Kinesio Taping Improves Perceptions of Pain and Function of Patients With Knee Osteoarthritis: A Randomized, Controlled Trial.

Context: Although increasingly used for therapeutic treatment, only limited evidence exists regarding the effects of kinesio taping on patients with knee osteoarthritis (OA). Objective: To determine the effects of kinesio taping on pain, function, gait, and neuromuscular control concerning patients with knee OA. Design: Randomized sham-controlled trial. Setting: University laboratory. Participants: A total of 141 patients (65.1 [7.0] y) with a clinical and radiographic diagnosis of knee OA. Intervention: Kinesio tape, sham tape, or no tape for 3 consecutive days. Main Outcome Measures: Self-reported pain, stiffness, and function were measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Further tests included the Balance Error Scoring System, 10-m walk test, the maximum voluntary isometric contraction force of the quadriceps femoris, and knee active range of motion. Results: At baseline, there were no differences in all outcomes between groups except for knee flexion. Significant effects were found for WOMAC pain (tape vs sham, P = .05; tape vs control, P = .047), stiffness (tape vs sham, P = .01; tape vs control, P ≤ .001), and physical function (tape vs sham, P = .03; tape vs control P = .004). No interactions were found for balance, muscle strength, walking speed, or active range of motion. Conclusion: Wearing kinesio tape for 3 consecutive days had beneficial effects regarding self-reported clinical outcomes of pain, joint stiffness, and function. This emphasizes that kinesio taping might be an adequate conservative treatment for the symptoms of knee OA.

Reliability of tensiomyography and myotonometry in detecting mechanical and contractile characteristics of the lumbar erector spinae in healthy volunteers.

PURPOSE: Tensiomyography™ (TMG) and MyotonPRO® (MMT) are two non-invasive devices for monitoring muscle contractile and mechanical characteristics. This study aimed to evaluate the test-retest reliability of TMG and MMT parameters for measuring (TMG:) muscle displacement (Dm), contraction time (Tc), and velocity (Vc) and (MMT:) frequency (F), stiffness (S), and decrement (D) of the erector spinae muscles (ES) in healthy adults. A particular focus was set on the establishment of reliability measures for the previously barely evaluated secondary TMG parameter Vc. METHODS: Twenty-four subjects (13 female and 11 male, mean ± SD, 38.0 ± 12.0 years) were measured using TMG and MMT over 2 consecutive days. Absolute and relative reliability was calculated by standard error of measurement (SEM, SEM%), Minimum detectable change (MDC, MDC%), coefficient of variation (CV%) and intraclass correlation coefficient (ICC, 3.1) with a 95% confidence interval (CI). RESULTS: The ICCs for all variables and test-retest intervals ranged from 0.75 to 0.99 indicating a good to excellent relative reliability for both TMG and MMT, demonstrating the lowest values for TMG Tc and between-day MMT D (ICC < 0.90). Absolute reliability was suitable for all parameters (CV 2-8%) except for Dm (10-12%). Vc demonstrated to be the most reliable and repeatable TMG parameter (ICC > 0.95, CV < 8%). CONCLUSION: The reliability for TMG Vc could be established successfully. Its further applicability needs to be confirmed in future studies. MMT was found to be more reliable on repeated testing than the two other TMG parameters Dm and Tc.

Epidemiology of injuries in outdoor and indoor hockey players over one season: a prospective cohort study.

OBJECTIVES: To determine the incidence and characteristics of hockey ('field hockey') injuries over the course of one outdoor and indoor season. Comparisons of female versus male players, outdoor versus indoor season and match versus practice were performed. METHODS: Female and male teams of the first, second, third, regional and youth divisions were recruited among a local hockey association in Northern Germany, and followed over an indoor and an outdoor season. Exposure times and location, type, severity and cause of injuries during practice and matches were documented by the coaches or medical staff and collected weekly. Prevalence and incidence rates were calculated. RESULTS: Of the 232 players (mean±SD age 20.7±4.7 years, 68.1% male, 31.9% first division), 84 players (36.2%) suffered 108 new injuries during the season. The overall incidence rate was 3.7 injuries per 1000 player hours (95% CI 3.0 to 4.4). The injury incidence was lower in practice (2.7 per 1000 player practice hours, 95% CI 2.0 to 3.3) than in matches (9.7 per 1000 player match hours, 95% CI 6.8 to 12.7), and was similar for female and male players as well as during the outdoor and the indoor season. Most injuries affected the lower limb (thigh, knee and ankle) and occurred without contact (58.3%). Severe injuries (n=34; 31.5%) were predominantly located at the knee and hand/finger. CONCLUSION: Hockey players have a high prevalence and incidence of injuries, especially at the lower limb.

