Effects of different endurance exercise modalities on migraine days and cerebrovascular health in episodic migraineurs: A randomized controlled trial.

Aerobic exercise training is a promising complementary treatment option in migraine and can reduce migraine days and improve retinal microvascular function. Our aim was to elucidate whether different aerobic exercise programs at high vs moderate intensities distinctly affect migraine days as primary outcome and retinal vessel parameters as a secondary. In this randomized controlled trial, migraine days were recorded by a validated migraine diary in 45 migraineurs of which 36 (female: 28; age: 36 (SD:10)/BMI: 23.1 (5.3) completed the training period (dropout: 20%). Participants were assigned (Strata: age, gender, fitness and migraine symptomatology) to either high intensity interval training (HIT), moderate continuous training (MCT), or a control group (CON). Intervention groups trained twice a week over a 12-week intervention period. Static retinal vessel analysis, central retinal arteriolar (CRAE) and venular (CRVE) diameters, as well as the arteriolar-to-venular diameter ratio (AVR) were obtained for cerebrovascular health assessment. Incremental treadmill testing yielded maximal and submaximal fitness parameters. Overall, moderate migraine day reductions were observed (ηP2 = .12): HIT revealed 89% likely beneficial effects (SMD = 1.05) compared to MCT (SMD = 0.50) and CON (SMD = 0.59). Very large intervention effects on AVR improvement (ηP2 = 0.27), slightly favoring HIT (SMD=-0.43) over CON (SMD=0), were observed. HIT seems more effective for migraine day reduction and improvement of cerebrovascular health compared to MCT. Intermittent exercise programs of higher intensities may need to be considered as an additional treatment option in migraine patients.

Slackline training and neuromuscular performance in seniors: A randomized controlled trial.

Slackline training (balancing on nylon ribbons) has been shown to improve neuromuscular performance in children and adults. Comparable studies in seniors are lacking. Thus, 32 seniors were randomly assigned [strata: age, gender, physical activity (PA)] to an intervention [INT; n = 16, age: 65 ± 4 years, PA: 9 ± 5 h/week] or control [CON, n = 16, age: 63 ± 4 years, PA: 8 ± 4 h/week] group. Slackline training was given for 6 weeks (3 times per week, attendance 97%). Static and slackline standing balance performance, force development, and maximal strength of the ankle muscles were assessed before and after slackline training. Muscle activity (lower limb and trunk) was recorded during balance testing. Moderate to large group × time interactions (0.02 < P < 0.04, 0.11 < ηp (2) < 0.17) in favor of INT were found for slackline standing times (INT: left, +278%, P = 0.02; right, +328%, P = 0.03; tandem, +94%, P = 0.007) and muscle activity during single-limb slackline standing [INT: right: rectus abdominis (RA), P = 0.003, -15%; multifidus (MF), P = 0.01, -15%; left: tibialis anterior (TIB), P = 0.03, -12%; soleus (SOL), P = 0.006, -18%; RA, P = 0.04, -11%; MF, P = 0.01, -16%; gastrocnemius medialis (GM), P = 0.02, -19%]. Static balance performance, ankle strength, and power were not affected. Slackline training induced large task-specific improvements of slackline standing performance accompanied with reductions of lower limb and trunk muscle activity. Transfer effects to static balance and strength measures seem limited.

Pilates vs. Balance Training in Health Community-Dwelling Seniors: a 3-arm, Randomized Controlled Trial.

