[Effects of the COVID-19 lockdown on physical performance parameters in professional football]. / Auswirkungen des COVID-19-Lockdowns auf physische Leistungsparameter im professionellen Fußball: Eine narrative Literaturübersicht.

Background: Governmental measures in 2020 to contain the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) brought training and competition in professional soccer to a temporary halt in many countries. As a result of the lockdown, training possibilities were mostly limited to nonspecific home-based training methods. It is unclear whether the lack of sport-specific stimuli led to a reduction in the physical performance of soccer players. Methods: For the narrative review, the PubMed, Google Scholar and BISp-Surf databases were selectively searched for studies examining the effects of the lockdown on physical performance parameters in adult professional soccer players. Results: In this review six prospective longitudinal studies were included. In all studies home-based training was performed during quarantine. Of the studies four compared the performance of the soccer players with data from previous seasons and two studies assessed the performance of players immediately before and after the lockdown period. Discussion: While general strength and endurance performances can be maintained through home-based substitute training programs, the studies indicated that the lack of football-specific stimuli could have an impact on the rapid power and speed performances of soccer players. Progressive loading control especially for speed training should be considered when returning to regular training in order to reduce the risk of injuries.

Correction to: Neural therapy of an athlete's chronic plantar fasciitis: a case report and review of the literature.

In the publication of this article [1], there are reference errors in four positions the respective references are missing since reference Fischer [26] was omitted.

Neural therapy of an athlete's chronic plantar fasciitis: a case report and review of the literature.

BACKGROUND: The focus of this case report is on the role of inflammation as a contributor to pain in plantar fasciitis and its cure by the injection of local anesthetics. CASE PRESENTATION: This is a case report on a 24-year-old white man, a middle-distance runner, with chronic unilateral plantar fasciitis and perceived heel pain for almost 1.5 years. He was treated with neural therapy (that is, injection of < 1 ml procaine 1% which is a local anesthetic with strong anti-inflammatory properties) of the surgical scar and along the surgical puncture channel. The follow-up period from the time of first presentation until publication was 2.5 years. At admission, pain intensity (visual analog scale) in the affected leg was severe (10 cm, visual analog scale; range 0-10 cm) when walking and moderate (5 cm, visual analog scale) when standing. After the first session of injections he could stand pain-free and pain when walking was markedly reduced (- 90%). After the third session, he reported no pain in the affected leg and could return to sports at his former level (no difference in training load compared to non-injured state). There was no recurrence of inflammatory signs or heel pain despite intense athletics training up to the date of publication. CONCLUSIONS: In prolonged cases of plantar fasciitis, inflammation is an important component in the development of persistent pain. The results of our case describe the effects of three neural therapy sessions that abolished inflammation and associated heel pain. Neural therapy might be an effective and time-efficient approach in the treatment of plantar fasciitis, enabling an early return to sports.

Head coaches' attitudes towards injury prevention and use of related methods in professional basketball: A survey.

OBJECTIVES: To investigate the practices and attitudes of professional basketball head coaches towards injury prevention. DESIGN: Survey. SETTING: Elite-level basketball. PARTICIPANTS: Head coaches of all 366 German professional teams. MAIN OUTCOME MEASURES: Use of injury risk screening methods, rated importance of different musculoskeletal injuries and rated effectiveness of preventive interventions. RESULTS: Eighty-three of 366 invited coaches (23%) responded to the survey. No non-response bias was detected. Only one of three teams conducts systematic injury screenings. The most commonly used test was the functional movement screen (73.1% of users), while balance and strength testing (both 38.5%) were least prevalent. Top-rated preventive interventions included balance and strength training, training of functional movement patterns, and stretching. In contrast, passive interventions, e.g. the use of orthoses, were not considered effective. The involvement of a health professional (e.g. physiotherapist) was associated with the performance of injury screening, but not with the choice of specific tests or preventive strategies. CONCLUSIONS: The methods applied to conduct injury screening and prevent musculoskeletal disorders in German professional basketball teams seem only partially backed by scientific evidence. Although not correlated with the tests and interventions used, the involvement of health-related stakeholders might help to identify players at increased injury risk.

Effects of aerobic exercise on brain metabolism and grey matter volume in older adults: results of the randomised controlled SMART trial.

