we observed significant positive training effects for LBM, total and abdominal body fat rate and the MetSZ (all p<0.001). Abrupt cessation of HIT-RT for 6 months resulted in significantly higher unfavorable changes in the HIT-RT compared with the CG for LBM (p=0.001), total body fat (p=0.003) and the MetSZ (p=0.003), apart from abdominal body fat (p=0.059). However, significant overall effects were still present after 24 months for LBM and body fat indices but not for the MetSZ. Conclusion The present study clearly indicates the unfavorable effects of 6 months of detraining after HIT-RT. Correspondingly, exercise protocols particularly for older people should focus on continuous exercise with short regeneration periods rather than on intermitted protocols with pronounced training breaks.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, 91053, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, 91053, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, 78054, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, 91053, Germany
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Ghasemikaram M, Chaudry O, Nagel AM, Uder M, Jakob F, Kemmler W, Kohl M, Engelke K. Effects of 16 months of high intensity resistance training on thigh muscle fat infiltration in elderly men with osteosarcopenia. GeroScience 2021; 43:607-617. [PMID: 33449309 PMCID: PMC8110662 DOI: 10.1007/s11357-020-00316-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/10/2020] [Indexed: 12/13/2022] Open
Abstract
Osteosarcopenia is characterized by a progressive decline in muscle function and bone strength and associated with muscle fat accumulation. This study aimed to determine the effect of long-term high intensity resistance training (HIRT) on thigh muscle fat infiltration in older men with osteosarcopenia. Forty-three community-dwelling men (72 years and older) were randomly assigned to either an exercise group (EG, n = 21) or an inactive control group (CG, n = 22). EG participants performed a supervised single-set exercise training with high effort two times per week. Participants of both groups were individually provided with dietary protein to reach a cumulative intake of 1.5-1.6 g/kg/day or 1.2-1.3 g/kg/day (EG/CG), respectively, and Up to 10,000 IE/week of Vitamin-D were supplemented in participants with 25 OH Vitamin-D 3 levels below 100 nmol/l. Magnetic resonance (MR) imaging was performed to determine muscle and adipose tissue volume and fat fraction of the thigh. At baseline, there were no significant differences between the two groups. After 16 month,, there were significant training effects of 15% (p = 0.004) on intermuscular adipose tissue (IMAT) volume, which increased in the CG (p = 0.012) and was stable in the EG. In parallel, fat fraction within the deep fascia of the thigh (Baseline, EG: 18.2 vs CG: 15.5, p = 0.16) significantly differed between the groups (Changes, EG: 0.77% vs. CG: 7.7%, p = 0.009). The study confirms the role of fat infiltration of the muscles as an advanced imaging marker in osteosarcopenia and the favorable effects of HIRT on adipose tissue volume of the thigh, in men with osteosarcopenia.
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Affiliation(s)
- Mansour Ghasemikaram
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Henkestr. 91, 91052, Erlangen, Germany.
| | - Oliver Chaudry
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Armin M Nagel
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Henkestr. 91, 91052, Erlangen, Germany
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Franz Jakob
- Bernhard-Heine-Center for Locomotion Research, University of Würzburg, Brettreichstrasse 11, 97074, Würzburg, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Henkestr. 91, 91052, Erlangen, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Neckarstrasse 1, 78054, Villingen-Schwenningen, Germany
| | - Klaus Engelke
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
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Kemmler W, Shojaa M, Steele J, Berger J, Fröhlich M, Schoene D, von Stengel S, Kleinöder H, Kohl M. Efficacy of Whole-Body Electromyostimulation (WB-EMS) on Body Composition and Muscle Strength in Non-athletic Adults. A Systematic Review and Meta-Analysis. Front Physiol 2021; 12:640657. [PMID: 33716787 PMCID: PMC7952886 DOI: 10.3389/fphys.2021.640657] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 12/11/2020] [Accepted: 01/19/2021] [Indexed: 12/12/2022] Open
Abstract
