Institute for Sports Medicine

Innsbruck, Austria

Institute for Sports Medicine

Innsbruck, Austria

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Herbst E.,Innsbruck Medical University | Herbst E.,TU Munich | Hoser C.,Sportsclinic Austria | Hildebrandt C.,University of Innsbruck | And 5 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2015

Purpose: The purpose of this study was to utilize a novel functional test system to facilitate determining the time of return to sports following ACL reconstruction.Methods: Sixty-nine patients with unilateral ACL reconstruction were included in this pilot study. All the patients performed a standardized test battery consisting of one- and two-legged stability tests, counter movement jumps, speedy jumps, plyometric jumps and a quick feed test. The first test was administered on average 170.7 ± 75.1 days post-operatively, and the retest was administered on average 239.1 ± 79.7 days post-operatively. The values of the subtests were compared with the normative data of healthy gender- and age-matched controls to determine the functional capacities of patients following ACL reconstruction.Results: After the first and second test, 15.9 and 17.4 % of the patients met the criteria for a “return to non-competitive sports”. One patient fulfilled the criteria for a “return to competitive sports” after the second test battery. The most limiting factor was a poor LSI value of <90 % if the dominant leg was involved and <80 % if the non-dominant leg was involved.Conclusion: This test battery demonstrates that, in terms of neuromuscular abilities, most patients, compared to healthy controls, are most likely not ready for a safe return to sports, even 8 months post-operatively. This should be considered in the future to determine when it is safe to return to sports and should avoid a premature return to competitive sports.Level of evidence: III. © 2015, The Author(s).


Hammerer-Lercher A.,University of Innsbruck | Moser C.,University of Innsbruck | Leichtfried V.,Institute for Sports Medicine | Schobersberger W.,Institute for Sports Medicine | And 2 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2012

Background: The determination of urinary neopterin using high performance liquid chromatography (HPLC) has routinely been performed in Innsbruck since the middle of the 1980s. The aim was to compare the HPLC method with a commercially available radioimmunoassay. Methods: Neopterin to creatinine ratios were calculated in the urine of 33 healthy volunteers (33 ±7.3 years) collected at eight given time points. Neopterin and creatinine were simultaneously determined by HPLC and by radioimmuno-assay (RIA; BRAHMS; neopterin) and an enzymatic method (Roche; creatinine), respectively. Assays were compared with Bland-Altman plots and Passing-Bablok regression analysis. Results: Neopterin to creatinine ratios ranged from 62 to 490 μ mol/mol (HPLC) and from 17 to 425 μmol/mol (RIA-enzymatic combined). The ratios were on average 17.3% lower using the combined RIA-enzymatic method compared to the HPLC method. Neopterin concentrations measured by RIA were only slightly lower (on average 4.9 %) than by the HPLC and the regression analysis revealed a good accordance with linearity. In contrast, creatinine concentrations by the enzymatic method were on average 12.8 % higher than by HPLC. Conclusions: There is a marked bias between HPLC and the combined RIA-enzymatic method for measurement of urinary neopterin to creatinine ratios which has to be considered when methods are switched during the follow-up of patients. © 2012 by Walter de Gruyter • Berlin • Boston.


Gehring D.,Albert Ludwigs University of Freiburg | Faschian K.,Albert Ludwigs University of Freiburg | Lauber B.,Albert Ludwigs University of Freiburg | Lohrer H.,Institute for Sports Medicine | And 2 more authors.
British Journal of Sports Medicine | Year: 2014

