Torsten Frech

Physical performance profile of handball players is related to playing position and playing class.

Abstract Krüger, K, Pilat, C, Ueckert, K, Frech, T, and Mooren, FC. Physical performance profile of handball players is related to playing position and playing class. J Strength Cond Res 28(1): 117–125, 2014—The purpose of the study was to compare anthropometric data and physical performance characteristics between different playing positions in professional team handball. Furthermore, a comparison between performance profiles of first and second division players was made. Thirty-four male professional handball players were recruited. Measurement of heart rates (HRs) during official games anthropometric data, sprint ability, jumping performance, throwing velocity, and endurance performance were determined and analyzed with respect to playing position. In a further step, additional 31 players from German second division were recruited to compare their profile on each position with profile of the first division players. Players of wings and backs positions had highest average HRs during game, best times in 30-m sprint tests, best jumping performance, and best anaerobic endurance performance. Similarly, backs and wings reached highest throwing velocities. Regarding anthropometric characteristics, wings were players with lowest body height and weight, whereas pivots were heaviest players and players with highest body mass index (BMI). We further found that wings from first division had a better sprint performance compared with wings from second division. Furthermore, pivots from first division had higher BMI and drop jump performance. Our data demonstrated a close relationship of anthropometric data, physical performance characteristic, and the playing position of handball. These information might be helpful for the assessment and evaluation of talents and may help to develop and optimize position-specific training regimes and identification of talents.

Progenitor cell mobilization after exercise is related to systemic levels of G‐CSF and muscle damage

Different types of exercise are characterized by the ability to induce specific physiological stimuli that might be able to induce the mobilization of progenitor cells. The aim of the current study was to investigate the mobilization of hematopoietic progenitor cells (HPCs) and endothelial progenitor cells (EPCs) in response to endurance, resistance, and eccentric endurance exercise and their relation to markers of muscle damage and inflammation. Healthy male subjects performed acute bouts of either endurance exercise, resistance exercise, or eccentric endurance exercise. Numbers of progenitor cells and several markers of muscle damage and inflammation were determined. Although the endurance exercise was followed by an immediate and short increase of both HPCs and EPCs, the eccentric exercise evoked a long lasting increase up to 24 h for HPCs and 48 h for EPCs (P < 0.05). After resistance exercise, an increase of HPCs was only found 3 h after exercise (P < 0.05). A correlation was found between mobilized progenitor cells and systemic levels of granulocyte colony‐stimulating factor (G‐CSF) levels (r = 0.54 and r = 0.51, P < 0.05) as well as for HPCs and creatine kinase levels (r = 0.57, P < 0.05). These results suggest that mobilization of progenitor cells is related to the type of exercise and possibly mediated by G‐CSF and muscle damage.

Effects of Traumeel (Tr14) on Exercise-Induced Muscle Damage Response in Healthy Subjects: A Double-Blind RCT

The present double-blind, randomized, placebo-controlled clinical trial intended to test whether ingestion of a natural combination medicine (Tr14 tablets) affects serum muscle damage and inflammatory immune response after downhill running. 96 male subjects received Tr14 tablets, which consist of 14 diluted biological and mineral components, or a placebo for 72 h after the exercise test, respectively. Changes in postexercise levels of various serum muscle damage and immunological markers were investigated. The area under the curve with respect to the increase (AUCi) of perceived pain score and creatine kinase (CK) were defined as primary outcome measures. While for CK the p value of the difference between the two groups is borderline, the pain score and muscle strength were not statistically significant. However, a trend towards lower levels of muscle damage (CK, p = 0.05; LDH, p = 0.06) in the Tr14 group was shown. Less pronounced lymphopenia (p = 0.02), a trend towards a lower expression of CD69 count (p = 0.07), and antigen-stimulated ICAM-1 (p = 0.01) were found in the verum group. The Tr14 group showed a tendentially lower increase of neutrophils (p = 0.10), BDNF (p = 0.03), stem cell factor (p = 0.09), and GM-CSF (p = 0.09) to higher levels. The results of the current study indicate that Tr14 seems to limit exercise-induced muscle damage most likely via attenuation of both innate and adaptive immune responses. This study was registered with ClinicalTrials.gov (NCT01912469).

