Thomas Horstmann

Predicting competition performance in long-distance running by means of a treadmill test.

PURPOSE The purpose of this study was to examine the power of 16 parameters beside the individual anaerobic threshold (IAT) in predicting performance in various competition distances. METHODS This study examined 427 competitive runners to test the prediction probability of the IAT and other parameters for various running distances. All runners (339 men, 88 women; ages, 32.5 +/- 10.14 yr; training, 7.1 +/- 5.53 yr; training distance, 77.9 +/- 35.63 km.wk-1) performed an increment test on the treadmill (starting speed, 6 or 8 km.h-1; increments, 2 km.h-1; increment duration, 3 min to exhaustion). The heart rate (HR) and the lactate concentrations in hemolyzed whole blood were measured at rest and at the end of each exercise level. The IAT was defined as the running speed at a net increase in lactate concentration 1.5 mmol.L-1 above the lactate concentration at LT. RESULTS Significant correlations (r = 0.88-0.93) with the mean competition speed were found for the competition distances and could be increased using stepwise multiple regression (r = 0.953-0.968) with a set of additional parameters from the training history, anthropometric data, or the performance diagnostics. CONCLUSIONS The running speed at a defined net lactate increase thus produces an increasing prediction accuracy with increasing distance. A parallel curve of the identity straight lines with the straight lines of regression indicates the independence of at least a second independent performance determining factor.

Effects of contract-relax stretching training on muscle performance in athletes.

Abstract The effects of an 8-week unilateral contract-relax (CR) stretching training program (passive stretch after isometric contraction) on muscular performance were investigated in a group of 16 athletes. The flexibility, maximum torque and angular position as well as contraction work in movements of the knee joint were determined before training and after 4 and 8 weeks of training. The torque measurements were performed under isokinetic conditions, eccentrically at angular velocities of 60° · s−1 and 120° · s−1, isometrically at five different joint positions, and concentrically at angular velocities of 60, 120, 180 and 240° · s−1 using an isokinetic dynamometer. A surface electromyogram (EMG) of the thigh muscles (quadriceps and hamstrings) was recorded simultaneously. As compared to untrained control limbs, significant improvements in active and passive flexibility (up to 6.3° in range of motion), maximum torque (up to 21.6%) and work (up to 12.9%) were observed, and these were especially pronounced under eccentric load conditions. A comparison between integrated EMG recordings during eccentric and concentric loads, as well as the interpretation of the training-induced changes in the EMG, suggest that muscular activity under eccentric loads may be impaired by mental processes.

Sex-related differences in foot shape

The purpose of the study was to investigate sex-related differences in foot morphology. In total, 847 subjects were scanned using a 3-D-footscanner. Three different analysis methods were used: (1) comparisons were made for absolute foot measures within 250–270 mm foot length (FL); (2) and for averaged measures (% FL) across all sizes; (3) the feet were then classified using a cluster analysis. Within 250–270 mm FL, male feet were wider and higher (mean differences (MD) 1.3–5.9 mm). No relevant sex-related differences could be found in the comparison of averaged measures (MD 0.3–0.6% FL). Foot types were categorised into voluminous, flat-pointed and slender. Shorter feet were more often voluminous, longer feet were more likely to be narrow and flat. However, the definition of ‘short’ and ‘long’ was sex-related; thus, allometry of foot measures was different. For shoe design, measures should be derived for each size and sex separately. Different foot types should be considered to account for the variety in foot shape. Improper footwear can cause foot pain and deformity. Therefore, knowledge of sex-related differences in foot measures is important to assist proper shoe fit in both men and women. The present study supplements the field of knowledge within this context with recommendations for the manufacturing of shoes.