There is mounting evidence that aerobic exercise has a positive effect on cognitive functions in older adults. To date, little is known about the neurometabolic and molecular mechanisms underlying this positive effect. The present study used magnetic resonance spectroscopy and quantitative MRI to systematically explore the effects of physical activity on human brain metabolism and grey matter (GM) volume in healthy aging. This is a randomised controlled assessor-blinded two-armed trial (n=53) to explore exercise-induced neuroprotective and metabolic effects on the brain in cognitively healthy older adults. Participants (age >65) were allocated to a 12-week individualised aerobic exercise programme intervention (n=29) or a 12-week waiting control group (n=24). The main outcomes were the change in cerebral metabolism and its association to brain-derived neurotrophic factor (BDNF) levels as well as changes in GM volume. We found that cerebral choline concentrations remained stable after 12 weeks of aerobic exercise in the intervention group, whereas they increased in the waiting control group. No effect of training was seen on cerebral N-acetyl-aspartate concentrations, nor on markers of neuronal energy reserve or BDNF levels. Further, we observed no change in cortical GM volume in response to aerobic exercise. The finding of stable choline concentrations in the intervention group over the 3 month period might indicate a neuroprotective effect of aerobic exercise. Choline might constitute a valid marker for an effect of aerobic exercise on cerebral metabolism in healthy aging.

Is remote stretching based on myofascial chains as effective as local exercise? A randomised-controlled trial.

Lower limb stretching based on myofascial chains has been demonstrated to increase cervical range of motion (ROM) in the sagittal plane. It is, however, unknown whether such remote exercise is as effective as local stretching. To resolve this research deficit, 63 healthy participants (36 ± 13 years, ♂32) were randomly assigned to one of three groups: remote stretching of the lower limb (LLS), local stretching of the cervical spine (CSS) or inactive control (CON). Prior (M1), immediately post (M2) and 5 min following intervention (M3), maximal cervical ROM was assessed. Non-parametric data analysis (Kruskal-Wallis tests and adjusted post hoc Dunn tests) revealed significant differences between the disposed conditions. With one exception (cervical spine rotation after CSS at M2, P > .05), both LLS and CSS increased cervical ROM compared to the control group in all movement planes and at all measurements (P < .05). Between LLS and CSS, no statistical differences were found (P > .05). Lower limb stretching based on myofascial chains induces similar acute improvements in cervical ROM as local exercise. Therapists might consequently consider its use in programme design. However, as the attained effects do not seem to be direction-specific, further research is warranted in order to provide evidence-based recommendations.

Range of motion and cervical myofascial pain.

Several studies investigating myofascial pain syndrome include assessments of range of motion (ROM) as a diagnostic criterion. However, the value of ROM in this context has not yet been evaluated in controlled clinical studies. We aimed to examine whether patients with myofascial pain syndrome display alterations of ROM when compared to healthy subjects. Twenty-two individuals (13 females, 9 males; aged 33.4 ± 13.9 yrs) afflicted with active myofascial trigger points in the upper trapezius muscle as well as 22 age and sex matched healthy controls were included. All subjects underwent an examination of maximal active cervical ROM in flexion/extension assessed by means of a 3D ultrasonic movement analysis system (30 Hz; Zebris CMS 70). In the patients group, pressure pain threshold (PPT) of the trigger points was determined using a pressure algometer. Maximum range of motion in the sagittal plane did not differ between individuals with MTrP (125.9 ± 23.2°, 95% CI: 116.2-135.6°) and asymptomatic subjects (128.2 ± 20.4°, 95% CI: 119.7-136.7°; p > .05). In patients, PPT (1.7 ± .6, 95% CI: 1.5-1.9) was not correlated with cervical mobility (r = -.13; p > .05). Based on these pilot data, range of motion in flexion/extension is not a valid criterion for the detection of myofascial trigger points. Additional research incorporating movement amplitudes in other anatomical planes and additional afflicted muscles should be conducted in order to further delineate the relative impact of MTrP on range of motion.

Appraising the methodological quality of cadaveric studies: validation of the QUACS scale.

