Validation of a non-linear index of heart rate variability to determine aerobic and anaerobic thresholds during incremental cycling exercise in women.

Studies highlight the usage of non-linear time series analysis of heart rate variability (HRV) using the short-term scaling exponent alpha1 of Detrended Fluctuation Analysis (DFA-alpha1) during exercise to determine aerobic and anaerobic thresholds. The present study aims to further verify this approach in women. Gas exchange and HRV data were collected from 26 female participants with different activity levels. Oxygen uptake (VO2) and heart rate (HR) at first (VT1) and second ventilatory thresholds (VT2) were compared with DFA-alpha1-based thresholds 0.75 (HRVT1) and 0.50 (HRVT2). Results: VO2 at VT1 and VT2 were 25.2 ml/kg/min (± 2.8) and 31.5 ml/kg/min (± 3.6) compared with 26.5 ml/kg/min (± 4.0) and 31.9 ml/kg/min (± 4.5) for HRVT1 and HRVT2, respectively (ICC3,1 = 0.77, 0.84; r = 0.81, 0.86, p < 0.001). The mean HR at VT1 was 147 bpm (± 15.6) and 167 bpm (± 12.7) for VT2, compared with 152 bpm (± 15.5) and 166 bpm (± 13.2) for HRVT1 and HRVT2, respectively (ICC3,1 = 0.87, 0.90; r = 0.87, 0.90, p < 0.001). Bland-Altman analysis for VT1 vs. HRVT1 showed a mean difference of - 1.3 ml/kg/min (± 2.4; LoA: 3.3, - 6.0 ml/kg/min) for VO2 and of - 4.7 bpm (± 7.8; LoA: 10.6, - 20.0 bpm) for HR. VT2 vs. HRVT2 showed a mean difference of - 0.4 ml/kg/min (± 2.3; LoA: 4.1, - 4.9 ml/kg/min) for VO2 and 0.5 bpm (± 5.7; LoA: 11.8, - 10.8 bpm) for HR. DFA-alpha1-based thresholds showed good agreement with traditionally used thresholds and could be used as an alternative approach for marking organismic transition zones for intensity distribution in women.

Validity of the Polar H10 Sensor for Heart Rate Variability Analysis during Resting State and Incremental Exercise in Recreational Men and Women.

Heart rate variability (HRV) is frequently applied in sport-specific settings. The rising use of freely accessible applications for its recording requires validation processes to ensure accurate data. It is the aim of this study to compare the HRV data obtained by the Polar H10 sensor chest strap device and an electrocardiogram (ECG) with the focus on RR intervals and short-term scaling exponent alpha 1 of Detrended Fluctuation Analysis (DFA a1) as non-linear metric of HRV analysis. A group of 25 participants performed an exhaustive cycling ramp with measurements of HRV with both recording systems. Average time between heartbeats (RR), heart rate (HR) and DFA a1 were recorded before (PRE), during, and after (POST) the exercise test. High correlations were found for the resting conditions (PRE: r = 0.95, rc = 0.95, ICC3,1 = 0.95, POST: r = 0.86, rc = 0.84, ICC3,1 = 0.85) and for the incremental exercise (r > 0.93, rc > 0.93, ICC3,1 > 0.93). While PRE and POST comparisons revealed no differences, significant bias could be found during the exercise test for all variables (p < 0.001). For RR and HR, bias and limits of agreement (LoA) in the Bland−Altman analysis were minimal (RR: bias of 0.7 to 0.4 ms with LoA of 4.3 to −2.8 ms during low intensity and 1.3 to −0.5 ms during high intensity, HR: bias of −0.1 to −0.2 ms with LoA of 0.3 to −0.5 ms during low intensity and 0.4 to −0.7 ms during high intensity). DFA a1 showed wider bias and LoAs (bias of 0.9 to 8.6% with LoA of 11.6 to −9.9% during low intensity and 58.1 to −40.9% during high intensity). Linear HRV measurements derived from the Polar H10 chest strap device show strong agreement and small bias compared with ECG recordings and can be recommended for practitioners. However, with respect to DFA a1, values in the uncorrelated range and during higher exercise intensities tend to elicit higher bias and wider LoA.