Apoptosis of T-cell Subsets after Acute High-intensity Interval Exercise

INTRODUCTION High-intensity interval training (HIT) exercise has gained much interest in both performance and recreational sports. This study aims to compare the effect of HIT versus continuous (CONT) exercise with regard to changes of circulating T cells and progenitor cells. METHODS Subjects (n = 23) completed an HIT test and an isocaloric CONT test. Blood samples were collected before, immediately after, and 3 and 24 h postexercise for the assessment of low differentiated (CD3CD28CD57), highly differentiated T cells (CD3CD28CD57), regulatory T cells (Tregs) (CD4CD25CD127), hematopoietic progenitor cells (CD45CD34), and endothelial progenitor cells (CD45CD34KDR) by flow cytometry. The detection of apoptosis was performed by using labeling with annexin V. To analyze potential mechanisms affecting T cells, several hormones and metabolites were analyzed. RESULTS Both exercise tests induced an increase of catecholamines, cortisol, and thiobarbituric acid-reactive substances (P < 0.05). CONT induced a higher increase of apoptosis in low differentiated T cells compared with the HIT (CONT: 3.66% ± 0.21% to 6.48% ± 0.29%, P < 0.05; HIT: 3.43% ± 0.31% to 4.71% ± 0.33%), whereas HIT was followed by a higher rate of apoptotic highly differentiated T cells (CONT: 21.45% ± 1.23% to 25.32% ± 1.67%; HIT: 22.45% ± 1.37% to 27.12% ± 1.76%, P < 0.05). Regarding Tregs, HIT induced a mobilization, whereas CONT induced apoptosis in these cells (P < 0.05). The mobilization of progenitor cells did not differ between the exercise protocols. CONCLUSION These results suggest that HIT deletes mainly highly differentiated T cells known to affect immunity to control latent infections. By contrast, CONT deletes mainly low differentiated T cells and Tregs, which might affect defense against new infectious agents.

Exploring effects of a natural combination medicine on exercise‐induced inflammatory immune response: A double‐blind RCT

Traumeel (Tr14) is a natural, combination drug, which has been shown to modulate inflammation at the cytokine level. This study aimed to investigate potential effects of Tr14 on the exercise‐induced immune response. In a double‐blind, randomized, controlled trial, healthy, untrained male subjects received either Tr14 (n = 40) or placebo (n = 40) for 24 h after a strenuous experimental exercise trial on a bicycle (60 min at 80%VO2max). A range of antigen‐stimulated cytokines (in vitro), white blood cell count, lymphocyte activation and apoptosis markers, and indicators of muscle damage were assessed up to 24 h following exercise. The area under the curve with respect to the increase (AUCI) was compared between both groups. The Tr14 group showed a reduced exercise‐induced leukocytosis and neutrocytosis (P < 0.01 for both), a higher AUCI score of antigen‐stimulated IL‐1β and IL‐1α (absolute and per monocyte, all P < 0.05), a lower AUCI score of antigen‐stimulated GM‐CSF (P < 0.05) and by trend a lower AUCI score of antigen‐stimulated IL‐2 and IL‐4 as well as a higher AUCI score of antigen‐stimulated IL‐6 (all P < 0.1). Tr14 might promote differentiated effects on the exercise‐induced immune response by (a) decreasing the inflammatory response of the innate immune system; and (b) augmenting the pro‐inflammatory cytokine response.

Exercise-induced cytokine changes in antigen stimulated whole-blood cultures compared to serum

Strenuous exercise is followed by an elevation of many cytokines with inflammation regulating properties. Since most cytokines act at pico- or nanomolar concentrations many investigations failed to detect their concentrations in vivo. Hence, the aim of this study was to evaluate the significance of cytokine measurements (IL-1β, TNF-α, IL-1ra, IL-6, CCL2 and CXCL8) in a stimulated whole-blood culture (sWBC) compared to serum with respect to their exercise-induced kinetics and detection rates. 40 male volunteers (age: 25,5±4,3years, BMI: 24,00±2,24, VO2peak: 46,9±4,1mL/kg×min) performed 60min of intensive bicycle exercise (80% VO2peak). Blood samples were taken before and for up to 24h after exercise. All cytokines were determined by a multiplex ELISA. There were weak to moderate correlations between cytokines in sWBC and serum. While exercise did not affect pro-inflammatory cytokines in serum, in sWBC only IL-1β was increased 1.2-fold at 3h (p<0,05). All other cytokines increased both in sWBC and serum. The detection rate was superior in sWBC vs serum for most cytokines. Exercise-induced cytokine kinetics in sWBC do not reflect systemic changes. Both approaches provide a synergistic insight into inflammatory processes on the cytokine level.