The study examined effects of traditional balance vs. mat-based Pilates training on balance and trunk strength in healthy community dwellers. Forty-eight seniors were either stratified to a balance training group (BAL, n=16, 69.1 (SD 5.8) y), Pilates training group (PIL, n=17, 70.8 (6.5) y) or control group (CON, n=15, 69.2 (6.1) y). BAL performed traditional balance training, while PIL conducted mat-based Pilates-exercises (8 weeks, 2 sessions/week 66 min each). Balance performance (single limb stance and perturbed kneeling, Y-Balance test), dynamic and isometric trunk flexion and extension were assessed during pre- and post-testing. According to the magnitude-based inference approach, substantial positive effects in favor of BAL compared to CON were found for the Y-balance score (right leg, effect size (d)=0.68; left leg, d=0.56), trunk extension (d=0.68) and single leg stance (right leg, d=0.61; left leg, d=0.38). Dynamic (d=0.32) and isometric (d=0.15) trunk flexion revealed unclear effects. For the Y-balance score (right leg, d=0.48, left leg, d=0.75) and single leg stance (right leg, +d=0.61%; left leg, d=0.67), interestingly, BAL substantially exceeded PIL. PIL vs. CON revealed unclear effects for most parameters (0.05

A new injury prevention programme for children's football--FIFA 11+ Kids--can improve motor performance: a cluster-randomised controlled trial.

The present study evaluated the effects of a newly developed injury prevention programme for children's football ("FIFA 11+ Kids") on motor performance in 7-12-year-old children. We stratified 12 football teams (under-9/-11/-13 age categories) into intervention (INT, N = 56 players) and control groups (CON, N = 67). INT conducted the 15-min warm-up programme "FIFA 11+ Kids" twice a week for 10 weeks. CON followed a standard warm-up (sham treatment). Pre- and post-tests were conducted using: single leg stance; Y-balance test; drop and countermovement jump; standing long jump; 20-m sprint; agility run; slalom dribble; and wall volley test. We used magnitude-based inferences and linear mixed-effects models to analyse performance test results. We observed likely beneficial effects favouring INT in Y-balance (right leg; +3.2%; standardised mean difference (SMD) = 0.34; P = 0.58) and agility run (+3.6%; SMD = 0.45; P = 0.008). Possibly beneficial effects were found in Y-balance, drop jump reactive strength index, drop jump height, countermovement jump, standing long jump, slalom dribble and wall volley test. At least possibly beneficial improvements in favour of "FIFA 11+ Kids" were observed in nearly all parameters. Most effects were small, but slight improvements in motor performance may potentially contribute to a reduction of injury risk.

Fundamental movement skills in preschoolers: a randomized controlled trial targeting object control proficiency.

BACKGROUND: Adequately developed fundamental movement skills, particularly object control dimensions, are considered essential to learn more complex movement patterns and to increase the likelihood to successfully participate in organized and non-organized sports during later years. Thus, the present randomized controlled trial aimed at improving object control dimensions at an early state in a kindergarten setting. METHODS: Catching, throwing, kicking, rolling and stationary dribbling were assessed via gross motor development 2 (TGMD-2) testing in 41 normally developed preschoolers. On a cluster-randomized basis [strata: age, sex and body mass index (BMI)], three kindergartens were randomly assigned to an intervention group (n = 22, INT, age: 4.6 ± 1.0 years; BMI: 16.2 ± 1.1 kg/m(2) ) and three to a control group (n = 19, CON: age: 4.5 ± 1.2 years; BMI: 16.8 ± 1.2 kg/m(2) ). Twelve structured training sessions were given within 6 weeks (12 sessions). The total training volume was 330 min. RESULTS: Moderate time × group interaction were observed for the total sum score (Δ+22%, P = 0.05) and dribbling (Δ+41%, P = 0.002). Adjusting for baseline differences analyses of covariance did not affect these results. Interestingly, likely to most likely practically worthwhile effects were detected for the total sum score, catching and dribbling. CONCLUSION: Object control dimensions such as dribbling and catching that apparently rely on rhythmical movement patterns and anticipatory eye-hand coordination seem to benefit from short-term object control training. These skills are considered important for successful team-sport participation and appropriate sportive motor development.

Effects of stair-climbing on balance, gait, strength, resting heart rate, and submaximal endurance in healthy seniors.