Kinematic Analysis of Runners with Achilles Mid-Portion Tendinopathy

Background: Despite anecdotal evidence linking overpronation to the onset of Achilles tendinopathy (AT), there is little conclusive evidence of a particular movement pattern of the lower extremity associated with this injury. Therefore, the objective of the present study was to observe differences in the kinematic profiles of healthy runners (CON) and runners with mid-portion Achilles tendinopathy (ATG). Materials and Methods: In this cross-sectional analysis, 48 male height and weight matched subjects were invited to participate: 27 with mid-portion Achilles tendon pain and 21 asymptomatic controls. Subjects underwent lower extremity clinical examination, then ran barefoot for 10-trials at a self-selected pace. A 3D motion capture system analysed tri-plane kinematic data for the lower extremity. Results: The ATG displayed significantly greater sub-talar joint eversion displacement during mid-stance of the running gait (13 ± 3 degrees vs. 11 ± 3 degrees; p = 0.04). Trends were observed such that the ATG showed lower peak dorsiflexion velocity (300 ± 39 degrees/s vs. 330 ± 59 degrees/s; p = 0.08) and greater overall frontal plane ankle joint range of motion (45 degrees ± 7 vs. 41 degrees ± 7; p = 0.09). Conclusion: We found an increase in eversion displacement of the sub-talar joint in runners with Achilles mid-portion tendinopathy. Based on the findings from this study, there is evidence that devices used to control sub-talar eversion may be warranted in patients with Achilles mid-portion tendinopathy who demonstrate over-pronation during mid-stance of the running gait. Level of Evidence: III, Comparative Study

Metabolic reaction after concentric and eccentric endurance-exercise of the knee and ankle.

PURPOSE Power training plays an essential part in many sport disciplines. The importance of eccentric power training remains a matter of controversial discussion. The objective of this study was therefore to investigate the difference in metabolic reaction between eccentric and concentric stress in comparable work. METHODS Sixty-four men between 22 and 60 yr of age performed maximum isokinetic 1-min endurance tests of the knee and ankle each in concentric (180 degrees.s-1) and eccentric (60 degrees.s-1) modes with comparable total area of contraction-time curve (NS). Higher strength values (mean peak torque, P < 0.01), lower fatigue (fatigue index, P < 0.001), lower increase in lactate (P < 0.01), and lower ammonia production (P < 0.01) were found in eccentric than in concentric exercise, independent of the joint. The eccentric form of stress showed lower decrease and thus age-dependence in maximum strength and in fatigue than the concentric form. RESULTS The results permit the conclusion that eccentric exercise leads to less fatigue and lower lactate and ammonia reaction than concentric exercise in comparable work levels. Variable visco-elastic properties of the muscle fibers themselves with additive passive strength in eccentric mode is considered as the cause. CONCLUSIONS It remains uncertain whether the lower metabolic stress might be useful during the training process. A greater scope of training and increased number of training stimuli might be applied in primarily eccentric forms of exercise.

A new approach to children's footwear based on foot type classification

Current shoe designs do not allow for the comprehensive 3-D foot shape, which means they are unable to reproduce the wide variability in foot morphology. Therefore, the purpose of this study was to capture these variations of childrens feet by classifying them into groups (types) and thereby provide a basis for their implementation in the design of childrens shoes. The feet of 2867 German children were measured using a 3-D foot scanner. Cluster analysis was then applied to classify the feet into three different foot types. The characteristics of these foot types differ regarding their volume and forefoot shape both within and between shoe sizes. This new approach is in clear contrast to previous systems, since it captures the variability of foot morphology in a more comprehensive way by using a foot typing system and therefore paves the way for the unimpaired development of childrens feet. Previous shoe systems do not allow for the wide variations in foot morphology. A new approach was developed regarding different morphological foot types based on 3-D measurements relevant in shoe construction. This can be directly applied to create specific designs for childrens shoes.

Deficits 10-Years after Achilles Tendon Repair

The purpose of this study was to determine the long-term impact of surgical repair and subsequent 6-week immobilization of an Achilles tendon rupture on muscle strength, muscle strength endurance and muscle activity. 63 patients participated in this study on average 10.8 ± 3.4 years after surgically repaired Achilles tendon rupture and short-term immobilization. Clinical function was assessed and muscle strength, strength endurance and muscle activity were measured using a dynamometer and electromyography. Ankle ROM, heel height during heel-raise tests and calf circumference were smaller on the injured than on the contralateral side. Ankle torques during the concentric dorsiflexion tasks at 60 °/sec and 180 °/sec and ankle torques during the eccentric plantarflexion task and during the concentric plantarflexion task at 60 °/sec for the injured leg were significantly lower than those for the contralateral leg. The total work during a plantarflexion exercise at 180 °/sec was 14.9% lower in the injured compared to the contralateral leg (p < 0.001). Muscle activity for the gastrocnemius muscle during dorsiflexion tasks was significantly higher in the injured than in the contralateral limb. Limited ankle joint ROM and increased muscle activity in the injured leg suggest compensatory mechanisms to account for differences in muscle morphology and physiology caused by the injury.