Effects of a structured counselling-based intervention to improve physical activity behaviour of adolescents and young adult cancer survivors - the randomized phase II Motivate AYA - MAYA trial.

OBJECTIVE: To explore whether a structured counselling-based intervention increases vigorous physical activity behaviour of adolescent and young adult cancer survivors. DESIGN: Randomized controlled phase II trial. SETTING: University Cancer Center Hamburg, Germany. SUBJECTS: Eighty-nine participants (mean age 24.1 ± 6.3) were randomized to control (n = 44) or intervention group (n = 45). INTERVENTIONS: The intervention group was consulted about physical activity behaviour via interview (week 0), and telephone counselling (weeks 1, 3 and 12). The control group only received general physical activity guidelines for cancer survivors (week 0). MAIN MEASURES: The primary outcome was the rate of participants with ⩾9 metabolic equivalent (MET)-hours per week of vigorous activity post-intervention, measured with the International Physical Activity Questionnaire. Secondary outcomes included assessing physical activity behaviour (e.g. amount and type of physical activity) and quality of life. Assessments were completed in weeks 0 (baseline), 12 (post-intervention) and 52 (follow-up). RESULTS: Sixty-nine participants completed the post-intervention- and 47 the follow-up-assessment. The rate of participants performing vigorous physical activity increased from baseline to post-intervention for both without differing significantly (P = 0.541). Both increased their total metabolic equivalent from baseline to post-intervention (intervention group from 55.2 ± 43.7 to 61.7 ± 29.4, control group from 75.3 ± 81.4 to 88.3 ± 80.2). At follow-up the intervention group (73.7 ± 80.2) was more active than baseline when compared to the control group (78.5 ± 50.0). CONCLUSIONS: A structured counselling-based physical activity intervention did not significantly impact the level of vigorous physical activity behaviour in adolescent and young adult cancer survivors.

[Reference values in isometric strength diagnostics : Measurement of core strength values in patients with back pain]. / Referenzwerte in der isometrischen Kraftdiagnostik : Messung von Rumpfkraftwerten bei Patienten mit Rückenschmerzen.

OBJECTIVE: Isometric strength testing is known as a valid and reliable tool in the context of functional diagnostics and quality control for chronic low back pain rehabilitation, but reference values differ markedly between varied assessment devices, depending on their biomechanical lever arm framework. This study aimed to evaluate sex and age-specific isometric peak force reference values of trunk muscle functions in all dimensions using the Myoline® test device (Diers, Schlangenbad, Germany). MATERIAL AND METHODS: In a retrospective cross-sectional study, data of 678 (541 females, 137 males) age-clustered (18-35, 36-50, 51-65 years) low back pain patients (ICD-10: M54) were analyzed referring to their absolute (N) and body weight related (N/kg) isometric maximum peak forces in all spatial dimensions (flexion, extension, rotation, lateral flexion) and the corresponding ratios (M ± SD, 95% CI), accompanied by sex and age-related effect analyses (two-way ANOVA). RESULTS: Male and younger patients were significantly stronger than females and older patients (p < 0.05), but none of the ratios differed significantly between any sex or age cluster (p > 0.05). The flexion/extension ratio showed a 1:2 relation, and the rotation and lateral flexion ratios demonstrated a 1:1 relation, but all ratios varied markedly (30-50%). CONCLUSIONS: The demonstrated data represented a special norm for sex and age clustered low back pain patients assessed with the recent Myoline® test device. The markedly varying peak forces and their ratios underlined the individual diversity and heterogeneous state of functional capacities within low back pain patients.

[Job-related satisfaction and health perception of dance teachers]. / Berufsbezogene Zufriedenheit und Gesundheitswahrnehmung von Tanzpädagoginnen und -pädagogen.

