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1.  Association of dual-task walking performance and leg muscle quality in healthy children 
BMC Pediatrics  2015;15(1):2.
Previous literature mainly introduced cognitive functions to explain performance decrements in dual-task walking, i.e., changes in dual-task locomotion are attributed to limited cognitive information processing capacities. In this study, we enlarge existing literature and investigate whether leg muscular capacity plays an additional role in children’s dual-task walking performance.
To this end, we had prepubescent children (mean age: 8.7 ± 0.5 years, age range: 7–9 years) walk in single task (ST) and while concurrently conducting an arithmetic subtraction task (DT). Additionally, leg lean tissue mass was assessed.
Findings show that both, boys and girls, significantly decrease their gait velocity (f = 0.73), stride length (f = 0.62) and cadence (f = 0.68) and increase the variability thereof (f = 0.20-0.63) during DT compared to ST. Furthermore, stepwise regressions indicate that leg lean tissue mass is closely associated with step time and the variability thereof during DT (R2 = 0.44, p = 0.009). These associations between gait measures and leg lean tissue mass could not be observed for ST (R2 = 0.17, p = 0.19).
We were able to show a potential link between leg muscular capacities and DT walking performance in children. We interpret these findings as evidence that higher leg muscle mass in children may mitigate the impact of a cognitive interference task on DT walking performance by inducing enhanced gait stability.
PMCID: PMC4325950  PMID: 25652949
Gait; Cognitive interference; Body composition; Muscle mass; Children
2.  Metastability in plyometric training on unstable surfaces: a pilot study 
In the past, plyometric training (PT) has been predominantly performed on stable surfaces. The purpose of this pilot study was to examine effects of a 7-week lower body PT on stable vs. unstable surfaces. This type of exercise condition may be denoted as metastable equilibrium.
Thirty-three physically active male sport science students (age: 24.1 ± 3.8 years) were randomly assigned to a PT group (n = 13) exercising on stable (STAB) and a PT group (n = 20) on unstable surfaces (INST). Both groups trained countermovement jumps, drop jumps, and practiced a hurdle jump course. In addition, high bar squats were performed. Physical fitness tests on stable surfaces (hexagonal obstacle test, countermovement jump, hurdle drop jump, left-right hop, dynamic and static balance tests, and leg extension strength) were used to examine the training effects.
Significant main effects of time (ANOVA) were found for the countermovement jump, hurdle drop jump, hexagonal test, dynamic balance, and leg extension strength. A significant interaction of time and training mode was detected for the countermovement jump in favor of the INST group. No significant improvements were evident for either group in the left-right hop and in the static balance test.
These results show that lower body PT on unstable surfaces is a safe and efficient way to improve physical performance on stable surfaces.
PMCID: PMC4118276  PMID: 25089202
Instability resistance training; Stretch-shortening cycle; Physical fitness test; Balance training
3.  Effect of living area and sports club participation on physical fitness in children: a 4 year longitudinal study 
BMC Public Health  2014;14:499.
Cross-sectional studies detected associations between physical fitness, living area, and sports participation in children. Yet, their scientific value is limited because the identification of cause-and-effect relationships is not possible. In a longitudinal approach, we examined the effects of living area and sports club participation on physical fitness development in primary school children from classes 3 to 6.
One-hundred and seventy-two children (age: 9–12 years; sex: 69 girls, 103 boys) were tested for their physical fitness (i.e., endurance [9-min run], speed [50-m sprint], lower- [triple hop] and upper-extremity muscle strength [1-kg ball push], flexibility [stand-and-reach], and coordination [star coordination run]). Living area (i.e., urban or rural) and sports club participation were assessed using parent questionnaire.
Over the 4 year study period, urban compared to rural children showed significantly better performance development for upper- (p = 0.009, ES = 0.16) and lower-extremity strength (p < 0.001, ES = 0.22). Further, significantly better performance development were found for endurance (p = 0.08, ES = 0.19) and lower-extremity strength (p = 0.024, ES = 0.23) for children continuously participating in sports clubs compared to their non-participating peers.