Background Despite massive research efforts, it remains unclear how mechanical ankle instability (MAI) and functional ankle instability (FAI) affect joint control in the situation of ankle sprain. Thus, the purpose of this study was to evaluate whether individuals with MAI have deficits in stabilising their ankle joint in a close-toinjury situation compared with those with FAI and healthy controls. Methods Ankle-joint control was assessed by means of three-dimensional motion analysis and electromyography in participants with FAI and MAI (n=19), in participants with pure FAI (n=9) and in healthy controls (n=18). Close-to-injury situations were simulated during standing, walking and jumping by means of a custommade tilt platform. Results Individuals with FAI and MAI displayed significantly greater maximum ankle inversion angles (+5°) and inversion velocities (+50°/s) in the walking and jumping conditions compared to those with pure FAI and controls. Furthermore, individuals in the FAI and MAI group showed a significantly decreased preactivation of the peroneus longus muscle during jumping compared to those with FAI. No differences between groups were found for plantar flexion and internal rotation, or for muscle activities following tilting of the platform. Conclusions The present study demonstrates that MAI is characterised by impairments of ankle-joint control in close-to-injury situations. This could make these individuals more prone to recurrent ankle sprains, and suggests the need for additional mechanical support such as braces or even surgery. In addition, the study highlights the fact that dynamic experimental test conditions in the acting participant are needed to further unravel the mystery of chronic ankle instability.


Nauck T.,Institute for Sports Medicine | Lohrer H.,Institute for Sports Medicine | Padhiar N.,London Independent Hospital | King J.B.,London Independent Hospital
British Journal of Sports Medicine | Year: 2015

Background: Currently, there is no generally agreed measure available to quantify a subject's perceived severity of exercise-induced leg pain symptoms. The aim of this study was to develop and validate a questionnaire that measures the severity of symptoms that impact on function and sports ability in patients with exercise-induced leg pain. Methods: The exercise-induced leg pain questionnaire for German-speaking patients (EILP-G) was developed in five steps: (1) initial item generation, (2) item reduction, (3) pretesting, (4) expert meeting and (5) validation. The resulting EILP-G was tested for reliability, validity and internal consistency in 20 patients with exercise-induced leg pain, 20 asymptomatic track and field athletes serving as a population at risk and 33 asymptomatic sport students. Results: The patient group scored the EILP-G questionnaire significantly lower than both control groups (each p<0.001). Test-retest demonstrates an excellent reliability in all tested groups (Intraclass Correlation Coefficient, ICC=0.861-0.987). Concurrent validity of the EILP-G questionnaire showed a substantial agreement when correlated with the chronic exertional compartment syndrome classification system of Schepsis (r=-0.743; p<0.001). Internal consistency for the EILP-G questionnaire was 0.924. Conclusions: EILP-G questionnaire is a valid and reliable self-administered and disease-related outcome tool to measure the severity of symptoms that impact on function and sports ability in patients with exerciseinduced leg pain. It can be recommended as a robust tool for measuring the subjectively perceived severity in German-speaking patients with exercise-induced leg pain.


Lohrer H.,Institute for Sports Medicine | Raabe T.,RI Ingenieurdienstleistungen | Nauck T.,Institute for Sports Medicine | Arentz S.,Institute for Sports Medicine
Archives of Orthopaedic and Trauma Surgery | Year: 2011

Up to now diagnosis of Haglund's disease is based on patient's history and clinical findings. There is no valid diagnostic tool described to functionally detect retrocalcaneal bursitis. Retrocalcaneal bursa pressure may be increased in these patients. We hypothesized that retrocalcaneal bursa pressure can directly be measured. In this pilot investigation we tested the feasibility of a system which is already in clinical use for arterial blood pressure monitoring to quantitatively assess retrocalcaneal bursa pressure in a human and a swine cadaver specimen and in vivo. Using the presented system retrocalcaneal bursa pressure measurement is demonstrated to be feasible. Moreover, intrabursal pressure is reproducibly and validly quantified. In an uninjured subject increasing ankle dorsiflexion was not associated with increasing pressure in the retrocalcaneal bursa. Experimental liquid injection in the retrocalcaneal bursa was associated with increased intrabursal pressure and increasing pain. Feasibility of the tested setup could be proven. The question, if retrocalcaneal bursitis can be distinguished from further heel pathologies by different pressures in the retrocalcaneal bursa has to be addressed in a subsequent in vivo study. © 2010 Springer-Verlag.