BACKGROUND: The dance teacher's own body is considered to be the central working instrument within the movement mediation. Up to now there is a lack of knowledge about the subjective perception of one's own occupationally associated health and satisfaction as well as the identification of occupational characteristics that are detrimental to health. MATERIAL AND METHODS: Within the framework of a questionnaire-based cross-sectional survey, a cohort of dance teachers in Germany were investigated about dimensions of their own health and general job satisfaction in connection with their profession as a dance teacher. Likert scales were primarily used for these assessments. Additionally, general anthropometric and sociodemographic characteristics were recorded. Beside examining the overall cohort, gender-specific differences were tested. The statistical analysis included n = 232 dance teachers (male 51/female 181) aged 43.1 ± 11.0 years. RESULTS: The general state of health was rated as satisfactory (26.1%) to very good (14.7%) by 85.3% of those surveyed. Of the dance teachers 59.2% even rated their health as good (35.3%) to very good. There was a high degree of satisfaction with their own professional practice for 80% of the participants. Most of the dance teachers felt that they were able to deal with the physical (75.7%) and psychological demands of their profession (70.3%). In addition to fears about the future (51.5%), the main burdensome professional characteristics on dance teachers' self-perception were organizational aspects of work (lack of time for family and friends in 28.4%) and economic aspects (income insecurity in 61.0% and lack of old age security in 65.7%). CONCLUSION: The profession as a dance teacher is accompanied by a high level of general satisfaction and a positive perception of one's own state of health. A confirmation of these positive results by injury and illness statistics is still pending. In addition, an improvement in work organization and economic aspects would be desirable.

[Reference values for isometric strength tests]. / Orientierungswerte in der isometrischen Kraftdiagnostik.

BACKGROUND: In the environment of orthopaedic rehabilitation, isometric strength testing is part of the monitoring in order to document the success of the therapy. For clinical applications, reference values, or at least orientation benchmarks, are needed for every single device, because of serious concerns for direct inter-device comparisons. According to functional ratios, there is only little literature covering comparability concerns. This study aimed to demonstrate reference values for two strength diagnosis systems for trunk and knee-joint flexion and extension as well as resulting functional ratios along with analyses of reproducibility and vice-versa comparisons. MATERIALS AND METHODS: In a cross-sectional design, reference values (M, SD, Median, IQR, 5 and 95% percentiles) of 98 healthy adults (47 females, age 25.7±8.2 years, BMI 23.3±2.6 kg/m2) were assessed for trunk and knee flexion and extension and the according functional ratios using either the Myoline or the Frei medical system. For a sub-sample of 20 persons (50% females), the mutual explained total variance (r2) and reliability (ICC3.1, SEM, VK%) were analyzed. RESULTS: Both systems were shown to be reliable (ICC3.1 0.76-0.95), while functional ratios demonstrated a lower reliability (ICC3.1 0.62-0.92). For peak forces, the mutual total explained variance (r2) ranged between 19-68%, for functional ratios on an even lower level (5-21%). CONCLUSION: The resulting strength test values, and especially the related functional ratios, obtained with the two strength test devices are not comparable at all, but each device was shown to be a reliable tool. Distributions of body weight adjusted peak forces and functional ratios may serve as device specific benchmark values for strength testing in clinical environments.

[The effect of electromagnetic fields on tendinopathies : Study on the effect analysis of a singular application of high-energy pulsed electromagnetic fields]. / Die Wirkung von elektromagnetischen Feldern auf Tendinopathien : Studie zur Effektanalyse einer singulären Anwendung von hochenergetischen gepulsten elektromagnetischen Feldern.

OBJECTIVE: Tendinopathies are diseases that often entail long-term treatment consisting of analgesics, physiotherapy, orthotics, and sparing. The aim of this study was to investigate the effect of a single application of a high-energy PEMF (pulsed electromagnetic field) on pain perception and blood born inflammation parameters. METHODS: 34 patients were randomly assigned to a verum group (10 min PEMF, 0,78 T) or a placebo group (10 min sham condition). Prior to and up to one week after the patient blinded treatment (t1-t5), local pain state was assessed by means of algometry as pain pressure threshold (PPT). Accordingly, heat-shock protein 70 (HSP70) levels were analysed. Statistical analyses included 2­way ANOVA (2â€¯× 5). The clinical trial was registered (DRKS00031321). RESULTS: After randomization and drop-out (verum n = 17, placebo n = 13) baseline-analyses did not reveal significant between-group differences for PPT (p = 0,096), for HSP70 (p = 0,524), or any other sample characteristics (p > 0,05). Pain reduction during one week of observation showed to be significantly higher (p = 0,045, η2 = 0,013) for the PEMF group (PPT: +83 bis +139%) compared to the placebo group (PPT: +10 bis +36%). There were no HSP70 associated effects. CONCLUSIONS: A single bout of high energy PEMF led to an immediate pain relief in tendinopathy patients lasting at least for one week, but the hypothesized underlying HSP70 associated inflammatory pathway could not be confirmed.