This systematic review and meta-analysis set out to determine the efficacy on whole-body electromyostimulation (WB-EMS) on body composition and strength parameters in non-athletic cohorts. A systematic review of the literature according to the PRISMA statement included (a) controlled trials, (b) WB-EMS trials with at least one exercise and one control group, (c) WB-EMS as primary physical intervention, (d) WB-EMS with at least six electrodes covering most muscle groups, (e) non-athletic cohorts. We searched eight electronic databases up to June 30, 2020, without language restrictions. Standardized mean differences (SMD) for muscle mass parameters, total body fat mass, maximum leg extension, and trunk extension strength were defined as outcome measures. In summary, 16 studies with 19 individual WB-EMS groups representing 897 participants were included. Studies vary considerably with respect to age, BMI, and physical conditions. Impulse protocols of the studies were roughly comparable, but training frequency (1-5 sessions/week) and intervention length (6-54 weeks) differed between the studies. SMD average was 1.23 (95%-CI: 0.71-1.76) for muscle mass, 0.98 (0.74-1.22) for maximum leg, and 1.08 (0.78-1.39) for maximum trunk extension strength changes (all p < 0.001). SMD for body fat changes (-0.40, [-0.98 to 0.17]), however, did not reach significance. I 2 and Q-statistics revealed substantial heterogeneity of muscle and fat mass changes between the trials. However, rank and regression tests did not indicate positive evidence for small-study bias and funnel plot asymmetries. This work provided further evidence for significant, large-sized effects of WB-EMS on muscle mass and strength parameters, but not on body fat mass. Clinical Trial Registration: ClinicalTrials.gov, PROSPERO; ID: CRD42020183059.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Mahdieh Shojaa
- Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - James Steele
- Ukactive Research Institute, London, United Kingdom.,Faculty of Sport, Health, and Social Sciences, Solent University, Southampton, United Kingdom
| | - Joshua Berger
- Department of Sports Science, Technische Universität Kaiserslauter, Kaiserslautern, Germany
| | - Michael Fröhlich
- Department of Sports Science, Technische Universität Kaiserslauter, Kaiserslautern, Germany
| | - Daniel Schoene
- Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany
| | | | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, Germany
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Bhetuwal D, Matter J, Szumila-Vance H, Kabir ML, Dutta D, Ent R, Abrams D, Ahmed Z, Aljawrneh B, Alsalmi S, Ambrose R, Androic D, Armstrong W, Asaturyan A, Assumin-Gyimah K, Ayerbe Gayoso C, Bandari A, Basnet S, Berdnikov V, Bhatt H, Biswas D, Boeglin WU, Bosted P, Brash E, Bukhari MHS, Chen H, Chen JP, Chen M, Christy EM, Covrig S, Craycraft K, Danagoulian S, Day D, Diefenthaler M, Dlamini M, Dunne J, Duran B, Evans R, Fenker H, Fomin N, Fuchey E, Gaskell D, Gautam TN, Gonzalez FA, Hansen JO, Hauenstein F, Hernandez AV, Horn T, Huber GM, Jones MK, Joosten S, Karki A, Keppel C, Khanal A, King PM, Kinney E, Ko HS, Kohl M, Lashley-Colthirst N, Li S, Li WB, Liyanage AH, Mack D, Malace S, Markowitz P, Meekins D, Michaels R, Mkrtchyan A, Mkrtchyan H, Nazeer SJ, Nanda S, Niculescu G, Niculescu I, Nguyen D, Pandey B, Park S, Pooser E, Puckett A, Rehfuss M, Reinhold J, Santiesteban N, Sawatzky B, Smith GR, Sun A, Tadevosyan V, Trotta R, Wood SA, Yero C, Zhang J. Ruling out Color Transparency in Quasielastic ^{12}C(e,e^{'}p) up to Q^{2} of 14.2 (GeV/c)^{2}. Phys Rev Lett 2021; 126:082301. [PMID: 33709760 DOI: 10.1103/physrevlett.126.082301] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/15/2020] [Accepted: 01/14/2021] [Indexed: 06/12/2023]
Abstract
Quasielastic ^{12}C(e,e^{'}p) scattering was measured at spacelike 4-momentum transfer squared Q^{2}=8, 9.4, 11.4, and 14.2 (GeV/c)^{2}, the highest ever achieved to date. Nuclear transparency for this reaction was extracted by comparing the measured yield to that expected from a plane-wave impulse approximation calculation without any final state interactions. The measured transparency was consistent with no Q^{2} dependence, up to proton momenta of 8.5 GeV/c, ruling out the quantum chromodynamics effect of color transparency at the measured Q^{2} scales in exclusive (e,e^{'}p) reactions. These results impose strict constraints on models of color transparency for protons.