Foot Strike Patterns Differ Between Children and Adolescents Growing up Barefoot vs. Shod.

Effects of early and permanent footwear use are not well understood. The aim of this study was to investigate the effects of habituation to footwear on foot strike patterns of children and adolescents. Healthy habitually barefoot and shod participants (aged 6-18 years) from South Africa (n=288) and Germany (n=390) performed multiple 20-m jogging and running trials with and without shoes. Each foot strike was captured using a high-speed camera to determine a rearfoot or non-rearfoot strike. The probability of a rearfoot strike in both cohorts and each age was analyzed by using a mixed-effects logistic regression adjusted for possible confounders. Habitually barefoot children showed a higher probability of using rearfoot strikes than habitually shod children (p<0.001). The probability was age-dependent and decreased in habitually barefoot children with age (ORbarefoot-jogging=0.82, 95% CI, 0.71 to 0.96, p=0.014; ORbarefoot-running=0.58, 95% CI, 0.50 to 0.67, p<0.001 and ORshod-running=0.68, 95% CI, 0.59 to 0.79, p<0.001). In habitually shod children, the probability increased significantly for shod jogging (OR=1.19, 95% CI, 1.05 to 1.35, p=0.006). To conclude, foot strike patterns of children are influenced by habituation to footwear. Younger habitually barefoot children show higher rates of rearfoot strikes for shod and barefoot running, and it converges in later adolescence.

Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science.

This updated guideline replaces the "Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science" first published in 2014. Based on the older version of the guideline, the authors have reviewed and evaluated the findings on the use of heart rate (HR) and heart rate variability (HRV) that have been published in the meantime and incorporated them into a new version of this guideline.This guideline was developed for application in clinical practice and research purposes in the fields of occupational medicine and occupational science to complement evaluation procedures with respect to exposure and risk assessment at the workplace by the use of objective physiological workload indicators. In addition, HRV is also suitable for assessing the state of health and for monitoring the progress of illnesses and preventive medical measures. It gives an overview of factors influencing the regulation of the HR and HRV at rest and during work. It further illustrates methods for measuring and analyzing these parameters under standardized laboratory and real workload conditions, areas of application as well as the quality control procedures to be followed during the recording and evaluation of HR and HRV.

Cardiovascular exercise, learning, memory, and cytokines: Results of a ten-week randomized controlled training study in young adults.

Physical exercise has been shown to enhance memory and to increase neuroplasticity. Rodent studies have revealed modulating effects of signaling molecules of the immune system (cytokines) on hippocampal plasticity and memory. Acute and chronic exercise have been both found to alter the number and function of immune cells. Thus, physical exercise might enhance neuroplasticity via an altered immune response. In this study we tested whether multiple repetitions of a vocabulary learning task combined with a bout of cardiovascular exercise enhances learning in humans and whether memory improvements correlated with acute exercise-induced cytokine changes. Data of 52 participants (20-40 years of age) who were randomly assigned to a cardiovascular exercise group (cycling) or a control group (stretching) were analyzed. During the 10-week treatment, participants completed 18 learning-exercise sessions. In each of these sessions, the vocabulary learning task was always performed immediately before exercising started. To assess acute exercise-induced changes in cytokine levels, blood sampling was performed at rest and immediately after exercising in two of the sessions. Learning success measured as increase in learning across all sessions and vocabulary retention four weeks after the treatment had ended did not differ between groups. The cycling group showed a relatively larger acute increase in IL-6, IL-1ra, IL-4, and IFN-γ compared to the stretching group. Exploratory analyses revealed significant positive associations between within-session learning and acute exercise-induced increases in IL-6 and IL-1ra in the cycling group only. These results suggest that the immune system may act as a mediator of exercise-induced cognitive benefits.