Factors that influence the angular error in active knee angle reproduction tests: A systematic review and meta-analysis.

Purpose: The systematic review and meta-analysis investigated subject-independent test factors that influence the absolute angle error in active knee angle reproduction tests. Methods: Five electronic databases were searched to identify relevant studies published before 20 December 2023. Studies were included that were published in either English or German and that investigated joint proprioception in the healthy knee. Included studies were also required to have participants 18-60 years old and free of lower-limb injury, neurological disorders and diseases affecting joint position sense. Risk of bias was assessed using a Cochrane risk-of-bias tool. Results: Of the 2023 articles identified, 26 studies (1082 participants) were included in the meta-analysis. The meta-analysis showed a significant pooled standard mean difference in the absolute angular error for body orientation, direction of movement and fatigue. Active knee angle reproduction tests were found to have a lower absolute angular error when performed in the sitting position compared to the prone position (SMD = -0.56; 95% CI = -1.00 to -0.12). The absolute angular error was found to be greater in cases of knee flexion compared to knee extension (SMD = 0.71; 95% CI = 0.18-1.24). General and local muscle fatigue were found to result in a higher absolute angular error (SMD = 1.39; 95% CI = 1.04-1.75). Conclusion: Hence, fatigue, body orientation and direction of movement influence the extent of the absolute angular error in active knee angle reproduction tests. Practitioners should be aware that the test conditions and the patient's level of fatigue can affect the results of such tests and that directly comparing results obtained using different test protocols may not be appropriate. The test protocol should be well documented and applied consistently in the clinical setting. Level of Evidence: Level III, systematic review with meta-analysis.

Prevalence of obesity and associated health risks in soldiers of the German Armed Forces.

BACKGROUND: Obesity rates are rising in the armed forces of Western democratic countries, impacting military readiness and health. This highlights the need for preventive health risk assessments and countermeasures. METHODS: Using mandatory health examination data from 2018 to 2022, we analyzed the prevalence of obesity, health risks, and associated specific military risk factors (rank and unit) in 43,214 soldiers of the German Armed Forces. Statistical methods included χ2 contingencies and binary logistic regressions. RESULTS: The prevalence of obesity (BMI ≥ 30) was 18.0%. Male soldiers (OR = 3.776) and those with an officer's rank (OR = 1.244) had an increased chance for obesity. Serving in a combat unit reduced the chance of being obese (OR = .886). Considering BMI and waist circumference, 2.4% of the total sample faced extremely high cardiovascular and metabolic health risks, while 11.0% and 11.6% had very high or high health risks, respectively. CONCLUSIONS: Our data underscore the importance of targeting obesity-related health risk factors in soldiers to ensure their well-being and deployment readiness.

Quantifying thoracolumbar fascia deformation to discriminate acute low back pain patients and healthy individuals using ultrasound.

Reduced shear strain and deformability of the thoracolumbar fascia has been linked to low back pain. A number of ultrasound examination methods have been developed for laboratory rather than clinical practice. The aim of this study was to examine the reliability and discriminative validity (patients vs. healthy individuals) of an ultrasound (US) measurement method for the quantification of thoracolumbar fascia deformation (TLFD). A cross-sectional study with US assessment and rater blinding was conducted in a manual therapy clinic and a university laboratory. 16 acute low back pain (aLBP) patients and 15 healthy individuals performed a standardized trunk extension task. US measurements of TLFD were carried out independently by two raters by imaging the TLF in the starting and ending positions of the movement. Intra-rater and inter-rater reliability were calculated using intraclass correlation coefficients (ICCs) and minimal detectable changes (MDC) were calculated. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-off for TLFD to discriminate the study groups. Kappa statistics were performed to assess rater agreement in discrimination. Intra-rater reliability was excellent (ICC: .92, MDC: 5.54 mm, p < .001) and inter-rater reliability was good (ICC: .78, MDC: 8.70 mm, p < .001). The cut-off for TLFD was 6 mm with a sensitivity of 100% and a specificity of 93.75% and the raters agreed moderately (κ = 0.74, p < .001) when distinguishing patients and controls. The reliability of the US method for assessing TLFD is moderate to excellent, and the ability to discriminate aLBP patients from healthy individuals is moderate. The method could be used to capture an additional parameter in morphological aLBP screenings.

