@article{MuellerKrauthGerssetal.2016, author = {M{\"u}ller, Carsten and Krauth, Konstantin A. and Gerß, Joachim and Rosenbaum, Dieter}, title = {Physical activity and health-related quality of life in pediatric cancer patients following a 4-week inpatient rehabilitation program}, series = {Supportive Care in Cancer}, volume = {24}, journal = {Supportive Care in Cancer}, doi = {10.1007/s00520-016-3198-y}, pages = {3793 -- 3802}, year = {2016}, abstract = {Abstract Purpose Chronic health conditions and impaired quality of life are commonly experienced in childhood cancer survivors. While rehabilitation clinics support patients in coping with the disease, studies evaluating an inpatient rehabilitation program on promoting physical activity (PA) and health-related quality of life (HRQoL) are missing. Methods A 4-week inpatient rehabilitation program was prospectively evaluated. One hundred fifty patients with leukemia or lymphoma (N = 86), brain tumors (N = 38), and sarcomas (N = 26) were enrolled on average 17 months after cessation of acute medical treatment. PA amount and cadence (indicating the intensity of walking activity) using the StepWatch™ 3 Activity Monitor and HRQoL global and physical well-being scores using the KINDL® questionnaire were assessed before, immediately after, and 6 and 12 months following the program and analyzed using multiple linear mixed models. Results Significant effects on PA were only found at 12-month follow-up for amount and cadence variables (all p < 0.05). While leukemia and lymphoma patients revealed the highest PA level throughout the study, rehabilitation effects were more pronounced for cadence variables in brain tumor and sarcoma patients. The rehabilitation program had immediate (t = 4.56, p < 0.001) and sustainable effects on HRQoL global scores (6-month follow-up, t = 4.08, p < 0.001; 12-month follow-up, t = 3.13, p < 0.006). Conclusions Immediate and sustainable increases in HRQoL indicate that a 4-week rehabilitation program is beneficial for improving psychosocial well-being, while the significant increase in PA levels could be related to general recovery as well. The lack of a control group hampers the evaluation of the rehabilitation program on promoting PA levels in pediatric cancer patients.}, language = {en} } @article{KestingGoetteSeideletal.2016, author = {Kesting, Sabine and G{\"o}tte, Miriam and Seidel, Corinna and M{\"u}ller, Carsten and Michel, Thomas and Kr{\"u}ger, Michael and Rosenbaum, Dieter and Boos, Joachim}, title = {Bewegungs- und Sportf{\"o}rderung in der P{\"a}diatrischen Onkologie am Universit{\"a}tsklinikum M{\"u}nster - Erfahrungen und Ergebnisse aus 5 Jahren}, series = {Bewegungstherapie und Gesundheitssport}, volume = {32}, journal = {Bewegungstherapie und Gesundheitssport}, number = {02}, doi = {10.1055/s-0042-103432}, pages = {60 -- 65}, year = {2016}, abstract = {Die weitreichenden Potenziale individualisierter Bewegungsf{\"o}rderung f{\"u}r krebskranke Kinder und Jugendliche sollten {\"u}ber den gesamten Zeitraum der Akuttherapie, in der Nachsorge und bei der R{\"u}ckkehr in den Alltag genutzt und als Bestandteil der Normalit{\"a}t aufrechterhalten und gef{\"o}rdert werden. Dieser Artikel stellt beispielhaft f{\"u}r den Standort M{\"u}nster Ergebnisse und Erfahrungen aus den letzten 5 Jahren sporttherapeutischer und sportp{\"a}dagogischer Bewegungsf{\"o}rderung im kinderonkologischen Setting dar und liefert konkrete Zahlen {\"u}ber die Bewegungsumf{\"a}nge, die erreichten Patienten sowie die M{\"o}glichkeiten und Grenzen eines derartigen Angebots.}, language = {de} } @article{MuellerRosenbaumKrauth2017, author = {M{\"u}ller, Carsten and Rosenbaum, Dieter and Krauth, Konstantin A.