Although systematic reviews are conducted in the field of anatomical research, no instruments exist for the assessment of study quality. Thus, our objective was to develop a valid tool that reliably assesses the methodological quality of observational cadaveric studies. The QUACS scale (QUality Appraisal for Cadaveric Studies) was developed using an expert consensus process. It consists of a 13-item checklist addressing the design, conduct and report of cadaveric dissection studies. To evaluate inter-rater reliability, a blinded investigator obtained an initial pool of 120 observational cadaveric studies. Sixty-eight of them were selected randomly according to sample size calculations. Three independent researchers rated each publication by means of the QUACS scale. The reliability of the total score was estimated using the intraclass correlation coefficient (ICC). To assess agreement among individual items, margin-free kappa values were calculated. For construct validity, two experts (an anatomist and an experienced physician) categorized the quality of 15 randomly selected studies as 'excellent' (4 points), 'moderate to good' (3 points), poor to moderate' (2 points) or 'poor' (1 point). Kendall's tau rank correlation was used to compare the expert ratings with the scores on the QUACS scale. An evaluation of feasibility was carried out during the reliability analysis. All three raters recorded the duration of quality appraisal for each article. Means were used to describe average time exposure. The ICC for the total score was 0.87 (95% confidence interval: 0.82-0.92; P < 0.0001). For individual items, margin-free kappa values ranged between 0.56 and 0.96 with an agreement of 69-97% among the three raters. Kendall's tau B coefficient of the association between expert ratings and the results obtained with the QUACS scale was 0.69 (P < 0.01). Required rating time per article was 5.4 ±â€…1.6 min. The QUACS scale is highly reliable and exhibits strong construct validity. Thus, it can confidently be applied in assessing the methodological quality of observational dissection studies.

[Sedentary behaviour and health]. / Sedentäres Verhalten und Gesundheit--Eine selektive Literaturübersicht.

Exercise-related public health recommendations and research for increased fitness and health had long focused on vigorous exercise or the lack thereof. Recently scientific interest in possible effects of sedentary behaviour (SB) (sitting) independent of moderate-vigorous intensity exercise has been growing.We conducted a selective literature search in Pubmed and the Sedentary Research Database with the outcomes SB, risk factors, mortality and morbidity in adults. We included only reviews and systematic reviews.Observational studies suggest an association between SB and all-cause and cardiovascular, but not cancer mortality. SB also seems to be associated with diabetes and overweight/weight gain. Evidence for other diseases, such as cardiovascular diseases, hypertension, cancer, and mental diseases is limited also because of the heterogeneity and poor methodology of the -studies. Intervention studies found inconsistent evidence that SB is associated with detrimental effects on markers of cardiometabolic risk.The evidence on the detrimental effects of sedentary behaviour is decreasingly convincing with the endpoints of mortality, -morbidity, and markers of metabolic risk, in that order. Higher TV and screen time, but not total SB seems to be associated with higher all-cause and cardiovascular, but not cancer mortality. Further intervention studies are needed to establish -dose-response relationships and potentially protective effects of cardiorespiratory fitness and physical activity.

Short-term effects of acupuncture and stretching on myofascial trigger point pain of the neck: a blinded, placebo-controlled RCT.

OBJECTIVES: This trial aimed to evaluate the short-term effectiveness of acupuncture plus stretching to reduce pain and improve range of motion in patients afflicted by cervical myofascial pain syndrome. DESIGN: Randomized, blinded, placebo-controlled crossover study. INTERVENTION: Nineteen patients (11 females, eight males, 33 ± 14 years) with myofascial neck pain in randomized order received the following treatments with one week washout between: acupuncture, acupuncture plus stretching, and placebo laser acupuncture. MAIN OUTCOME MEASURES: Mechanical pain threshold (MPT, measured with a pressure algometer) represented the primary outcome. Secondary outcomes were motion-related pain (Visual Analogue Scale, VAS) and cervical range of motion (ROM, recorded by means of an ultrasonic 3D movement analysis system). Outcomes were assessed immediately prior as well as 5, 15 and 30 min post treatment. Friedman tests with post hoc Bonferroni-Holm correction were applied to compare differences between treatments. RESULTS: Both acupuncture as well as acupuncture plus stretching increased MPT by five, respectively, 11 percent post treatment. However, only acupuncture in combination with stretching was superior to placebo (p<0.05). There were no significant differences between interventions at 15 and 30 min post treatment. VAS did not differ between treatments at any measurement. Five minutes after application of acupuncture plus stretching, ROM was significantly increased in the frontal and the transversal plane compared to placebo (p<0.05). CONCLUSIONS: The combination of acupuncture and stretching could represent a suitable treatment option to improve cervical movement behavior and reduce trigger point pain in the short-term. However, additional studies further discriminating the placebo effects are still warranted.

[Sporting loads to Spondylodesis of lumbar spine: The return-to-play process]. / Sportliche Belastungen nach Spondylodesen der Lendenwirbelsäule : Der Return-to-play-Prozess.