Acute effects of high-intensity exercise on hematological and iron metabolic parameters in elite male and female dragon boating athletes

ABSTRACT Objective: To investigate the acute effects of high-intensity exercise on blood hepcidin levels and other iron metabolic and hematological parameters in highly trained athletes of dragon boating as a sport performed in a sitting position. Methods: We conducted an exercise intervention study with a pre- and posttest blood measurement to determine the effects of high-intensity training on hematological and iron metabolic parameters in both male (n = 19) and female (n = 12) elite athletes of the German national dragon boating team. The study took place during the final training camp before the European championships. Blood samples were collected at baseline and 3 h after 3 consecutive high-intensity training bouts at the same day, each one lasting 1 h in duration. Results: After exercise, leukocytes, CPK, CKMB, and hepcidin levels increased significantly both in men and women. In contrast, iron concentrations decreased significantly. No gender-related differences were found. Compared with baseline, the postexercise concentrations of serum iron decreased significantly both in men [99.3 ± 46.3 to 61.2 ± 20.9 µg/dL (p < 0.001)] and in women [116.3 ± 34 to 67.1 ± 21.8 µg/dL (p < 0.001)] without a gender difference (p = 0.28). Hepcidin levels increased significantly both in men [9.1 ± 6.5 to 12.2 ± 5.8 ng/mL (p < 0.001)] and in women [8.0 ± 4.6 to 11.7 ± 5.7 ng/mL (p < 0.001)] without a significant gender difference in hepcidin changes (p = 0.34). Conclusions: In conclusion, three consecutive high-intensity training bouts lead to elevated hepcidin levels and decreased iron levels in elite athletes of dragon boating. The increase in hepcidin levels may contribute to the risk of anemia in these athletes.

Sport- und Bewegungstherapie bei Rückenschmerzen

Unspezifische Kreuzschmerzen Unspezifische Kreuzschmerzen stellen den Großteil des allgemein als Rückenschmerz bezeichneten Leidens dar. Die Nationale VersorgungsLeitlinie rät bei dieser Form der Beschwerden, bei der keine eindeutigen Hinweise auf eine spezifische Ursache erkannt werden, von Bettruhe ab. Zur Unterstützung der körperlichen Aktivität wird eine Bewegungstherapie in Kombination mit edukativen Maßnahmen empfohlen [4]. Zur primären Behandlung subakuter und chronischer unspezifischer Kreuzschmerzen liegt eine starke Empfehlung für Bewegungstherapie in Kombination mit edukativen Maßnahmen nach verhaltenstherapeutischen Prinzipien vor, um die körperliche Aktivität zu unterstützen. Bei akuten Beschwerden liegt ein geringerer Empfehlungsgrad vor. Wenngleich sich in der Mehrzahl der in Übersichtsarbeiten eingeschlossenen Studien unterschiedliche Bewegungstherapien bei akuten Beschwerden nicht wirksamer als das Beibehalten der normalen Aktivität zeigten, konnte hierdurch das Risiko einer Chronifizierung reduziert werden. Somit kann eine Empfehlung für Bewegungstherapie ausgesprochen werden. Beim subakuten und chronischen Krankheitsbild scheinen Bewegungsprogramme, die die Muskulatur kräftigen und stabilisierend wirken, die unspezifischen Kreuzschmerzen besser lindern zu können als kardiopulmonal betonte Belastungen. Allerdings lässt sich aus der aktuellen Studienlage nicht ableiten, welche Form der Bewegungstherapie am effektivsten Schmerzen reduziert und die Funktionsfähigkeit verbessert. Unter anderem werden Übungen zur Verbesserung der Bewegungskontrolle und sensorischen Wahrnehmung, Muskeltraining, Aerobic, die McKenzie-Methode, Dehnungsübungen, Yoga, Pilates, Tai-Chi und die Alexandertechnik bei den Patienten angewendet. Zu empfehlen ist eine fachlich qualifizierte Betreuung unter Berücksichtigung von Patientenpräferenzen, Fitness und Anforderungen des täglichen Lebens. Die Leitlinie empfiehlt zudem die Intensivierung der Therapie in Form des Rehabilitationssports oder Funktionstrainings für den ambulanten Versorgungsbereich, wenn neu aufgetretene Kreuzschmerzepisoden über das Akutstadium von sechs Wochen hinaus fortbestehen und dabei anhaltende alltagsrelevante Aktivitätseinschränkungen bestehen oder eine Gefährdung der beruflichen Wiedereingliederung gegeben ist. Hierbei sollen über Sport und sportliche Spiele insbesondere Kraft, Koordination, Ausdauer und Flexibilität trainiert werden. Zudem zielt die Empfehlung auf die Entwicklung gruppendynamischer Effekte wie Selbstbewusstsein, Selbsthilfe und Motivation ab. Die Verschreibung von Sport und Bewegung ist nicht dazu vorgesehen, mangelnde lokale Sportangebote auszugleichen. Rehabilitationssport soll in Gruppen mit maximal 15 Teilnehmern stattfinden. Eine Verordnung (Formularmuster 56, siehe Abb. 1) umfasst 50 Übungseinheiten, die in einem 18-monatigen Zeitraum in Anspruch genommen werden sollen [4].