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Affiliation(s)
- D Bhetuwal
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - J Matter
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - H Szumila-Vance
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M L Kabir
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Dutta
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - R Ent
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D Abrams
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - Z Ahmed
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - B Aljawrneh
- North Carolina A & T State University, Greensboro, North Carolina 27411, USA
| | - S Alsalmi
- Kent State University, Kent, Ohio 44240, USA
| | - R Ambrose
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - D Androic
- University of Zagreb, Zagreb, Croatia
| | - W Armstrong
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - A Asaturyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - K Assumin-Gyimah
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - C Ayerbe Gayoso
- Mississippi State University, Mississippi State, Mississippi 39762, USA
- The College of William & Mary, Williamsburg, Virginia 23185, USA
| | - A Bandari
- The College of William & Mary, Williamsburg, Virginia 23185, USA
| | - S Basnet
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - V Berdnikov
- Catholic University of America, Washington, DC 20064, USA
| | - H Bhatt
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Biswas
- Hampton University, Hampton, Virginia 23669, USA
| | - W U Boeglin
- Florida International University, University Park, Florida 33199, USA
| | - P Bosted
- The College of William & Mary, Williamsburg, Virginia 23185, USA
| | - E Brash
- Christopher Newport University, Newport News, Virginia 23606, USA
| | | | - H Chen
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - J P Chen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Chen
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - E M Christy
- Hampton University, Hampton, Virginia 23669, USA
| | - S Covrig
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K Craycraft
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Danagoulian
- North Carolina A & T State University, Greensboro, North Carolina 27411, USA
| | - D Day
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - M Diefenthaler
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Dlamini
- Ohio University, Athens, Ohio 45701, USA
| | - J Dunne
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - B Duran
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - R Evans
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - H Fenker
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - N Fomin
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - E Fuchey
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T N Gautam
- Hampton University, Hampton, Virginia 23669, USA
| | - F A Gonzalez
- Stony Brook University, Stony Brook, New York 11794, USA
| | - J O Hansen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Hauenstein
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A V Hernandez
- Catholic University of America, Washington, DC 20064, USA
| | - T Horn
- Catholic University of America, Washington, DC 20064, USA
| | - G M Huber
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - M K Jones
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Joosten
- Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - A Karki
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - C Keppel
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Khanal
- Florida International University, University Park, Florida 33199, USA
| | - P M King
- Ohio University, Athens, Ohio 45701, USA
| | - E Kinney
- University of Colorado Boulder, Boulder, Colorado 80309, USA
| | - H S Ko
- Institut de Physique Nucleaire, Orsay, France
| | - M Kohl
- Hampton University, Hampton, Virginia 23669, USA
| | | | - S Li
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - W B Li
- The College of William & Mary, Williamsburg, Virginia 23185, USA
| | - A H Liyanage
- Hampton University, Hampton, Virginia 23669, USA
| | - D Mack
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Malace
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Markowitz
- Florida International University, University Park, Florida 33199, USA
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Michaels
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Mkrtchyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - H Mkrtchyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - S J Nazeer
- Hampton University, Hampton, Virginia 23669, USA
| | - S Nanda
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - G Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - I Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - D Nguyen
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - B Pandey
- Hampton University, Hampton, Virginia 23669, USA
| | - S Park
- Stony Brook University, Stony Brook, New York 11794, USA
| | - E Pooser
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Puckett
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M Rehfuss
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - J Reinhold
- Florida International University, University Park, Florida 33199, USA
| | - N Santiesteban
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - B Sawatzky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - G R Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Sun
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - V Tadevosyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - R Trotta
- Catholic University of America, Washington, DC 20064, USA
| | - S A Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Yero
- Florida International University, University Park, Florida 33199, USA
| | - J Zhang
- Stony Brook University, Stony Brook, New York 11794, USA
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Saemann L, Wenzel F, Kohl M, Korkmaz-Icöz S, Hoorn F, Loganathan S, Guo Y, Ding Q, Zhou P, Veres G, Karck M, Szabó G. Monitoring of perfusion quality and prediction of donor heart function during ex-vivo machine perfusion by myocardial microcirculation versus surrogate parameters. J Heart Lung Transplant 2021; 40:387-391. [PMID: 33726982 DOI: 10.1016/j.healun.2021.02.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/25/2021] [Accepted: 02/19/2021] [Indexed: 11/27/2022] Open
Abstract
Currently, lactate (Lac) is used to evaluate machine perfusion (MP) of hearts, donated after circulatory death (DCD). We hypothesize that monitoring of myocardial microcirculation (mLDP) by Laser-Doppler-Perfusion is superior to Lac to evaluate perfusion and predict contractility. In a pig model, DCD-hearts were perfused 4 hours followed by reperfusion and left ventricular contractility measurement. Lac and mLDP were measured every 30 min in successfully (N = 9) and unsuccessfully (N = 7) maintained hearts. Successfully maintained hearts showed decreasing Lac (5.6 to 2.8 mmol/L) and slightly downregulated (92%) mLDP. In unsuccessfully maintained hearts Lac first decreased (5.1 to 3.8 mmol/L) followed by increase and mLDP dropped to 39%. In a single-variable regression only mLDP showed a significant r² for systolic (0.514, p = 0.045) and diastolic (0.501, p = 0.049) parameters. The combination of mLDP and Lac (r2 = 0.876, p = 0.005) showed best results. mLDP seems to be superior to Lac to show perfusion disorders and predict DCD-heart contractility.