Stair-climbing serves as a feasible opportunity to remain physically active within everyday-life. Data on neuromuscular and cardiorespiratory performance after regular stair-climbing in seniors are scarce. Forty-eight seniors were stratified to a one- (taking every step, INT1) or two-step strategy (every second step, INT2) or a control group (CON). Thirty-nine seniors [females: n = 22, males: n = 17; age: 70.5 (SD 5.1) years; BMI: 25.8 (3.1) kg/m(2)] completed the 8-week intervention (three weekly sessions). Before and after the intervention, balance, gait, strength, and submaximal endurance (at different intensities) were assessed. Maximal strength and explosive power did not improve significantly (0.10 < P < 0.78). Resting heart rate was significantly reduced in INT2 (-8/min) compared with INT1 (0/min, P = 0.02) and CON (0/min, P = 0.03). Compared with CON, perceived exertion for all intensities (0.007 < P < 0.03) and submaximal exercise heart rate during moderate uphill walking significantly decreased (-11/min; P < 0.05) in INT2. Step counts for forward beam balancing (4.5 cm width) increased in INT2 (P = 0.007) compared with CON. With more pronounced effects in INT2, stair-climbing significantly improved resting and exercise heart rates, perceived exertion, and dynamic balance performance in healthy seniors and may contribute to better overall fitness, reduced fall risk, and less perceived strain during daily life activities.

Work-relief ratios and imbalances of load application in sport climbing: another link to overuse-induced injuries?

An imbalanced load application of the upper extremity may contribute to overuse-induced injuries of the fingers. Thus, the present study evaluated load-application symmetry between the right and the left hand and its work-relief ratios (WRR) depending on climbing ability and pre-exhaustion level. Twenty-eight sport climbers (age: 29 ± 8 years; body mass index: 22 ± 2 kg/m(2); years of climbing: 10 ± 6; climbing level: 6+ UIAA to 9 UIAA) were assigned to a group of recreational (≤8-UIAA, n = 14) or a group of ambitious (≥8 UIAA, n = 14) climbers. Blood lactate and perceived exertion level were recorded at the end of the climbing attempt. Load application and WRR were derived from video analysis separately for the left and the right hand. Differences in load-application time between the left (47 ± 4%) and the right (53 ± 4%) hand (P < 0.001) were observed. Irrespective of side differences, the overall WRR was 5:1. Increasing climbing level leads to a more symmetric load application (r = -0.42, P < 0.03). Differences of lactate concentration and exertion level were found between the pre- and the non-pre-exhausted group. Depending on climbing ability and exhaustion level, load application for the dominant hand (right) prevails. Further longitudinal studies should focus on imbalanced load application and overuse-induced climbing injuries.

Effects of slackline training on balance, jump performance & muscle activity in young children.

The study investigated the effects of slackline training (rope balancing) on balance, jump performance and muscle activity in children. Two primary-school classes (intervention, n=21, INT: age: 10.1 (SD 0.4) y, weight: 33.1 (4.5) kg; control, n=13, CON: age: 10.0 (SD 0.4) y, weight: 34.7 (7.4) kg) participated. Training was performed within 6 weeks, 5 times per week for 10 min each day. Balance (static and dynamic stance), countermovement jumps, reverse balancing on beams (3, 4.5 and 6 cm width), slackline standing (single- and double-limb) and electromyographic activity (soleus, gastrocnemius, tibialis anterior) were examined. INT significantly improved single- and double-limb slackline standing (double limb: 5.1 (3.4) s-17.2 (14.4) s; right leg: 8.2 (5.8) s-38.3 (36.0) s; left leg: 10.6 (5.8) s-49.0 (56.3) s; p<0.001; 0.17<ηp²<0.22). Reduced left-leg dynamic sway (-20.8%, p=0.06, ηp²=0.10), improved 4.5 cm balancing (+18.5%, p=0.08, ηp²=0.10) and decreased muscle activity during slackline standing for the mm. soleus (-23%, p=0.10, ηp²=0.18) and tibialis anterior (-26%, p=0.15, ηp²=0.14) was observed for INT. Jump performance remained unchanged (p=0.28, ηp²=0.04). In conclusion, daily slackline training results in large slackline-specific balance improvements. Transfer effects to static and dynamic stance, reverse balancing or jumping performance seemed to be restricted.

Jeopardizing Christmas: Why spoiled kids and a tight schedule could make Santa Claus fall?