BACKGROUND: Return to play (RTP) and competition following spinal fusion is of particular importance for athletes. There is a lack of guidelines for decision making in RTP processes. OBJECTIVE: The purpose of this work was to provide a systematic review of the criteria and time of return in the RTP decision process for adults undergoing lumbar spinal fusion. METHODS: Two independent investigators searched MEDLINE using MeSH terms. Targeted outcomes were criteria for return to play decisions and total duration of the RTP process. RESULTS: So far, no prospective randomized controlled trials on RTP after spinal fusion considering inclusion and exclusion criteria are available. Five of the included studies are based on original data. Most of the identified studies are narrative reviews and, thus, exhibit low evidence levels. In addition to the narrative reviews, one observational study, two expert opinion surveys and two model development studies were found. CONCLUSION: Based on the literature research, a positive RTP decision can be made if the following criteria are fulfilled: (1) anatomical and functional healing is complete, (2) safety of the athlete and secondary subjects during training and competition is guaranteed, (3) sport-specific skills are regained, and (4) patient is psychosocially ready. The RTP process can often be successfully initiated 6 months after surgery; some patients however, will never manage the return to full-contact sports and/or sports with risk of collision.

Changes in exercise capacity, quality of life and fatigue in cancer patients during an intervention.

The study explored the interdependence of changes in oxygen uptake, quality of life and cancer-related side-effect fatigue during a 4-month exercise intervention. Participants were during adjuvant (curative) or palliative therapy and post-adjuvant therapy (finished within the previous 12 months). Aerobic exercise capacity (VO2 peak), quality of life and fatigue symptom (EORTC QLQ-C30) were obtained in 101 cancer patients (30-77 years). After initial examination, patients participated in supervised and/or home-based training interventions. Patients were re-examined after 16-20 weeks and stratified into 3 subgroups (terciles) with respect to the absolute change in VO2 peak. The ANCOVA, with significant covariate effect for pretest fatigue score (F(5,101) = 8.150, P < 0.001), indicated significant differences between groups in outcome measures (P < 0.001). Based on the absolute change of VO2 peak (1.9 ± 1.7; 1.8 ± 0.8; 5.7 ± 2.8 ml/kg/min) there were significant differences in the quality of life improvement (17.2 ± 15.1 vs. 4.8 ± 22.0 points, P < 0.05) and cancer-related fatigue reduction (-6.1 ± 30.7; -11.5 ± 20.9; -21.2 ± 21.4 points) between upper and lower tercile. The findings point towards a relationship of exercise capacity enhancement, quality of life improvement and fatigue symptom reduction during and shortly after cancer treatment.

Validity of the six-minute walk test in cancer patients.

The present study evaluated the validity of the six-minute walk test (6MWT) in cancer patients. 50 subjects (36 f, 14 m; 57.4±10.2 years; during (56%) or off (44%) cancer treatment) performed a 6MWT and a spiroergometry on a cycle ergo-meter (0+25 W, 3 min) to evaluate maximum exercise capacity (VO2peak). A subsample (n=30) completed a retest of the 6MWT within 2-7 days. Patients covered a distance of 594±81 m during 6MWT at an average intensity of 86.3±9.6% of HRmax and achieved a VO2peak of 21.2±4.86 ml · kg - 1 · min - 1 during cycle ergometry. The distance walked correlated significantly (p<0.001) with VO2peak (r=0.67) and perceived physical function (EORTC QLQ-C30 physical function subscale) (r=0.55). Concerning reliability the intraclass correlation coefficient was r=0.93 (95%CI: +0.86;+0.97; p<0.001) and the coefficient of variation 3%. During retest participants walked 3.1% (95%CI: +1.1; +5.2) farther and achieved a higher RPE (+1.0; 95%CI: +0.3;+1.8). Limits of agreement were between - 43.1 and 76.4 m. In cancer patients the 6MWT seems to be as valid and reliable as in healthy elderly, cardiac and pulmonary patients. Thus, it can be recommended for use in cancer patients.

[Activity trails, risk of falling, and health-related quality of life. Effects of a 12-week guided intervention]. / Bewegungsparcours, Sturzrisiko und gesundheitsbezogene Lebensqualität : Effekte einer 3-monatigen Bewegungsintervention.