Our findings suggest that sport club programs with appealing arrangements appear to represent a good means to promote physical fitness in children living in rural areas.
PMCID: PMC4049502  PMID: 24886425
Motor performance; Youth; Primary school; Maturation
4.  A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: study protocol for a randomized controlled trial 
BMC Geriatrics  2013;13:105.
With increasing age neuromuscular deficits (e.g., sarcopenia) may result in impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline. Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice. Thus, the objective of the present trial is to assess the effects of a fall prevention program that was developed by an interdisciplinary expert panel on measures of balance, strength / power, body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older adults. Additionally, the time-related effects of detraining are tested.
Healthy old people (n = 54) between the age of 65 to 80 years will participate in this trial. The testing protocol comprises tests for the assessment of static / dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test; countermovement jump). Further, body composition will be analysed using a bioelectrical impedance analysis system. In addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk determinants (i.e., Fall Efficacy Scale – International) will be included in the study protocol. Participants will be randomized into two intervention groups or the control / waiting group. After baseline measures, participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week, with each training session lasting 30 min. (actual training time). One intervention group will complete an extensive supervised training program, while the other intervention group will complete a short version ('3 times 3’) that is home-based and controlled by weekly phone calls. Post-tests will be conducted right after the intervention period. Additionally, detraining effects will be measured 12 weeks after program cessation. The control group / waiting group will not participate in any specific intervention during the experimental period, but will receive the extensive supervised program after the experimental period.
It is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance, strength / power, body composition, cognitive function, psychosocial well-being, and falls self-efficacy of older adults. In addition, information regarding fall risk assessment, dose–response-relations, detraining effects, and supervision of training will be provided. Further, training-induced health-relevant changes, such as improved performance in activities of daily living, cognitive function, and quality of life, as well as a reduced risk for falls may help to lower costs in the health care system. Finally, practitioners, therapists, and instructors will be provided with a scientifically evaluated feasible, safe, and easy-to-administer exercise program for fall prevention.
Trial registration Identifier: NCT01906034
PMCID: PMC3852637  PMID: 24106864
Seniors; Fall risk assessment; Resistance training; Postural stability
5.  Alteration of synergistic muscle activity following neuromuscular electrical stimulation of one muscle 
Brain and Behavior  2012;2(5):640-646.
The aim of the study was to determine muscle activation of the m. triceps surae during maximal voluntary contractions (MVCs) following neuromuscular electrical stimulation (NMES) of the m. gastrocnemius lateralis (GL). The participants (n = 10) performed three MVC during pretest, posttest, and recovery, respectively. Subsequent to the pretest, the GL was stimulated by NMES. During MVC, force and surface electromyography (EMG) of the GL, m. gastrocnemius medialis (GM), and m. soleus (SOL) were measured. NMES of GL induced no significant decline (3%) in force. EMG activity of the GL decreased significantly to 81% (P < 0.05), whereas EMG activity of the synergistic SOL increased to 112% (P < 0.01). The GM (103%, P = 1.00) remained unaltered. Decreased EMG activity in the GL was most likely caused by failure of the electrical propagation at its muscle fiber membrane. The decline of EMG activity in GL was compensated by increased EMG activity of SOL during MVC. It is suggested that these compensatory effects are caused by central contributions induced by NMES.
PMCID: PMC3489816  PMID: 23139909
Neuromuscular control; NMES; synergistic muscles; triceps surae
6.  A Qualitative Review of Balance and Strength Performance in Healthy Older Adults: Impact for Testing and Training 
Journal of Aging Research  2012;2012:708905.
A continuously greying society is confronted with specific age-related health problems (e.g., increased fall incidence/injury rate) that threaten both the quality of life of fall-prone individuals as well as the long-term sustainability of the public health care system due to high treatment costs of fall-related injuries (e.g., femoral neck fracture). Thus, intense research efforts are needed from interdisciplinary fields (e.g., geriatrics, neurology, and exercise science) to (a) elucidate neuromuscular fall-risk factors, (b) develop and apply adequate fall-risk assessment tools that can be administered in clinical practice, and (c) develop and design effective intervention programs that have the potential to counteract a large number of fall-risk factors by ultimately reducing the number of falls in the healthy elderly. This paper makes an effort to present the above-raised research topics in order to provide clinicians, therapists, and practitioners with the current state-of-the-art information.