Early and Strong Leptin Reduction Is Predictive for Long-Term Weight Loss during High-Protein, Low-Glycaemic Meal Replacement-A Subanalysis of the Randomised-Controlled ACOORH Trial.

Lifestyle interventions including meal replacement are suitable for prevention and treatment of obesity and type-2-diabetes. Since leptin is involved in weight regulation, we hypothesised that a meal replacement-based lifestyle intervention would reduce leptin levels more effectively than lifestyle intervention alone. In the international, multicentre, randomised-controlled ACOORH-trial (Almased-Concept-against-Overweight-and-Obesity-and-Related- Health-Risk), overweight or obese participants with metabolic syndrome criteria (n = 463) were randomised into two groups and received telemonitoring devices and nutritional advice. The intervention group additionally used a protein-rich, low-glycaemic meal replacement. Data were collected at baseline, after 1, 3, 6, and 12 months. All datasets providing leptin data (n = 427) were included in this predefined subanalysis. Serum leptin levels significantly correlated with sex, body mass index, weight, and fat mass at baseline (p < 0.0001). Stronger leptin reduction has been observed in the intervention compared to the control group with the lowest levels after 1 month of intervention (estimated treatment difference −3.4 µg/L [1.4; 5.4] for females; −2.2 µg/L [1.2; 3.3] for males; p < 0.001 each) and was predictive for stronger reduction of body weight and fat mass (p < 0.001 each) over 12 months. Strongest weight loss was observed after 6 months (−5.9 ± 5.1 kg in females of the intervention group vs. −2.9 ± 4.9 kg in the control group (p < 0.0001); −6.8 ± 5.3 kg vs. −4.1 ± 4.4 kg (p = 0.003) in males) and in those participants with combined leptin and insulin decrease. A meal replacement-based lifestyle intervention effectively reduces leptin which is predictive for long-term weight loss.

A High-Protein and Low-Glycemic Formula Diet Improves Blood Pressure and Other Hemodynamic Parameters in High-Risk Individuals.

Low-caloric formula diets can improve hemodynamic parameters of patients with type 2 diabetes. We, therefore, hypothesized that persons with overweight or obesity can benefit from a high-protein, low-glycemic but moderate-caloric formula diet. This post-hoc analysis of the Almased Concept against Overweight and Obesity and Related Health Risk- (ACOORH) trial investigated the impact of a lifestyle intervention combined with a formula diet (INT, n = 308) compared to a control group with lifestyle intervention alone (CON, n = 155) on hemodynamic parameters (systolic and diastolic blood pressure (SBP, DBP), resting heart rate (HR), and pulse wave velocity (PWV)) in high-risk individuals with prehypertension or hypertension. INT replaced meals during the first 6 months (1 week: 3 meals/day; 2−4 weeks: 2 meals/day; 5−26 weeks: 1 meal/day). Study duration was 12 months. From the starting cohort, 304 (68.3%, INT: n = 216; CON: n = 101) participants had a complete dataset. Compared to CON, INT significantly reduced more SBP (−7.3 mmHg 95% CI [−9.2; −5.3] vs. −3.3 mmHg [−5.9; −0.8], p < 0.049) and DBP (−3.7 mmHg [−4.9; −2.5] vs. −1.4 mmHg [−3.1; 0.2], p < 0.028) after 12 months. Compared to CON, INT showed a pronounced reduction in resting HR and PWV after 6 months but both lost significance after 12 months. Changes in SBP, DBP, and PWV were significantly associated positively with changes in body weight and fat mass (all p < 0.05) and resting HR correlated positively with fasting insulin (p < 0.001) after 12 months. Combining a lifestyle intervention with a high-protein and low-glycemic formula diet improves hemodynamic parameters to a greater extent than lifestyle intervention alone in high-risk individuals with overweight and obesity.

High-Protein, Low-Glycaemic Meal Replacement Improves Physical Health-Related Quality of Life in High-Risk Persons for Metabolic Syndrome-A Subanalysis of the Randomised-Controlled ACOORH Trial.