Aerobic endurance training status affects lymphocyte apoptosis sensitivity by induction of molecular genetic adaptations

Apoptosis is a genetically regulated form of programmed cell death which promotes the elimination of potentially detrimental immune cells. However, exercise-associated apoptosis is thought to induce a temporarily decline of the adaptive immune competence in the early post-exercise period. The purpose of the present study was to investigate if the aerobic endurance training status affects the sensitivity of human peripheral blood lymphocytes towards different types of apoptosis inducers and secondly, if this is mediated by the modulation of apoptosis-associated proteins and microRNAs. Collected at resting conditions, isolated lymphocytes of endurance trained athletes (ET) and healthy untrained subjects were either exposed to phytohemagglutinin-L (PHA-L), hydrogen peroxide (H2O2), or dexamethasone (DEX) as apoptosis inducer. Results revealed no significant differences between ET and UT in terms of lymphocyte apoptosis immediately following isolation as determined by flow cytometry using annexin V staining. After 24 h of ex vivo cultivation, lymphocytes of ET showed a reduced sensitivity to PHA-L-induced lymphocyte apoptosis which was accompanied by a noticeably up-regulation of the prominent apoptosis inhibitor genes X-linked inhibitor of apoptosis (XIAP) and Cyclin dependent kinase inhibitor 1B (CDKN1B) as analyzed by quantitative real-time PCR. Moreover, a trend was observed for the suppression of the corresponding pro-apoptotic miR-221. Lymphocyte apoptosis in control, H2O2 and DEX treated cells was not affected by aerobic endurance training status. However, distinct molecular signatures could be identified in un-treated control samples characterized by a counterbalanced modulation of pro- and anti-apoptotic mediators in ET. The results of the current study suggest that lymphocytes adapt to repetitive endurance exercise training by promoting lymphocyte homeostasis and increasing their resistance to apoptosis. This could be based on an up-regulation of anti-apoptotic proteins and a reduction in pro-apoptotic microRNAs which together tightly regulate the genetically defined apoptotic pathways governed by the type of apoptosis stimuli. Thus, the lymphocytes of endurance-trained athletes may be primed to counteract the transient immune suppression post-exercise.

Effects of an Exercise Intervention on Metabolism and Quality of Life in Patients with Diabetes Mellitus

Diseases of civilisation, such as type 2 diabetes mellitus, play an increasingly important role in shaping the occupational health management strategy. According to the guidelines of the DDG e.V. [German Diabetes Association], regular physical exercise is the basic therapy for type 2 diabetes mellitus. In this study, in a total of 110 subjects with diabetes mellitus, it was shown that a regular, intensively supervised, exercise intervention over a period of 6 months led to a significant improvement in the glucose metabolism (reduction in hemoglobin A1c). In addition, an improvement in the health-related quality of life was observed. A twice-weekly exercise intervention carried out within the framework of occupational health management [OHM] thus appears to represent a sensible therapeutic option and a sensible supplement to the treatment of this disease of civilisation.