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Affiliation(s)
- Lars Saemann
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany; Department of Cardiac Surgery, University of Halle, Halle, Germany; Faculty Medical and Life Sciences, Furtwangen University, Villingen-Schwenningen, Germany.
| | - Folker Wenzel
- Faculty Medical and Life Sciences, Furtwangen University, Villingen-Schwenningen, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, Furtwangen University, Villingen-Schwenningen, Germany
| | - Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Fabio Hoorn
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany; Faculty Medical and Life Sciences, Furtwangen University, Villingen-Schwenningen, Germany
| | - Sivakkanan Loganathan
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany; Department of Cardiac Surgery, University of Halle, Halle, Germany; Department of Anesthesiology, Ruhr-University Bochum, St. Josef- and St. Elisabeth Hospital, Bochum, Germany
| | - Yuxing Guo
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Qingwei Ding
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Pengyu Zhou
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Gábor Veres
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany; Department of Cardiac Surgery, University of Halle, Halle, Germany
| | - Matthias Karck
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany; Department of Cardiac Surgery, University of Halle, Halle, Germany
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Dieterich W, Tietz E, Kohl M, Konturek PC, Rath T, Neurath MF, Zopf Y. Food Intolerance of Unknown Origin: Caused by Mucosal Inflammation? A Pilot Study. Clin Transl Gastroenterol 2021; 12:e00312. [PMID: 33600102 PMCID: PMC7889373 DOI: 10.14309/ctg.0000000000000312] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 12/29/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION The prevalence of patients with food intolerance (FI) has increased significantly. Immunoglobulin (Ig)E-mediated food allergies (FAs) are detected by determining IgE antibodies and skin prick test. Carbohydrate malabsorptions are clarified with breath tests. However, these diagnostic measures cannot capture all intolerances and have limitations in case of gut-mediated FI. The aims of this pilot study were to evaluate different methods to determine intestinal mucosal IgE in patients with FA and to characterize the intestinal mucosa in patients with FI of unknown origin (FH). METHODS Patients with FA and FH were compared with healthy controls. To determine the IgE antibodies and the cytokines tumor necrosis factor (TNF)-α and interferon (IFN)-γ of the intestinal mucosal, a lavage was performed as part of an ileocolonoscopy and samples were taken using the cytobrush and biopsy forceps. In a subgroup, mucosal samples were also taken from the duodenum. RESULTS Data in homogenates of intestinal mucosal samples yielded the highest sensitivity for IgE antibody titers compared with lavage and cytobrush. Patients with FA presented increased intestinal TNF-α and low IFN-γ values. This was in contrast to FH patients, who showed low intestinal IgE antibodies and TNF-α levels, but increased IFN-γ values. DISCUSSION The determination of IgE antibodies to diagnose intestinal IgE-mediated FA is most reliable in intestinal mucosal samples. Increased TNF-α and low IFN-γ levels in patients with FA characterize an allergic reaction. Decreased TNF-α and increased IFN-γ levels in patients with FH indicate an inflammation-related intolerance reaction (see Visual Abstract, Supplementary Digital Content 1, http://links.lww.com/CTG/A520).