Blank C.,Institute for Sports Medicine | Leichtfried V.,Institute for Sports Medicine | Schaiter R.,Institute for Sports Medicine | Furhapter C.,Institute for Sports Medicine | And 2 more authors.
Scandinavian Journal of Medicine and Science in Sports | Year: 2015

Strategies for doping prevention are based on prior identification of opportunities for intervention. There is no current research focusing on the potential role in doping prevention, which might be played by the parents of junior elite athletes. The purpose of this study was to evaluate the knowledge and attitudes toward doping among parents of Austrian junior athletes and to analyze factors potentially influencing these beliefs. In this study, two questionnaires were distributed to 1818 student athletes, each with instructions that these surveys were to be completed by their parents (ntotal=3636). Parents filled in questionnaires at home without observation. Responses from 883 parents were included in this analysis. Compared to female parents, male parents demonstrated significantly better knowledge about doping and its side effects and were more likely to be influenced by their own sporting careers and amounts of sports activities per week. Parental sex did not demonstrate a significant influence on responses reflecting attitudes toward doping. Additional research is needed to compare these results with young athletes' knowledge and attitudes to determine if and to what degree parental attitudes and beliefs influence the behavior and attitudes of their children. © 2013 John Wiley & Sons A/S.


Mueller G.,Clinical Trial Unit | Mueller G.,Swiss Paraplegic Center | Hopman M.,Radboud University Nijmegen | Perret C.,Institute for Sports Medicine
Topics in Spinal Cord Injury Rehabilitation | Year: 2012

Objective: To compare the effects of inspiratory resistance training (IRT) and isocapnic hyperpnea (IH) versus incentive spirometry (placebo) on respiratory function, voice, and quality of life in individuals with motor complete tetraplegia. Methods: In this randomized controlled trial, 24 individuals with traumatic, motor complete (AIS A) tetraplegia (C5-C8), 6 to 8 months post injury, were randomly assigned to 1 of 3 groups. They completed either 90 repetitions of IRT, 10 minutes of IH, or 16 repetitions of placebo training in 32 supervised training sessions over 8 weeks. Before and after the training period, the following tests were performed: bodyplethysmography, inspiratory and expiratory muscle strength, subjective breathing parameters using the visual analogue scale (VAS), voice measurements, and an adapted SF-12 quality of life questionnaire. A Friedman test and Cohen's effect sizes for IRT and IH versus placebo were calculated for differences between pre- and posttraining values. Results: Compared to placebo training, IRT showed high effect sizes for inspiratory muscle strength (d = 1.19), VAS values of "cleaning the nose" (d = 0.99), and the physical component of subjective quality of life (d = 0.84). IH compared to placebo training showed only medium and low effect sizes. The Friedman analysis showed a significant effect for IRT versus placebo on inspiratory muscle strength (P = .030). Neither all other parameters of respiratory function nor voice measurements, subjective breathing parameters, or quality of life were significantly improved by one of the tested training methods. Conclusion: In individuals with motor complete tetraplegia, inspiratory muscle strength can be improved by IRT. Therefore, IRT is advantageous compared to IH for this group of patients and during the first year post injure. © 2012 Thomas Land Publishers, Inc.


Liebensteiner M.C.,Innsbruck Medical University | Krismer M.,Innsbruck Medical University | Koller A.,Institute for Sports Medicine | Semenitz B.,Innsbruck Medical University | Mayr E.,Innsbruck Medical University
Clinical Orthopaedics and Related Research | Year: 2012

Background Less invasive dissection of the extensor apparatus, one of the aspects of minimally invasive surgical (MIS) TKA, might result in less reduction of postoperative quadriceps strength. However, it is unclear whether MIS is associated with less strength reduction. Questions/purposes We asked whether knee strength (extensor or flexor torque) would be greater in patients having a MIS TKA compared with patients having a standard TKA and whether knee scores, alignment, ROM, tourniquet and operating times, and hospital length of stay were improved. Methods We prospectively recruited 52 patients awaiting MIS or standard TKA, matched for age, weight, height, BMI, sex, and surgically treated side, but not randomized. Isokinetic tests were performed preoperatively and postoperatively to obtain peak values of extensor and flexor torque. Postoperative-to-preoperative ratios and the extensor- flexor torque ratio also were calculated. Results Mean baseline extensor torques were 57 Nm and 53 Nm for MIS and standard TKAs, respectively. At 8 weeks postoperatively, absolute values of the mean postoperative knee extensor torque also were similar: 47 and 45 Nm for patients with MIS and standard TKAs, respectively. The postoperative-to-preoperative ratios were 0.8 for extensor and flexor torque in both groups. The extensor-flexor torque ratios were similar between groups. Conclusions Our data suggest a less invasive dissection of the extensor apparatus involved in MIS TKA does not enhance postoperative quadriceps strength. © The Association of Bone and Joint Surgeons® 2012.