A Multimodal Lifestyle Psychosocial Survivorship Program in Young Cancer Survivors: The CARE for CAYA Program-A Randomized Clinical Trial Embedded in a Longitudinal Cohort Study.

Importance: There is a lack of trials examining the effect of counseling interventions for child, adolescent, and younger adult (CAYA) cancer survivors. Objective: To assess lifestyle habits and the psychosocial situation of CAYAs to determine the efficacy of needs-based interventions in the CARE for CAYA program (CFC-P). Design, Setting, and Participants: The CFC-P was conducted as a multicenter program in 14 German outpatient clinics, mainly university cancer centers. Recruitment began January 1, 2018; a randomized clinical trial was conducted until July 15, 2019; and intervention was continued as a longitudinal cohort study until March 31, 2021. Data preparation was conducted from April 1, 2021, and analysis was conducted from August 14, 2021, to May 31, 2022. Herein, predefined confirmatory analyses pertain to the RCT and descriptive results relate to the overall longitudinal study. Data analysis was based on the full analysis set, which is as close as possible to the intention-to-treat principle. Intervention: A comprehensive assessment determined needs in physical activity, nutrition and psychooncology. Those with high needs participated in 1 to 3 modules. In the RCT, the IG received 5 counseling sessions plus newsletters, while the control group CG received 1 counseling session. Main Outcomes and Measures: The primary outcome was the change in the rate of CAYAs with high needs at 52 weeks. Secondary outcomes were feasibility, modular-specific end points, satisfaction, quality of life, and fatigue. Results: Of 1502 approached CAYAs aged 15 to 39 years, 692 declined participation. Another 22 CAYAs were excluded, resulting in 788 participants. In the randomized clinical trial, 359 CAYAs were randomized (intervention group [IG], n = 183; control group [CG], n = 176), and 274 were followed up. In the RCT, the median age was 25.0 (IQR, 19.9-32.2) years; 226 were female (63.0%) and 133 male (37.0%). After 52 weeks, 120 CAYAs (87.0%) in the IG and 115 (86.5%) in the CG still had a high need in at least 1 module (odds ratio, 1.04; 95% CI, 0.51-2.11; P = .91). Both groups reported reduced needs, improved quality of life, reduced fatigue, and high satisfaction with the CFC-P. Conclusions and Relevance: In this randomized clinical trial, the implementation of a lifestyle program in this cohort was deemed necessary, despite not meeting the primary outcome. The interventions did not alter the rate of high needs. The results may provide guidance for the development of multimodal interventions in the follow-up care of CAYAs. Trial Registration: German Clinical Trial Register: DRKS00012504.

What happens in the prefrontal cortex? Cognitive processing of novel and familiar stimuli in soccer: An exploratory fNIRS study.

The importance of both general and sport-specific perceptual-cognitive abilities in soccer players has been investigated in several studies. Although these perceptual-cognitive skills could contribute significantly to soccer players' expertise, the underlying cortical mechanisms have not been clarified yet. Examining activity changes in the prefrontal cortex under different cognitive demands may help to better understand the underlying mechanisms of sports expertise. The aim of this study was to analyse the prefrontal activity of soccer experts during general and sport-specific cognitive tasks. For this purpose, 39 semi-professional soccer players performed four perceptual-cognitive tests, two of which assessed general cognition, the other two assessed sport-specific cognition. Since soccer is a movement-intensive sport, two tests were performed in motion. While performing cognitive tests, prefrontal activity was recorded using functional near-infrared spectroscopy (fNIRS) (NIRSport, NIRx Medical Technologies, USA). Differences of prefrontal activity in general and sport-specific cognitive tasks were analysed using paired t-tests. The results showed significant increases in prefrontal activity during general cognitive tests (novel stimuli) compared to sport-specific tests (familiar stimuli). The comparatively lower prefrontal activity change during sport-specific cognition might be due to learned automatisms of experts in this field. These results seem in line with previous findings on novel and automated cognition, "repetition suppression theory" and "neural efficiency theory". Furthermore, the different cortical processes could be caused by altered prefrontal structures of experts and might represent a decisive factor for expertise in team sports. However, further research is needed to clarify the prefrontal involvement on expertise in general and sport-specific cognition.