BACKGROUND: The purpose was to evaluate the interventional effects of activity trails (courses) on fall risk factors and health-related quality of life (hrQoL). MATERIALS AND METHODS: A total of 94 subjects (67.7 ± 5.7 years; 29 men, 65 women) completed the following measurements prior to and 12 weeks after the initiation of the activity trail intervention: maximum isometric leg extensors force (Fmax, m3 diagnoses©), gait velocity (GV), and static postural stability (STAB, Zebris FDM©), fall-associated self-efficacy (FALL, FES-I), and hrQoL (SF-36). RESULTS: During the 12-week intervention period, the participants increased Fmax (1.63 ± 0.6 vs. 1.70 ± 0.6 N•kg(-1)) and GV (1.06 ± 0.25 vs. 1.11 ± 0.18m•s(-1); p < 0.05). Neither FALL (19.44 ± 3.6 vs. 19.41 ± 4.3 points) nor STAB (84.3 ± 56.4 vs. 79.7 ± 63.1 mm(2)) changed. Additionally, significant improvements in hrQoL regarding vitality (56.3 ± 17.2 vs. 63.2 ± 18.3 points) and mental health (69.4 ± 18.7 vs. 75.5 ± 16.5 points; p < 0.05) were found. CONCLUSION: The improvements in fall-related risk factors and hrQoL may be expected to contribute to fall prevention and psychosocial quality of life.

Exercise effects on HRV in cancer patients.

The present study evaluated the effects of physical exercise on heart rate variability (HRV) in cancer patients. 3 matched groups of each 15 tumour patients (60.4±8.9 years, 27 male, 18 female) were recruited: Physical exercise group 1 (acute treatment), Physical exercise group 2 (post treatment) and non-intervention group (acute treatment, no exercise). Exercise group patients received counselling for exercise and participated in a Nordic-Walking program. Short-term HRV-recordings, assessments of fatigue and quality of life (QoL) were performed prior to and 16 weeks after the exercise program initiation. MANCOVA revealed group × time differences in total power frequency domain of HRV and QoL (p<0.05). TP follow-up scores [logms(2)] differed significantly between non-intervention and intervention post treatment (2.0±0.5 vs. 2.6±0.5), but not between non-intervention and intervention during acute treatment. QoL follow-up scores differed significantly between non-intervention and intervention during acute treatment (47±15 vs. 64±18) and post treatment (47±15 vs. 69±19). Exercise enhances cardiac autonomic regulation of tumour patients during and after acute treatment. Because of the association of higher HRV-parameters and prolonged survival in cancer patients, improvement in autonomic control may be an important goal of exercise.

Recurrent childhood wheezing and exercise induced asthma in later life.

AIM: Exercise induced asthma (EIA) common in endurance and other athletes limits physical activity. Although a correlation between recurrent childhood bronchitis and the development of asthma has been reported, its relation to EIA in adult athletes has not been assessed. The study evaluates the EIA risk after recurrent childhood wheezing (RCW) and its aggravating influence on the known risk factors outdoor and professional sports. METHODS: To evaluate the effect of RCW on EIA, 570 multiple choice questionnaires were evaluated, assessing the history of RCW and the EIA occurrence. The latter was defined either according to physician-derived diagnosis, by typical symptoms or by decrease of the 1-second forced expiratory volume after a 6-minute running test. Contingency tables and a logistic regression model were worked out to describe referring parameters of EIA incidence. RESULTS: Almost one quarter of the athletes with RCW were attributed positive for EIA. Contingency calculations revealed a 2.6 times higher chance of symptoms of EIA after RCW which further increased in outdoor sports on a professional level. The duration of sports participation, cold environment and self-limiting of symptoms are predicting factors of a higher risk of EIA, being responsible for 53% of the prevalence variance. CONCLUSION: The results point towards a facilitating effect of recurrent affections of the respiratory tract in young age in addition to generally accepted factors of EIA in adults. For safe sports participation, the athlete, as well as involved caregivers (parents, coach) should have an adequate knowledge of EIA and prevention/intervention strategies like warming up or the use of inhalers.

[Sports medical counseling to promote physical activity in unemployed]. / Sportmedizinische Bewegungsberatung bei Arbeitslosen.

Although strong evidence suggests that unemployment increases health risks and physical activity results in significant health benefits, the participation rate in prevention programs among unemployed men is still low. For this reason, a sports medical counseling service was implemented at regional job centers in 2006 to refer unemployed persons into local sports for health programs. The participation rate from 741 long-term unemployed persons was analyzed with respect to gender, health, and physical activity status. Women were more active than men (p = 0.038). Among men, physically active persons differed from non-active persons in BMI, activity status, and self-reported health status (p < 0.05). Especially men with lower fitness, health, and activity status could be motivated for more physical activity (p < 0.001). The odds ratio for program participation of men with lower fitness, health, and activity status is 2.8 (95% confidence interval 1.8-4.3) compared to persons with lower risk factors. Sports medical counseling at job centers seems to be a promising and feasible intervention approach.