Reule C.A.,University of Stuttgart | Alt W.W.,University of Stuttgart | Lohrer H.,Institute for Sports Medicine | Hochwald H.,University of Stuttgart
British Journal of Sports Medicine | Year: 2011

Background There are many possible predisposing factors for Achilles tendon disorders suggested in the literature but their pathogenetic relevance is not proven in most cases. The asymmetric mechanical load distribution within the Achilles tendon during locomotion is frequently addressed as a major risk factor for Achilles tendon disorders. The spatial orientation of the subtalar joint axis (STA) may infl uence the Achilles tendon loading possibly leading to overload injuries. Hypothesis There is a signifi cant difference between the orientation of the STA in subjects with and without Achilles tendon pathologies. Materials and methods 614 subtalar joint axes determined in 307 long-distance runners with and without Achilles tendon disorders were included. Achilles tendon disorders were defi ned as any Achilles tendon-related pain during or following running, existing for more than 2 weeks in the past. Motion analysis of the foot was performed using an ultrasonic pulse-echo-based measurement system. The orientation of the STA was expressed by two angles. Results The mean inclination angle was 42±16° and the mean deviation angle was 11±23°. There was a signifi cant difference (p=0.002) between the mean deviation angle measured in subjects with Achilles tendon pathologies (18±23°) and those without (10±23°). Conclusions The results demonstrate a wide interindividual variability of the spatial orientation of the STA. In addition, the mean deviation angle in people with Achilles tendon pathologies is signifi cantly more oblique than in people without. This fi nding indicates that the spatial orientation of the STA is related to the incidence of overuse injuries of the Achilles tendon in the investigated sample.


Nauck T.,Institute for Sports Medicine | Lohrer H.,Institute for Sports Medicine
British Journal of Sports Medicine | Year: 2011

Objectives The evaluation of health-related quality of life and physical function is important for determining therapeutic strategies following ankle injuries. The Anglo-American Foot and Ankle Ability Measure (FAAM) is a valid and reliable self-reported measure to detect functional deficits in chronic lateral ankle instability. The purpose of this study was to translate, cross-culturally adapt and validate the FAAM questionnaire for use with German-speaking patients with chronic lateral ankle instability. Patients/Participants Preoperative and conservatively treated patients with chronic lateral ankle instability. Sport students and volleyball athletes served as control groups. Main Outcome Measurements The FAAM was forward and back translated, cross-culturally adapted and validated. The study population completed the FAAM-G questionnaire twice within 3-5 days. Additionally, the patients were scored with the Good ankle laxity classification system. Test-Retest reliability, construct validity and internal consistency were calculated. Results Reliability and validity of the FAAM-G were examined in presurgical chronic ankle instability patients (n=24), conservatively treated chronic ankle instability patients (n=17), university sport students (n=31) and volleyballers (n=37). Test-retest reliability revealed fair, good, or excellent reliability (inter-class correlation coefficient (ICC)=0.590-0.998; ρ=0.528-1.000). Construct validity, tested between the FAAM-G subscores and the Good et al ankle laxity classification system demonstrated strong correlations (ρ = -0.819 to -0.861). Conclusions The original FAAM questionnaire was successfully translated and cross-culturally adapted from English to German. Corresponding to the Anglo-American version, the FAAM-G is a reliable and valid questionnaire for self-reported assessment of pain and disability in German-speaking patients suffering from chronic ankle instability.

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