Changes in gait patterns and muscle activity following total hip arthroplasty: A six-month follow-up

BACKGROUND Appropriate gait function is an important determinant of the outcome of total hip arthroplasty and relies on appropriate joint motion and muscle activity. The purpose of this study was to test the hypothesis that 6-month postoperative dynamic joint range of motion, time-distance measures and muscle activity in the operated limb in patients undergoing total hip arthroplasty differ from preoperative levels and are more similar to those observed postoperatively in the contralateral limb and in healthy subjects. METHODS Basic time-distance gait measurements, knee and hip kinematics and electromyographic activity from eight hip muscles were obtained preoperatively and 6 months postoperatively in 52 patients undergoing total hip arthroplasty and in 24 age-matched healthy subjects during treadmill walking. FINDINGS Postoperative dynamic hip range of motion for the operated limb (confidence interval differences [-3.9°; -2.3°]) and postoperative knee range of motion for both limbs (operated: [-8.4°; -5.6°]; contralateral: [-8.1°; -5.3°]) in patients with total hip arthroplasty were significantly lower than values for the control subjects (P<0.001). Postoperative gait in patients with total hip arthroplasty was more symmetric than preoperative gait. Preoperative and postoperative electromyographic intensities were higher in patients with total hip arthroplasty than values for the control subjects (P<0.001), and patients had different EMG patterns compared to the control group. INTERPRETATION Pre- and postoperative differences not only in hip but also in knee kinematics emphasize the importance of evaluating the dynamic outcome of total hip arthroplasty by assessing joint motion of all lower extremity joints in both legs.

Kinematic classification of iliotibial band syndrome in runners

Several inconsistent causative biomechanical factors are considered to be crucial in the occurrence of iliotibial band syndrome (ITBS). The focus of this study was on assessing differences in the kinematic characteristics between healthy runners [control group (CO)] and runners with ITBS in order to recommend treatment strategies to deal with this injury. Three‐dimensional kinematics of barefoot running was used in the biomechanical setup. Both groups were matched with respect to gender, height and weight. After determining drop outs, the final population comprised 36 subjects (26 male and 10 female): 18 CO and 18 ITBS (13 male and five female, each). Kinematic evaluations indicate less hip adduction and frontal range of motion at the hip joint in runners with ITBS. Furthermore, maximum hip flexion velocity and maximum knee flexion velocity were lower in runners with ITBS. Lack of joint coordination, expressed as earlier hip flexion and a tendency toward earlier knee flexion, was found to be another discriminating variable in subjects with ITBS compared with CO subjects. We assume that an increase in range of motion at the hip joint, stretching of the hip abductors, as well as stretching the hamstrings, calf muscles and hip flexors will help treat ITBS.

Comparison of Female Foot Morphology and Last Design in Athletic Footwear—Are Men's Lasts Appropriate for Women?

The purpose of this study was to investigate differences between female feet and last design. Four hundred twenty-four feet and four mens running shoe lasts (U.S. women 6.0–9.5), which also are used for the manufacturing of womens shoes, were scanned in three dimensions. Six foot measures were quantified. Different foot types were classified using a cluster analysis. Comparisons were made between last measures and averaged as well as foot type specific foot measures. Differences in width measures between lasts and foot types vary substantially (0–9 mm). Length grading is similar for lasts and feet (differences < 1mm). Width grading is larger in lasts in comparison with average grading in feet (3.5–5.9 mm). Last design and grading should account for the sex-specific allometry in foot measures. The use of down-graded mens lasts for womens shoes has to be questioned. Therefore, sex-specific reference measures and wear tests should incorporate different foot types in different sizes to allow suitable implications for a proper design and grading of lasts.