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Affiliation(s)
- Walburga Dieterich
- Department of Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Hector-Center for Nutrition, Exercise, and Sports, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Esther Tietz
- Department of Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Hector-Center for Nutrition, Exercise, and Sports, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University Furtwangen, Furtwangen im Schwarzwald, Germany
| | - Peter C. Konturek
- Division of Gastroenterology, Department of Internal Medicine II, Thuringia Clinic Saalfeld, Saalfeld/Saale, Germany
| | - Timo Rath
- Department of Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Markus F. Neurath
- Department of Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Yurdagül Zopf
- Department of Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Hector-Center for Nutrition, Exercise, and Sports, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Hettchen M, von Stengel S, Kohl M, Murphy MH, Shojaa M, Ghasemikaram M, Bragonzoni L, Benvenuti F, Ripamonti C, Benedetti MG, Julin M, Risto T, Kemmler W. Changes in Menopausal Risk Factors in Early Postmenopausal Osteopenic Women After 13 Months of High-Intensity Exercise: The Randomized Controlled ACTLIFE-RCT. Clin Interv Aging 2021; 16:83-96. [PMID: 33469276 PMCID: PMC7810823 DOI: 10.2147/cia.s283177] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/19/2020] [Indexed: 12/13/2022] Open
Abstract
The menopausal transition is a critical period in women's lives. Exercise might be the most promising non-pharmaceutic intervention to address the large variety of risk factors related to the pronounced estradiol decline during peri- and early-postmenopause. The aim of this study was to determine the effect of an 18-month multipurpose exercise program on risk factors and symptoms related to the menopausal transition. Fifty-four women 1-5 years postmenopause with osteopenia or osteoporosis were randomly assigned 1) to a high impact weight-bearing/high-intensity/velocity resistance training group (EG: n=27) exercising three times a week or 2) to an attendance control group (CG: n=27) that performed low-intensity exercise once a week. Both groups were supplemented with cholecalciferol and calcium. The primary study endpoint was bone mineral density (BMD) at lumbar spine (LS) and total hip, secondary outcomes were lean body mass (LBM), total and abdominal body percentage, metabolic syndrome Z-Score (MetS-Z), menopausal symptoms and muscle strength and power. Due to COVID-19, the study was stopped after 13 months. We observed significant effects for BMD-LS (EG: 0.002±.018 versus CG: -.009±0.018 mg/cm2, p=0.027) but not for BMD total hip (EG: -0.01±.016 versus CG: -.009±0.020 mg/cm2, p=0.129). LBM improved significantly in the EG and decreased in the CG (0.39±1.08 vs -0.37±1.34 kg, p=0.026). Total and abdominal body fat improved significantly in the EG and was maintained in the CG (-1.44±1.49 vs -0.02±1.55 kg, p=0.002 and -1.50±2.33 vs 0.08±2.07 kg, p=0.011). Significant effects in favor of the EG were also determined for menopausal symptoms (p=0.029), hip/leg extension strength (p<0.001) and power (p<0.001). However, changes of the MetS-Z did not differ significantly (p=0.149) between EG and CG. In summary, with minor exceptions, we demonstrated the effectiveness of a multipurpose exercise protocol dedicated to early-postmenopausal women on various risk factors and complaints related to the menopausal transition.