[Influence of spinal orthosis on gait and physical functioning in women with postmenopausal osteoporosis]. / Einflüsse einer Wirbelsäulenorthese auf Gangparameter und Alltagsfunktion bei Postmenopausaler Osteoporose.

INTRODUCTION: Osteoporosis is a widespread chronic bone disease leading to an increased risk of bone fractures. The most common clinical consequences are back pain, hyperkyphosis, limitations of physical functioning and activities of daily living as well as reduced quality of life. Furthermore, osteoporosis is associated with decreased strength and deficits of gait and balance, all together resulting in an increased risk of falls and a subsequent aggravation of fracture risk. Besides pharmaceutical and exercise therapy, back orthoses are increasingly being used in the therapy of osteoporosis and rehabilitation after vertebral fractures. Previous studies have shown that wearing a spinal orthosis results in a reduction of pain as well as improvements of posture and back extensor strength. To date there is no study that has evaluated the effects of a spinal orthosis on gait stability and physical functioning in patients with osteoporosis. Therefore the purpose of the present study was to assess the effects of a spinal orthosis on gait and pain-induced limitations of activities of daily living (ADL) in women with osteoporosis. METHODS: A total of 69 postmenopausal osteoporotic women with and without vertebral fractures were randomly assigned to receive either a spinal orthosis (Thämert Osteo-med intervention group n=35; average age 74 ± 8.3 years, height 158.3 ± 6.3 cm, weight 62.8 ± 9.6 kg, t-score -2.6 ± 1.0, number of vertebral fractures 1.4 ± 2.0) or to a waiting list control group (n= 34, age 74.1 ± 7.7 years, height 159.6 ± 5.9 cm, weight 65.4 ± 11.3 kg, t-score -2.9± 0.8, number of vertebral fractures: 0.9 ± 1.2). The following outcome measures were collected at baseline and at 3 and 6 months follow-up: gait parameters including gait analysis: velocity, stride length and width, double support time (% of gait cycle) and perceived limitations in activities of daily living (numeric rating scale 1-10; 1=best, 10= worst situation). RESULTS: The ANCOVA indicated a significant reduction of the double support time at 6 months in the intervention group (p < 0.05) without a significant influence of the covariate vertebral fractures status. The other parameters remained unchanged (p > 0 .05). Regarding the pain-related ADL limitations there were significant differences in the amount of change over the study period depending on the baseline value. Stratified into terciles (≤ 2.5; 2.6-5.0; >5) patients with initially high values showed a significantly greater reduction in perceived ADL restrictions compared to patients in the lowest tercile (-2.7 ± 2.7 versus 1.5 ± 2.1). CONCLUSION: The study demonstrated that wearing a spinal orthosis introduced a reduction in double support time associated with a beneficial impact on gait stability. Furthermore, there was a positive effect on pain-related restrictions of ADL evident in women with a high level of limitations at baseline. Besides previously shown reductions in pain, improvements in back extensor strength and correction of posture, the application of a spinal orthosis may induce advantages for gait stability and physical functioning in women with postmenopausal osteoporosis. Future studies should consider a longer follow-up to evaluate possible effects on the risk of falling and fractures.

Acupuncture in children and adolescents with bronchial asthma: a randomised controlled study.

OBJECTIVE: This randomised controlled trial evaluates the immediate effects of acupuncture as an add-on therapy in in-patient rehabilitation of children and adolescents with bronchial asthma. PATIENTS AND METHODS: In a pre-post design, the severity of symptoms, lung function, illness-specific quality of life (Paediatric Asthma Quality of Life Questionnaire - PAQLQ) and general and asthma-specific level of anxiety (State-Trait Anxiety Inventory for Children - STAIC) were investigated in 46 acupuncture and 47 control patients. In addition to asthma sports, climate therapy and behavioural training, the intervention group received acupuncture treatment with a standardised needle pattern (12 × 30 min.). RESULTS: With acupuncture, the peak expiratory flow variability differs significantly (p<0.01) from that of the control patients' group. Moreover, the acupuncture group differs significantly in their rehabilitation response at the time of discharge concerning perceived anxiety (STAIC-S). The lung function tests do not present differences between groups. CONCLUSION: After additional acupuncture, amelioration of peak expiratory flow variability and anxiety can be shown, without any difference in objective lung function tests and quality of life between study groups. Further studies might evaluate the effects of acupuncture on childhood asthma in an outpatient setting.