This fNIRS study examines differences in the prefrontal activity of soccer experts during general and sport-specific cognitive tasks.In general cognitive tasks, increased prefrontal activity changes were detected, whereas lower cortical activity changes during sport-specific cognition were found.These findings support the "repetition suppression theory" and earlier findings on the processing of novel stimuli in the prefrontal cortex (PFC).The differences in the cortical processing of general and sport-specific tasks of soccer players might be caused by altered prefrontal structures of experts and could be of special importance for expertise in soccer.

Immediate Effects of Instrument-Assisted Soft Tissue Mobilization on Hydration Content in Lumbar Myofascial Tissues: A Quasi-Experiment.

BACKGROUND: Instrument-assisted soft tissue mobilization (IASTM) is thought to alter fluid dynamics in human soft tissue. The aim of this study was to investigate the influence of IASTM on the thoracolumbar fascia (TLF) on the water content of the lumbar myofascial tissue. METHODS: In total, 21 healthy volunteers were treated with IASTM. Before and after the procedure and 5 and 10 min later, lumbar bioimpedance was measured by bioimpedance analysis (BIA) and TLF stiffness was measured by indentometry. Tissue temperature was recorded at the measurement time points using an infrared thermometer. RESULTS: Bioimpedance increased significantly from 58.3 to 60.4 Ω (p < 0.001) at 10-min follow-up after the treatment. Temperature increased significantly from 36.3 to 36.6 °C from 5 to 10 min after treatment (p = 0.029), while lumbar myofascial stiffness did not change significantly (p = 0.84). CONCLUSIONS: After the IASTM intervention, there was a significant increase in bioimpedance, which was likely due to a decrease in water content in myofascial lumbar tissue. Further studies in a randomized control trial design are needed to extrapolate the results in healthy subjects to a symptomatic population as well and to confirm the reliability of BIA in myofascial tissue.

Immediate Effects of Myofascial Release Treatment on Lumbar Microcirculation: A Randomized, Placebo-Controlled Trial.

(1) Background: Inflammatory processes in the thoracolumbar fascia (TLF) lead to thickening, compaction, and fibrosis and are thought to contribute to the development of nonspecific low back pain (nLBP). The blood flow (BF) of fascial tissue may play a critical role in this process, as it may promote hypoxia-induced inflammation. The primary objective of the study was to examine the immediate effects of a set of myofascial release (MFR) techniques on the BF of lumbar myofascial tissue. The secondary objectives were to evaluate the influence of TLF morphology (TLFM), physical activity (PA), and body mass index (BMI) on these parameters and their correlations with each other. (2) Methods: This study was a single-blind, randomized, placebo-controlled trial. Thirty pain-free subjects (40.5 ± 14.1 years) were randomly assigned to two groups treated with MFR or a placebo intervention. Correlations between PA, BMI, and TLFM were calculated at baseline. The effects of MFR and TLFM on BF (measured with white light and laser Doppler spectroscopy) were determined. (3) Results: The MFR group had a significant increase in BF after treatment (31.6%) and at follow-up (48.7%) compared with the placebo group. BF was significantly different between disorganized and organized TLFM (p < 0.0001). There were strong correlations between PA (r = -0.648), PA (d = 0.681), BMI (r = -0.798), and TLFM. (4) Conclusions: Impaired blood flow could lead to hypoxia-induced inflammation, possibly resulting in pain and impaired proprioceptive function, thereby likely contributing to the development of nLBP. Fascial restrictions of blood vessels and free nerve endings, which are likely associated with TLFM, could be positively affected by the intervention in this study.