Santa Claus' spatio-temporal gait characteristics, ground reaction forces during treadmill walking as well as postural sway during loaded, unloaded and cognitive interference tasks were examined in order to estimate his fall risk. Seventeen healthy males, disguised as researchers and students (age: 30±10 years; height: 179±6 years; weight: 76±7kg; BMI: 24±2kg/m(2); physical activity: 12±4h/week) and who still believe in Santa Claus randomly underwent balance and gait analyses with and without cognitive interference. The conditions were to be dressed as "Santa Claus" (wearing costume consisting of a beard, cap, robe, heavy sack with a load of 20kg) or dressed in "normal clothing" (no costume). Spatiotemporal gait parameters (walking velocity, gait variability and stride time, length and width), ground reaction forces (GRF) (left- and right-sided heel strike and push off) and postural sway (30s tandem stance on a force plate) were measured. "Santa-effects" (0.001

[Association between trunk muscle activation and wall inclination during various static climbing positions: implications for therapeutic climbing]. / Zusammenhang zwischen Rumpfmuskelaktivität und Wandneigung bei statischen Kletterpositionen: Implikationen für die Klettertherapie.

BACKGROUND: Sport climbing has been increasingly applied as therapy for patients with orthopaedic problems. Results from previous intervention studies have already revealed positive effects, especially for people with back problems, although there is a lack of baseline knowledge regarding the general effects of climbing. The aim of this present study is to investigate the muscle activation of the trunk while performing various static climbing positions at different inclination angles. SUBJECTS/MATERIAL AND METHODS: Thirteen healthy adults without climbing experience were asked to hold three static climbing positions (base position, lifting a hand, lifting a foot) at three different handhold set-ups and six wall inclination angles (0°, 4°, 8°, 12°, 15°, 18°) for 5 seconds each. Bilateral muscle activity of Erector spinae, Multifidus, Latissimus dorsi, Obliquus externus abdominis, Obliquus internus abdominis and Rectus abdominis was measured using surface electromyography. Data were analysed for each muscle and climbing condition separately. RESULTS: Compared to the vertical wall, the muscle activity starts to differ significantly (p ≤ 0.05) from 12° onwards. This inclination angle particularly affects the activity of all muscles when lifting a hand (0.000 ≤ p ≤ 0.048). The oblique abdominal muscles did not show any or little effects when lifting a foot or being in the base position, while all other muscles demonstrate a continuous increase. The EMG data were normalised to the corresponding base position and analysed for each muscle and climbing condition separately. CONCLUSION: Inclinable climbing walls are an appropriate method to increase muscle activity. Compared to the base position, activation of the oblique abdominal muscles, which are relevant for a stable trunk, is increased only when a hand is lifted. Climbing walls used for therapy should offer variable inclination angles. Further research should concentrate on the development and evaluation of climbing exercises for specific patients (eg people with scoliosis).

Effects of acute bouts of endurance exercise on retinal vessel diameters are age and intensity dependent.

Alterations of retinal vessel diameters are associated with increased cardiovascular risk. We aimed to investigate changes in retinal vessel diameters in response to acute dynamic exercise of different intensities and whether these changes are age dependent. Seventeen healthy seniors (median (IQR) age 68 (65, 69) years) and 15 healthy young adults (median (IQR) age 26 (25, 28) years) first performed a maximal treadmill test (MTT) followed by a submaximal treadmill test (SMTT) and a resting control condition in randomised order. Central retinal arteriolar (CRAE) and central retinal venular (CRVE) diameter equivalents were measured before as well as 5 (t5) and 40 (t40) minutes after exercise cessation using a static retinal vessel analyser. Both exercise intensities induced a significant dilatation in CRAE and CRVE at t5 compared to the control condition (P < 0.001). At t40, the mean increase in CRAE and CRVE was greater for MTT compared to that for SMTT (CRAE 1.7 µm (95 % confidence interval (CI) -0.1, 3.6; P = 0.061); CRVE 2.2 µm (95 % CI 0.4, 4.1; P = 0.019)). However, the estimated difference at t5 between seniors and young adults in their response to MTT compared to SMTT was 5.3 µm (95 % CI 2.0, 8.5; P = 0.002) for CRAE and 4.1 µm (95 % CI -0.4, 8.6; P = 0.076) for CRVE. Wider arteries and veins after maximal versus submaximal exercise for seniors compared to young adults suggest that myogenic vasoconstriction in response to exhaustive exercise may be reduced in seniors. Age-related loss of vascular reactivity has clinical implications since the arteriolar vasoconstriction protects the retinal capillary bed from intraluminal pressure peaks.

