Whole body vibration for chronic patellar tendinopathy: A randomized equivalence trial.

Purpose: Whole body vibration (WBV) triggers anabolic responses in various tissues, including tendons, without requiring high force production. In this waitlist-controlled equivalence trial, we tested its clinical effectiveness as an alternative treatment for patellar tendinopathy against conventional heavy slow resistance training (HSR). Methods: Thirty-nine patients were randomized to either 3 months of WBV training (n = 13), HSR training (n = 11), or a waitlist control (WLC) group (n = 15). In a partly cross-over design, 14 patients of the WLC group were redistributed to one of the two intervention groups (5 in WBV, 9 in HSR). Pre- and post-intervention testing included pain assessments (VAS), functional limitations (VISA-P), knee extension strength and tendon morphological, mechanical and material properties. Follow-up measurements (VAS, VISA-P) were performed in the WBV and HSR groups 6 months after the intervention. Results: Comparisons with the WLC group revealed significant improvements in VISA-P and VAS scores after HSR (41%, p = 003; 54%, p = 0.005) and WBV (22%, p = 0.022; 56%, p = 0.031) training. These improvements continued until follow-up (HSR: 43%, 56%; WBV: 24%, 37%). Pre-post improvements in VAS scores were equivalent between WBV and HSR groups but inconclusive for the VISA-P score and all pre-test to follow up comparisons. The mid-tendon cross-sectional area was significantly reduced after WBV (-5.7%, p = 0.004) and HSR (-3.0%, p = 0.004) training compared to WLC although the equivalence test between interventions was inconclusive. Conclusion: Whole body vibration improved symptoms typically associated with patellar tendinopathy. This type of intervention is as effective as HSR against maximum pain, although equivalence could not be confirmed for other variables. The beneficial responses to WBV and HSR treatments persisted for 6 months after the end of the intervention. Clinical Trial Registration: https://www.drks.de/drks_web/setLocale_EN.do, identifier DRKS00011338.

A case report of COVID-19 monitoring in the Austrian professional football league.

Since the beginning of the COVID -19 pandemic, many contact sport teams are facing major challenges to safely continue training and competition. We present the design and implementation of a structured monitoring concept for the Austrian national football league. 146 professional players from five clubs of the professional Austrian football league were monitored for a period of 12 weeks. Subjective health parameters, PCR- test results and data obtained from a geo-tracking app were collected. Simulations modelling the consequences of a COVID-19 case with increasing reproduction number were computed. No COVID -19 infection occurred during the observation period in the players. Infections in the nearer surroundings lead to increased perceived risk of infection. Geo tracking was particularly hindered due to technical problems and reluctance of users. Simulation models suggested a hypothetical shut-down of all training and competition activities. A structured monitoring concept can help to continue contact sports safely in times of a pandemic. Cooperation of all involved is essential. Trial registration: ID: DRKS00022166 15/6/2020 https://www.who.int/ictrp/search/en/ .

[Eccentric Training after a Traumatic Apophysis Fracture at the Spina Iliaca Anterior Inferior: Case Study of a Junior Football Player]. / Exzentrisches Training nach einer traumatischen Apophysenfraktur an der Spina iliaca anterior inferior ­ Fallstudie an einem Nachwuchsfußballer.

Eccentric training is an established training method in competitive sports. It has been used effectively to improve muscle strength during rehabilitation after cruciate ligament reconstruction. However, it is still uncertain whether or not eccentric training contributes to successful rehabilitation after apophysis fractures. A fourteen-year-old soccer player, forward position, presents with an apophysis avulsion located at the right spina iliaca anterior inferior. After completing an early rehabilitation phase and isokinetic concentric strength development, the patient starts an eccentric training programme eight weeks after the injury, including training on an isokinetic dynamometer (Biodex) for four weeks, followed by a four-week eccentric ergometer training (Eccentron). Before and after each eccentric training phase, isokinetic maximum strength tests of the knee extensors and flexors are performed with angular velocities of 60 degrees per second (°/sec.), 180°/sec. and 240°/sec. In response to the eight-week eccentric rehabilitation program, maximum torque increases in all angular velocities in the injured (60°/sec. + 14.4 %; 180°/sec. + 8.8 %; 240°/sec. + 6.3 %) and the uninjured leg (60°/sec. + 15.6 %; 180°/sec. + 1.9 %; 240°/sec. + 8.1 %) between the first and the last test. Furthermore, neuromuscular coordination has improved during the eccentric training sessions. This case study demonstrates that controlled eccentric training in the open and closed kinetic chain increases coordination and strength of the trained muscles and therefore should be regarded as a valuable contribution toward a safe return to sport after apophysis fractures.

[Aspects and necessity of moderate-altitude research]. / Alpinmedizinische forschung in mittlerer Höhe: Aspekte und Notwendigkeit.

Alpinism in all its variations is a leading factor in tourism. Within a few decades, alpine sports, even at high altitudes, have become available to a wide range of people. Now, more people than ever before are hiking, trekking, climbing and skiing at moderate and high altitudes. Annually, 40 million people spend time in the Alps and 100 million visit high altitudes worldwide. However, alpine excursions may entail health problems and many aspects of impaired adaptation to altitude remain unstudied. High-altitude research has mainly been associated with expeditions, with moderate altitudes receiving far less attention, though most tourism takes place at that level. The overwhelming numbers of alpine tourists mean that there is urgent need for high- and moderate-altitude medical research, which would also be within the realm of political responsibility in mountainous countries. Research in mountain medicine and dissemination of relevant findings can show how to improve and conserve performance in healthy individuals and could point the way toward new, safe approaches in the rehabilitation of patients with chronic diseases. It is imperative that mountain medicine continues to develop on a scientific basis.