While obesity impairs health-related quality of life (HRQOL), lifestyle interventions targeting weight reduction have been effective in improving HRQOL. Therefore, we hypothesised that a meal replacement-based lifestyle intervention, which has been shown to successfully reduce weight, would also improve HRQOL more effectively than a lifestyle intervention alone. In the international, multicenter, randomised-controlled ACOORH-trial (Almased-Concept-against- Overweight-and-Obesity-and-Related-Health-Risk), overweight or obese participants with elevated risk for metabolic syndrome (n = 463) were randomised into two groups. Both groups received telemonitoring devices and nutritional advice. The intervention group additionally used a protein-rich, low-glycaemic meal replacement for 6 months. HRQOL was estimated at baseline, after 3 and 12 months, using the SF-36 questionnaire, and all datasets providing HRQOL data (n = 263) were included in this predefined subanalysis. Stronger improvements in the physical component summary (PCS) were observed in the intervention compared to the control group, peaking after 3 months (estimated treatment difference 2.7 [1.2; 4.2]; p < 0.0001), but also in the long-term. Multiple regression analysis demonstrated that insulin levels and the achieved weight loss were associated with the mental component summary (MCS) after 12 months (p < 0.05). Thus, meal replacement-based lifestyle intervention is not only effective in weight reduction but, concomitantly, in enhancing HRQOL.

Effects of an exercise program in children with cystic fibrosis: are there differences between females and males?

OBJECTIVE: To investigate the adaptive responses of an in-patient exercise program in children with cystic fibrosis (CF) and evaluate the effects of sex. STUDY DESIGN: In total, 158 female and 186 male subjects with CF (age, 12 to 43 years) were studied during a 6-week rehabilitation course. A maximal incremental cycling test was used to determine exercise capacity and responses after 6 weeks of exercise training. Measures included lung function, peak oxygen uptake, peak workload, and peak heart rate. RESULTS: Lung function values were lower in males (P < .05). Females had a lower aerobic capacity (P < .05) at the beginning and at the end of the exercise training program. Similar training effects (P > .05) were seen between sexes in peak oxygen uptake (mL/min, mL/kg/min) and peak heart rate (beats/min) but not in peak workload (Watts, W/kg). CONCLUSIONS: The exercise program improved the fitness level similarly in females and males with CF. Basic physiological sex differences were still seen at the beginning and end of the training, despite the better lung function in females. Moreover, the finding suggested that fitness level and not lung function determined the response to training in CF, with those who were less fit at baseline having the largest response to training.

Physical activity, quality of life, and the interest in physical exercise programs in patients undergoing palliative chemotherapy.

PURPOSE: Quality of life is of major importance in patients with advanced cancers undergoing palliative chemotherapy. In contrast to the number of studies on physical activity in patients with curable malignancies, data on patients undergoing palliative chemotherapy are scarce. METHODS: A total of 53 patients receiving palliative chemotherapy on an outpatient basis were interviewed using three standardized questionnaires within a time period of 4 weeks (Questionnaire for Measurement of Habitual Physical Activity, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C13 questionnaire, International Physical Activity questionnaire), and a questionnaire regarding patients' acceptance of a potential physical training program. RESULTS: Thirty-six percent of the patients still performed self-instructed physical activities during palliative chemotherapy. Patients showed significantly higher values in the "leisure time index" during their malignancy than before (p < 0.01). Significantly positive correlations were found between "work index" and quality of life (p = 0.004), "work index" and physical function (p = 0.02), and "hours of physical activity per week" and quality of life (p < 0.05). A negative correlation was found between "work index" and fatigue (p < 0.05). Quality of life scores were significantly higher in patients with sportive activities ≥ 9 metabolic equivalent (MET) h/week than in patients with <9 MET h/weeks (p < 0.01). Sixty percent of patients indicated that they would be willing to participate in an individually adapted activity training program. CONCLUSIONS: In patients undergoing palliative chemotherapy, a statistically significant positive correlation between physical activity and quality of life could be demonstrated. About two thirds of critically ill patients are interested in participating in training programs.

Effects of a physical exercise rehabilitation group program on anxiety, depression, body image, and health-related quality of life among breast cancer patients.