PMCID: PMC3270412  PMID: 22315687
7.  Socio-cultural determinants of adiposity and physical activity in preschool children: A cross-sectional study 
BMC Public Health  2010;10:733.
Both individual socio-cultural determinants such as selected parental characteristics (migrant background, low educational level and workload) as well as the regional environment are related to childhood overweight and physical activity (PA). The purpose of the study was to compare the impact of distinct socio-cultural determinants such as the regional environment and selected parental characteristics on adiposity, PA and motor skills in preschool children.
Forty preschools (N = 542 children) of two culturally different urban regions (German and French speaking part of Switzerland) participated in the study (Ballabeina Study). Outcome measures included adiposity (BMI and skinfold thickness), objectively measured sedentary activities and PA (accelerometers) and agility performance (obstacle course). Parental characteristics (migrant status, educational level and workload) were assessed by questionnaire.
Children from the French speaking areas had higher adiposity, lower levels of total and of more intense PA, were more sedentary and less agile than children from the German speaking regions (percent differences for all outcome parameters except for BMI ≥10%; all p ≤ 0.04). Differences in skinfold thickness, sedentary activities and agility, but not in PA, were also found between children of Swiss and migrant parents, though they were ≤8% (p ≤ 0.02). While paternal workload had no effect, maternal workload and parental education resulted in differences in some PA measures and/or agility performance (percent differences in both: ≤9%, p ≤ 0.008), but not in adiposity or sedentary activities (p = NS). Regional differences in skinfold thickness, PA, sedentary activities and agility performance persisted after adjustment for parental socio-cultural characteristics, parental BMI and, where applicable, children's skinfolds (all p ≤ 0.01).
The regional environment, especially the broader social environment, plays a prominent role in determining adiposity, PA and motor skills of young children and should be implicated in the prevention of obesity and promotion of PA in children.
Trial Registration NCT00674544
PMCID: PMC3008696  PMID: 21110865
8.  Effects of muscle fatigue on gait characteristics under single and dual-task conditions in young and older adults 
Muscle fatigue and dual-task walking (e.g., concurrent performance of a cognitive interference (CI) while walking) represent major fall risk factors in young and older adults. Thus, the objectives of this study were to examine the effects of muscle fatigue on gait characteristics under single and dual-task conditions in young and older adults and to determine the impact of muscle fatigue on dual-task costs while walking.
Thirty-two young (24.3 ± 1.4 yrs, n = 16) and old (71.9 ± 5.5 yrs, n = 16) healthy active adults participated in this study. Fatigue of the knee extensors/flexors was induced by isokinetic contractions. Subjects were tested pre and post fatigue, as well as after a 5 min rest. Tests included the assessment of gait velocity, stride length, and stride length variability during single (walking), and dual (CI+walking) task walking on an instrumented walkway. Dual-task costs while walking were additionally computed.
Fatigue resulted in significant decreases in single-task gait velocity and stride length in young adults, and in significant increases in dual-task gait velocity and stride length in older adults. Further, muscle fatigue did not affect dual-task costs during walking in young and older adults. Performance in the CI-task was improved in both age groups post-fatigue.
Strategic and/or physiologic rationale may account for the observed differences in young and older adults. In terms of strategic rationale, older adults may walk faster with longer strides in order to overcome the feeling of fatigue-induced physical discomfort as quickly as possible. Alternatively, older adults may have learned how to compensate for age-related and/or fatigue-induced muscle deficits during walking by increasing muscle power of synergistic muscle groups (e.g., hip flexors). Further, a practice and/or learning effect may have occurred from pre to post testing. Physiologic rationale may comprise motor unit remodeling in old age resulting in larger proportions of type I fibres and thus higher fatigue-resistance and/or increased muscle spindle sensitivity following fatigue leading to improved forward propulsion of the body. These findings are preliminary and have to be confirmed by future studies.
PMCID: PMC2993724  PMID: 21062458

Results 1-8 (8)