Efficacy and safety of rivaroxaban or fondaparinux thromboprophylaxis in major orthopedic surgery: findings from the ORTHO-TEP registry.

BACKGROUND: Thromboprophylaxis with rivaroxaban (R) is superior to enoxaparin in patients undergoing major orthopedic surgery (MOS). However, rivaroxaban has never been directly compared with fondaparinux (F), which also shows superior efficacy over enoxaparin. The clinical impact of switching from fondaparinux to rivaroxaban thromboprophylaxis is unclear. OBJECTIVES: To evaluate the efficacy and safety of rivaroxaban or fondaparinux thromboprophylaxis in unselected patients undergoing MOS. PATIENTS/METHODS: This is a monocentric, retrospective cohort study in 5061 consecutive patients undergoing MOS at our centre, comparing rates of symptomatic VTE, bleeding and surgical complications, length of hospital stay and risk factors for VTE. RESULTS: Rates of symptomatic VTE were 5.6% (F) and 2.1% (R; P < 0.001), with rates for distal DVT being 3.9 vs. 1.1% (P < 0.001). Rates of major VTE were numerically higher with fondaparinux (1.8 vs. 1.1%), but not statistically significant. Rates of severe bleeding (bleeding leading to surgical revision or death, occurring in a critical site, or transfusion of at least two units of packed red blood cells) were statistically lower with rivaroxaban compared with fondaparinux (2.9 vs. 4.9%; P = 0.010). The mean length of hospital stay was significantly shorter in the rivaroxaban group (8.3 days, 95% CI 8.1-8.5 vs. 9.3 days, 9.1-9.5; P < 0.001). CONCLUSION: Based on an indirect comparison of two consecutive cohorts, our data suggest that thromboprophylaxis with rivaroxaban is associated with less VTE and bleeding events than fondaparinux in unselected patients undergoing MOS. Prospective comparisons are warranted to confirm our findings.

[Severe and moderate haemophilia under prophylactic replacement treatment--maximal knee extensor and flexor torque of children and adolescents]. / Schwere und mittelschwere Hämophilie unter prophylaktischer Substitutionstherapie. Maximale Drehmomente der Knieextensoren und Knieflexoren bei Kindern und Jugendlichen.

UNLABELLED: Due to its influence on haemophilic arthropathy, the evaluation of knee extensor (K(Ext)) and flexor (K(Flex)) torques plays an important role in the preventive and rehabilitative context of haemophilia. Thus, the present study aimed at investigating maximal static torque (M(Max)) of K(Ext) and K(Flex). 14 boys with haemophilia (8 severe, 6 moderate; age: 11.7 ± 2.8 years; prophylactic treatment > 5 years) and 14 healthy carefully pair-matched controls (age: 11.5 ± 2.7 years) were separately measured for the left and right leg for M(Max). Furthermore, the ratio K(Flex)/K(Ext )was calculated and the joint situation assessed using the Haemophilia Joint Health Score. RESULTS: No significant group-effect was observed for M(Max) of the K(Ext) and K(Flex) as well as for the ratio K(Flex)/K(Ext) (p>0.05). Despite significant higher joint scores in haemophilic children compared to their healthy controls (p<0.01), patients merely showed minor joint impairments. CONCLUSION: Children and adolescents with severe and moderate haemophilia under prophylactic replacement treatment with a good joint status showed comparable maximal strength performance of relevant knee muscles compared to their healthy peers.