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Affiliation(s)
- Michael Hettchen
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - Marie H Murphy
- Doctoral College, Ulster University, Newtownabbey, Antrim, Northern Ireland, UK
| | - Mahdieh Shojaa
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Mansour Ghasemikaram
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | | | | | - Claudio Ripamonti
- Center for Osteoporosis and Bone Metabolic Disease, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Maria Grazia Benedetti
- Physical Medicine and Rehabilitation Unit, IRCCS - Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Mikko Julin
- Laurea University of Applied Sciences, Espoo, Finland
| | - Tapani Risto
- Laurea University of Applied Sciences, Espoo, Finland
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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Kemmler W, Kohl M, Fröhlich M, Schoene D, von Stengel S. Detraining effects after 18 months of high intensity resistance training on osteosarcopenia in older men-Six-month follow-up of the randomized controlled Franconian Osteopenia and Sarcopenia Trial (FrOST). Bone 2021; 142:115772. [PMID: 33249320 DOI: 10.1016/j.bone.2020.115772] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/22/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Detraining after dedicated exercise programs might be a frequent situation in older people's exercise patterns. The aim of the present study was thus to determine the effects of 6 months of detraining after 18 months of high intensity resistance exercise (HIT-RT) on musculoskeletal outcomes in older men with sarcopenia. METHODS Community-dwelling men aged 72 years and older with osteosarcopenia (n = 43) were randomly assigned to an 18-month HIT-RT (EG: n = 21) or a non-training control group (CG, n = 22). After the intervention, participants of the EG stopped HIT-RT for 6 months, but continued their habitual physical activity. Study outcomes were skeletal muscle mass index, bone mineral density (BMD) at the lumbar-spine and total-hip, maximum hip/leg-extensor strength, handgrip strength and gait velocity. We applied an intention-to-treat analysis with multiple imputation. RESULTS Changes in the HIT-RT were much more pronounced during the detraining period compared with the CG, although this effect was only significant for skeletal muscle mass index and hip-/leg-extensor strength (p = .002 and p = .013), but not for lumbar-spine BMD (p = .068), total-hip BMD (p = .069), handgrip strength (p = .066) or gait velocity (p = .067). Apart from total-hip BMD (p = .055), handgrip strength (p = .069) and gait velocity (p = .881) values of the HIT-RT group decreased significantly during detraining. However, after 24 months, overall effects (p < .001) were still observed for skeletal muscle mass index and hip-/leg-extensor strength. CONCLUSION Although unable to state from which point in time relevant detraining effects emerge, we conclude that health care providers should focus on continuous rather than intermitted exercise programs for older people. Clinical trial number: clinicalTrials.gov: NCT03453463; NCT04444661.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany.
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, 78054 Villingen-Schwenningen, Germany.
| | - Michael Fröhlich
- Department of Sports Science, University of Kaiserslautern, 67663 Kaiserslautern, Germany.
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany.
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany.
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49
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Saemann L, Wenzel F, Kohl M, Korkmaz-Icöz S, Veres G, Simm A, Karck M, Szabó G. Development of a Prediction Model for Donor Heart Function Based on Myocardial Microcirculation during Ex Vivo Blood Perfusion. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | - M. Kohl
- Villingen-Schwenningen, Deutschland
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50
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Kemmler W, Kohl M, von Stengel S, Schoene D. Effect of high-intensity resistance exercise on cardiometabolic health in older men with osteosarcopenia: the randomised controlled Franconian Osteopenia and Sarcopenia Trial (FrOST). BMJ Open Sport Exerc Med 2020; 6:e000846. [PMID: 33408874 PMCID: PMC7768961 DOI: 10.1136/bmjsem-2020-000846] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Sarcopenia is related to the metabolic syndrome (MetS), a cluster of cardiometabolic risk-factors (CRF). Most exercise trials apply aerobic rather than resistance exercise to address CRF, while the strategy for maintaining muscle and bone is the opposite. However, there is considerable evidence that resistance exercise positively affects CRF. In the present study, we determined the effect of high-intensity resistance exercise training (HIT-RT) on CRF represented by the MetS in older men. METHODS Forty-three osteosarcopenic and predominately obese older men (>72 years) living independently in Erlangen-Nürnberg, Germany were randomly assigned to two study arms. The HIT-RT group (n=21) conducted a periodised high intensity/effort protocol dedicated to muscle and bone mass and function two times per week, while the control group (CG: n=22) maintained their habitual physical activities. Both groups were supplemented with protein, cholecalciferol and calcium. Study outcomes presented here were the MetS-Z (MetSZ) score and its underlying risk-factors. RESULTS After 18 months of intervention, we observed significant effects for the MetSZ score (p<0.001), with significant improvements in the HIT-RT and significant worsening in the CG. In detail, all parameters constituting the MetS contributed to this result, however, only waist-circumference, HDL-cholesterol and mean arterial blood pressure revealed significant effects. No adverse events were reported and high adherence was determined for the HIT-RT-protocol. CONCLUSION Continuously supervised HIT-RT is an effective, attractive, feasible and safe method to address cardiometabolic risk factors in community-dwelling men aged 72 years and older. Further, considering the proven effects on musculoskeletal risk factors, the present results indicate a more prominent role for HIT-RT within non-pharmacological prevention strategies of older adults. TRIAL REGISTRATION NUMBER NCT03453463.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, Furtwangen University of Applied Sciences, Furtwangen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
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