BACKGROUND: Since physical exercise programs have the potential to help cancer patients regain physical fitness and may exert a range of positive consequences for recovery and psychological well-being, the impact of a physical exercise program was investigated in this prospective study. PATIENTS AND METHODS: Women with primary nonmetastatic breast cancer after a minimum 4-week period post chemotherapy and/or radiotherapy completion were randomly assigned to one of 2 groups: intervention group (IG) (n = 30) and waiting group (WG) (n = 28). The 10-week twice weekly exercise group program consisted of gymnastics, movement games, relaxation, walking, and jogging. Anxiety, depression, body image, and quality of life were measured using standardized questionnaires. Maximal oxygen uptake (VO(2)max/kg) was assessed as a measure of physical fitness. RESULTS: Patients in the IG improved significantly over time with regard to anxiety (p = 0.03, d = 0.45), depression (p = 0.05, d = 0.43), individual body image (p = 0.006, d = 0.44), and VO(2)max/kg (p < 0.001, d = 0.50), whereas no improvements were observed in the WG. However, this randomized controlled trial failed to demonstrate significant intervention effects in quality of life and social body image. CONCLUSIONS: This prospective study provided evidence for the effectiveness of a 10-week physical exercise intervention to significantly improve psychosocial wellbeing, individual body image, and physical fitness.

Game Exposure, Player Characteristics, and Neuromuscular Performance Influence Injury Risk in Professional and Youth Field Hockey Players.

BACKGROUND: Identifying factors that contribute to the occurrence of injury is an important step in designing training programs to minimize the risk of injury. However, despite high injury rates, variables contributing to injury in field hockey players remain relatively unexplored. PURPOSE: To identify factors that may predict injury in professional and youth field hockey players. STUDY DESIGN: Cohort study; Level of evidence, 2. METHOD: Professional and youth hockey players completed preseason neuromuscular performance testing and were monitored for injuries, training, and game exposure throughout the subsequent 12-month indoor and outdoor hockey season. Least absolute shrinkage and selection operator analysis was conducted to identify injury risk factors. Receiver operating characteristic curves were then calculated to determine the individual predictive accuracy of the identified variables. RESULTS: A total of 83 players (mean ± SD age, 20.7 ± 4.9 years; 34.9% female) with complete performance, injury, and exposure data were included for data analysis. Almost half of players (44.6%) sustained a time-loss injury during the season, and 73% of these injuries occurred in the lower limb. Playing more games and having an older age, asymmetrical and poor dynamic postural control, and better explosive performance were identified as jointly influencing the risk of injury. When considered individually, number of games played throughout the season was the most accurate predictor of injury risk (area under the curve [AUC] = 0.74; P < .001), while asymmetrical and poor dynamic postural control (AUCs = 0.61-0.65; P = .01-.04) and better explosive athletic performance (AUCs = 0.65-0.67; P < .01) were identified as moderate individual predictors of sustaining a general or lower limb injury. CONCLUSION: A number of modifiable factors were individually and jointly associated with an increased injury risk in field hockey players, providing initial evidence for the design of targeted and sport-specific training programs to mitigate the risk of injury.

The Effects of Acute Cardiovascular Exercise on Memory and Its Associations With Exercise-Induced Increases in Neurotrophic Factors.

Due to increasing life expectancy, low-cost interventions to counteract age-related memory impairment have gained popularity. Physical activity has been shown to positively affect memory and hippocampal plasticity in rodents and humans. These effects have been proposed to be mediated by the release of neurotrophic factors. However, studies examining the effects of a single cardiovascular exercise session on human memory have yielded conflicting results. Moreover, it remains unclear whether exercise-induced memory enhancements are related to changes in peripheral neurotrophic factor concentrations. The present study tested whether one bout of cardiovascular exercise during an early phase of memory consolidation, compared to one bout of stretching and toning, positively affected memory. Furthermore, it was analyzed whether exercise-induced changes in the brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) were related to memory enhancement after a single bout of physical exercise. Fifty healthy participants (20-40 years) were randomly assigned to either a cycling group (BIKE) or a stretching and toning group (STRETCH). Participants performed an implicit vocabulary learning task which was immediately followed by physical exercise. Memory for the learned vocabulary was tested 1-2 weeks later. To measure exercise-induced changes in serum neurotrophic factor levels, blood samples were collected at rest (baseline) and immediately after the exercise session. Results did not show a significant difference in memory between the BIKE group and the STRETCH group. However, in the BIKE group, a larger increase in BDNF and VEGF levels was observed than in the STRETCH group. Moreover, the increase in BDNF and memory performance tended to be positively related in the BIKE group. We speculate that the correlation between exercise-increased BDNF levels and memory in the cycling group may indicate an involvement of BDNF in mediating memory processes after acute cardiovascular exercise.