BMI Alterations and Prevalence of Overweight and Obesity Related to Service Duration at the German Armed Forces.

The aim of this study was to assess body mass index (BMI) and the prevalence of overweight and obesity at entry and release of service at the German Armed Forces and related associations to service duration. In a cohort study, 85,076 paired BMI data sets (entry and release of service) of German soldiers (5.4% females) between 2010 to 2022 were analyzed retrospectively to assess BMI alterations and the prevalence of overweight (BMI ≥ 25) and obesity (BMI ≥ 30) after service durations of ≤2 years, 2−5 years, or ≥5 years. Between 2010 and 2022, we observed a trend for BMI increases of about 0.5 kg/m2 (X2 = 27.104, p = 0.007). BMI increases differed significantly (X2 = 7622.858, p < 0.001) after ≤2 years (0.0 kg/m2), after 2−5 years (1.1 kg/m2), and after ≥5 years (2.4 kg/m2) and were correlated to service duration (r = 0.34, p < 0.001). The prevalence of overweight increased from 33.0% to 39.5%. Obesity prevalence increased from 3.7% to 6.3%. The switch to obesity was more pronounced for longer service durations. Although secular trends for BMI increases among soldiers were in line with the general population, service duration was related to BMI increases. Especially, the service time depending on pronounced prevalence of obesity should be a matter of debate leading to counteracting measures at the German Armed Forces.

Thoracolumbar fascia deformation during deadlifting and trunk extension in individuals with and without back pain.

Background: Alterations in posture, lumbopelvic kinematics, and movement patterns are commonly seen in patients with low back pain. Therefore, strengthening the posterior muscle chain has been shown to result in significant improvement in pain and disability status. Recent studies suggest that thoracolumbar fascia (TLF) has a major impact on the maintenance of spinal stability and paraspinal muscle activity, and thus is likely to have an equal impact on deadlift performance. Objective: Aim of the study was to evaluate the role of thoracolumbar fascia deformation (TFLD) during spinal movement in track and field athletes (TF) as well as individuals with and without acute low back pain (aLBP). Methods: A case-control study was performed with n = 16 aLBP patients (cases) and two control groups: untrained healthy individuals (UH, n = 16) and TF (n = 16). Participants performed a trunk extension task (TET) and a deadlift, being assessed for erector spinae muscle thickness (EST) and TLFD using high-resolution ultrasound imaging. Mean deadlift velocity (VEL) and deviation of barbell path (DEV) were measured by means of a three-axis gyroscope. Group differences for TLFD during the TET were examined using ANOVA. Partial Spearman rank correlations were calculated between TLFD and VEL adjusting for baseline covariates, EST, and DEV. TLFD during deadlifting was compared between groups using ANCOVA adjusting for EST, DEV, and VEL. Results: TLFD during the TET differed significantly between groups. TF had the largest TLFD (-37.6%), followed by UH (-26.4%), while aLBP patients had almost no TLFD (-2.7%). There was a strong negative correlation between TLFD and deadlift VEL in all groups (r = -0.65 to -0.89) which was highest for TF (r = -0.89). TLFD during deadlift, corrected for VEL, also differed significantly between groups. TF exhibited the smallest TLFD (-11.9%), followed by aLBP patients (-21.4%), and UH (-31.9%). Conclusion: TFLD maybe a suitable parameter to distinguish LBP patients and healthy individuals during lifting tasks. The cause-effect triangle between spinal movement, TFLD and movement velocity needs to be further clarified. Clinical trial registration: https://drks.de/register/de/trial/DRKS00027074/, German Clinical Trials Register DRKS00027074.

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.

Acute effects of an exercise based multimodal in-patient rehabilitation protocol in male knee osteoarthritis patients and the two years follow-up sustainability.

BACKGROUND: Working with lifting and carrying heavy loads and kneeling postures with crawling, squats or heel seat position lead to progressive cartilage wear with premature degenerative changes. OBJECTIVE: To investigate the effects of the exercise based multimodal 'knee college' and its sustainability in patients with knee osteoarthritis with data assessments before and after a starter course, before a 1-year and a 2-year follow-up refresher course in a retrospective observational study. METHODS: A sample of 401 male patients (ICD10: M17 [arthrosis of knee]/ICF: s75011 [knee joint]) from the construction industries were assessed with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQol (EQ-5D), Performance Assessment Capacity Testing (PACT), Isokinetic torque H/Q ratio and Physical Work Capacity Test (PWC). Retrospectively, after two years they were divided into three groups based on their intermediate sporting activity: gym (n = 194, age: 50.8±7.0, BMI: 28.8±4,3), home training (n = 110, age: 50.2±7.0, BMI: 28.4±4,2), no exercising (n = 97, age: 48.2±7.0, BMI: 29.2±4,6). RESULTS: Patients did not differ significantly in their demographic and anthropometric data prior to the rehab program. Significant interaction effects indicated group-dependent differing sustainability effects for the 2-year follow-up (all outcomes: p < 0.001, except for H/Q ratio: p = 0.03). Group-wise analyses revealed significant acute improvements (after 3-week in-patient starter rehab program: p < 0.05) for all groups in almost all outcomes (except the 'no sport' group, H/Q ratio p = 0.08). These effects remained significant (p < 0.001) only for the 'gym' group during the 1-year and 2-year follow-up. CONCLUSION: Our data indicate that 2-year sustainability of acute rehabilitation starter effects was demonstrated especially for patients with adherence and compliance to long-term gym based exercises.

The Impact of "Home Office" Work on Physical Activity and Sedentary Behavior during the COVID-19 Pandemic: A Systematic Review.

In 2020, as part of the COVID-19 pandemic, governments around the world enacted a wide variety of regulations and laws to contain the incidence of infection. One of these measures was the relocation of work to the home office. The objective of this review was to analyze the influence of the home office in correlation with regulations on sedentary and activity behavior. A search was conducted on various electronic databases from November 2019 to January 2022, using the search terms physical activity (PA), COVID-19, and working from home. The primary outcomes were changes in PA and sedentary behavior (SB). Secondary outcomes included pain, mood, and parenting stress. The risk of bias was assessed using the (NHLBI) Quality Assessment Tool. For the review, 21 articles met the inclusion criteria (total n = 1268). There was a significant increase in SB (+16%) and a decrease in PA (-17%), Light PA (-26%), and moderate to vigorous PA (-20%). There was also an increase in pain and parenting stress and a decrease in well-being. Due to our significant results, programs that promote movement should be created. Future studies should explore how an increase of PA and a reduction of SB in the home office could be achieved.

Fractal correlation properties of HRV as a noninvasive biomarker to assess the physiological status of triathletes during simulated warm-up sessions at low exercise intensity: a pilot study.

BACKGROUND: The non-linear index alpha 1 of Detrended Fluctuation Analysis (DFA a1) of heart rate variability, has been shown to be a marker of fatigue during endurance exercise. This report aims to explore its ability to assess the physiological status as a surrogate metric for "readiness to train" while performing simulated warm-up sessions the day after two different exercise sessions. METHODS: 11 triathletes were recruited to determine the first ventilatory threshold (VT1) during a baseline assessment and to perform 10-min of cycling at 90% of VT1 (simulating a warm-up bout) before (PRE) and within 36 h after (POST) light and heavy running exercise. RR intervals were recorded for DFA a1 analysis along with neuromuscular testing to verify the effects of the performed exercise sessions. In addition to common statistical methods, magnitude-based inferences (MBI) were applied to assess the changes in true score and thus also the practical relevance of the magnitude. RESULTS: Rating of perceived exertion for the heavy exercise session showed a significant higher rating as opposed to the light exercise session (p < 0.001, d = 0.89). In regard of MBIs, PRE versus POST comparisons revealed a significant reduced DFA a1 with large effect size after the heavy exercise session (p = 0.001, d = - 1.44) and a 99% chance that this negative change was clinically relevant. CONCLUSIONS: Despite inter-individual differences, DFA a1 offers potential to assess physiological status and guide athletes in their training as an easy-to-apply monitoring procedure during a standardized warm-up. A regular assessment including individual data history and statistical references for identification of response is recommended. Further data are necessary to confirm the results in a larger and more homogeneous population.