Effects of a Protein-Rich, Low-Glycaemic Meal Replacement on Changes in Dietary Intake and Body Weight Following a Weight-Management Intervention-The ACOORH Trial.

Although meal replacement can lead to weight reduction, there is uncertainty whether this dietary approach implemented into a lifestyle programme can improve long-term dietary intake. In this subanalysis of the Almased Concept against Overweight and Obesity and Related Health Risk (ACOORH) study (n = 463), participants with metabolic risk factors were randomly assigned to either a meal replacement-based lifestyle intervention group (INT) or a lifestyle intervention control group (CON). This subanalysis relies only on data of participants (n = 119) who returned correctly completed dietary records at baseline, and after 12 and 52 weeks. Both groups were not matched for nutrient composition at baseline. These data were further stratified by sex and also associated with weight change. INT showed a higher increase in protein intake related to the daily energy intake after 12 weeks (+6.37% [4.69; 8.04] vs. +2.48% [0.73; 4.23], p < 0.001) of intervention compared to CON. Fat and carbohydrate intake related to the daily energy intake were more strongly reduced in the INT compared to CON (both p < 0.01). After sex stratification, particularly INT-women increased their total protein intake after 12 (INT: +12.7 g vs. CON: -5.1 g, p = 0.021) and 52 weeks (INT: +5.7 g vs. CON: -16.4 g, p = 0.002) compared to CON. Protein intake was negatively associated with weight change (r = -0.421; p < 0.001) after 12 weeks. The results indicate that a protein-rich dietary strategy with a meal replacement can improve long-term nutritional intake, and was associated with weight loss.

High-Protein, Low-Glycaemic Meal Replacement Decreases Fasting Insulin and Inflammation Markers-A 12-Month Subanalysis of the ACOORH Trial.

Lifestyle interventions, including meal replacement, are effective in the prevention and treatment of type-2-diabetes and obesity. Since insulin is the key weight regulator, we hypothesised that the addition of meal replacement to a lifestyle intervention reduces insulin levels more effectively than lifestyle intervention alone. In the international multicentre randomised controlled ACOORH (Almased Concept against Overweight and Obesity and Related Health Risk) trial, overweight or obese persons who meet the criteria for metabolic syndrome (n = 463) were randomised into two groups. Both groups received nutritional advice focusing on carbohydrate restriction and the use of telemonitoring devices. The intervention group substituted all three main meals per day in week 1, two meals per day in weeks 2-4, and one meal per day in weeks 5-26 with a protein-rich, low-glycaemic meal replacement. Data were collected at baseline and after 1, 3, 6 and 12 months. All datasets providing insulin data (n = 446) were included in this predefined subanalysis. Significantly higher reductions in insulin (-3.3 ± 8.7 µU/mL vs. -1.6 ± 9.8 µU/mL), weight (-6.1 ± 5.2 kg vs. -3.2 ± 4.6 kg), and inflammation markers were observed in the intervention group. Insulin reduction correlated with weight reduction and the highest amount of weight loss (-7.6 ± 4.9 kg) was observed in those participants with an insulin decrease > 2 µU/mL. These results underline the potential for meal replacement-based lifestyle interventions in diabetes prevention, and measurement of insulin levels may serve as an indicator for adherence to carbohydrate restriction.

Meal replacement by formula diet reduces weight more than a lifestyle intervention alone in patients with overweight or obesity and accompanied cardiovascular risk factors-the ACOORH trial.

BACKGROUND: As formula diets have demonstrated to be effective in reducing weight, we hypothesised that in patients with overweight or obesity and accompanied cardiovascular risk factors, combining a liquid formula diet with a lifestyle intervention is superior in reducing weight and improving cardiovascular risk factors than lifestyle intervention alone. METHODS: In this multicenter RCT 463 participants with overweight or obesity (BMI: 27-35 kg/m²; at least one additional co-morbidity of the metabolic syndrome) were randomised (1:2) into either a control group with lifestyle intervention only (CON, n = 155) or a lifestyle intervention group including a liquid meal replacement (INT, n = 308). Both groups used telemonitoring devices (scales and pedometers), received information on healthy diet and were instructed to increase physical activity. Telemonitoring devices automatically transferred data into a personalised online portal and acquired data were discussed. INT obtained a liquid meal replacement substituting three meals/day (~1200 kcal) within the first week. During weeks 2-4, participants replaced two meals/day and during weeks 5-26 only one meal/day was substituted (1300-1500 kcal/day). Follow-up was conducted after 52 weeks. Intention-to-treat analyses were performed. Primary outcome was weight change. Secondary outcomes comprised changes in cardiometabolic risk factors including body composition and laboratory parameters. RESULTS: From the starting cohort 360 (78%, INT: n = 244; CON: n = 116) and 317 (68%, INT: n = 216; CON: n = 101) participants completed the 26-weeks intervention phase and the 52-weeks follow-up. The estimated treatment difference (ETD) between both groups was -3.2 kg [-4.0; -2.5] (P < 0.001) after 12 weeks and -1.8 kg [-2.8; -0.8] (P < 0.001) after 52 weeks. CONCLUSIONS: A low-intensity lifestyle intervention combined with a liquid meal replacement is superior regarding weight reduction and improvement of cardiovascular risk factors than lifestyle intervention alone.

On-Field Perceptual-Cognitive Training Improves Peripheral Reaction in Soccer: A Controlled Trial.

Abilities such as peripheral reaction are of special importance in soccer. Whether these abilities can be improved by sport-specific on-field interventions remains unclear. The aim of the present controlled trial was to investigate the effect of a soccer-specific perceptual-cognitive on-field training on peripheral reaction of highly talented soccer players aged 12-13 years. N = 38 male elite athletes from young talent centers were allocated to an intervention (n = 19) and a control group (CG) (n = 19). Computer-based peripheral perception tests were conducted before and after intervention. Combining a sport-specific and a juggling task, the intervention was performed once a week (8 weeks, 20 min per week) in addition to team training. The CG exclusively underwent usual team training. Analyses show significant differences between the two groups for peripheral reaction time (PRT), with significant improvements for the intervention group and none for the CG. Furthermore, results indicate that improvements in peripheral reaction might be due to changes in the reaction time of right-footed players. Future studies should be conducted to clarify the effect of sport-specific on-field training approaches on PRT. These analyses should consider the influence of lateralization on effectivity of perceptual-cognitive on-field training approaches.

Sex-Based Differences in Tensiomyography as Assessed in the Lower Erector Spinae of Healthy Participants: An Observational Study.

BACKGROUND: Although there is mounting evidence on sex-linked differences in paraspinal muscle function, it is unknown whether sex-based variations in mechanical and contractile characteristics of the lumbar erector spinae (LES) can be monitored noninvasively in healthy participants at rest using tensiomyography (TMG). HYPOTHESIS: Sex-specific effects in muscle displacement (Dm) and velocity of muscle deformation (Vd) will be observed via TMG assessed in the LES. STUDY DESIGN: Observational study. LEVEL OF EVIDENCE: Level 3. METHODS: LES response was measured in a relaxed state in 40 healthy adults (20 females). Possible differences between the conditions were investigated using mixed-model analyses of variance. Two-stage hierarchical linear regression analyses were performed to predict the outcome of TMG Dm and Vd based on participant sex. RESULTS: There were significant main effects of sex with large effect sizes for both TMG parameters, resulting from lower mean values in women compared with men (Dm, P < 0.01; Vd, P < 0.01). In contrast, neither the main effect of side (left vs right LES) nor the interaction between the side and sex reached significance (all P > 0.3). Introducing the sex variable in stage 2 of the regression analyses significantly improved the prediction of the TMG parameters (all ∆R2 ≥ 0.18; all P < 0.01; all f2 ≥ 0.29). CONCLUSION: Sex-based differences in muscle stiffness and contractile characteristics could be observed by TMG on LES muscles in healthy individuals at rest. The data suggest that these disparities are not exclusively attributable to anthropometric measures but may be linked to intrinsic sex-based differences in skeletal muscle characteristics. CLINICAL RELEVANCE: We recommend implementing TMG in a clinical setting using the obtained results as a basis to factor for the patient's biological sex when assessing effects of therapeutic/exercise regimens aiming at the optimization of myofascial tissue regeneration and performance.