}, title = {Prospective Evaluation of Postural Control and Gait in Pediatric Patients with Cancer After a 4-Week Inpatient Rehabilitation Program}, series = {American journal of physical medicine \& rehabilitation / Association of Academic Physiatrists}, volume = {96}, journal = {American journal of physical medicine \& rehabilitation / Association of Academic Physiatrists}, number = {9}, doi = {10.1097/PHM.0000000000000729}, pages = {646 -- 653}, year = {2017}, abstract = {Objective The aim of the study was to investigate the effects of a 4-wk inpatient rehabilitation program on postural control and gait in pediatric patients with cancer. Design Eighty-eight patients with brain tumors (n = 59) and bone/soft tissue sarcomas (n = 29) were evaluated. Postural control was assessed examining the velocity of the center of pressure and single-leg stance time on a pressure distribution platform. Walk ratio, a measure of neuromotor control, was used to evaluate intervention effects on gait. Results Repeated measures analysis of variance showed improvements in postural control measures, indicated by a decrease in velocity of center of pressure of -0.4 cm/sec (F1,80 = 7.175, P = 0.009, ηp2 = 0.082) and increase in single-leg stance time (mean [median] = 1.1 [2.6] sec, respectively; F1,80 = 12.617, P = 0.001, ηp2 = 0.136). Walk ratio increased by 0.2 mm/steps per min (F1,82 = 3.766, P = 0.056, ηp2 = 0.044). Mean changes in dependent variables did not differ between both patient groups (P > 0.05). Conclusions The results indicate benefits of an inpatient rehabilitation program comprising standard physical therapy as well as aquatic and hippo therapy on postural control and gait after treatment of pediatric patients with cancer.}, language = {en} } @article{MuellerWinterRosenbaumetal.2010, author = {M{\"u}ller, Carsten and Winter, Corinna and Rosenbaum, Dieter and Boos, Joachim and Gosheger, Georg and Hardes, Jendrik and Vieth, Volker}, title = {Early decrements in bone density after completion of neoadjuvant chemotherapy in pediatric bone sarcoma patients}, series = {BMC Musculoskeletal Disorders}, volume = {11}, journal = {BMC Musculoskeletal Disorders}, number = {287}, doi = {10.25974/fhms-16866}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-168661}, pages = {1 -- 8}, year = {2010}, abstract = {Background Bone mineral density (BMD) accrual during childhood and adolescence is important for attaining peak bone mass. BMD decrements have been reported in survivors of childhood bone sarcomas. However, little is known about the onset and development of bone loss during cancer treatment. The objective of this cross-sectional study was to evaluate BMD in newly diagnosed Ewing's and osteosarcoma patients by means of dual-energy x-ray absorptiometry (DXA) after completion of neoadjuvant chemotherapy. Methods DXA measurements of the lumbar spine (L2-4), both femora and calcanei were performed perioperatively in 46 children and adolescents (mean age: 14.3 years, range: 8.6-21.5 years). Mean Z-scores, areal BMD (g/cm2), calculated volumetric BMD (g/cm3) and bone mineral content (BMC, g) were determined. Results Lumbar spine mean Z-score was -0.14 (95\% CI: -0.46 to 0.18), areal BMD was 1.016 g/cm2 (95\% CI: 0.950 to 1.082) and volumetric BMD was 0.330 g/cm3 (95\% CI: 0.314 to 0.347) which is comparable to healthy peers. For patients with a lower extremity tumor (n = 36), the difference between the affected and non-affected femoral neck was 12.1\% (95\% CI: -16.3 to -7.9) in areal BMD. The reduction of BMD was more pronounced in the calcaneus with a difference between the affected and contralateral side of 21.7\% (95\% CI: -29.3 to -14.0) for areal BMD. Furthermore, significant correlations for femoral and calcaneal DXA measurements were found with Spearman-rho coefficients ranging from ρ = 0.55 to ρ = 0.80. Conclusions The tumor disease located in the lower extremity in combination with offloading recommendations induced diminished BMD values, indicating local osteopenia conditions. However, the results revealed no significant decrements of lumbar spine BMD in pediatric sarcoma patients after completion of neoadjuvant chemotherapy. Nevertheless, it has to be taken into account that bone tumor patients may experience BMD decrements or secondary osteoporosis in later life. Furthermore, the peripheral assessment of BMD in the calcaneus via DXA is a feasible approach to quantify bone loss in the lower extremity in bone sarcoma patients and may serve as an alternative procedure, when the established assessment of femoral BMD is not practicable due to endoprosthetic replacements.}, language = {en} } @article{WinterBrandesMuelleretal.2010, author = {Winter, Corinna and Brandes, Mirko and M{\"u}ller, Carsten and Schubert, Tim and Ringling, Michael and Hillmann, Axel and Rosenbaum, Dieter and Schulte, Tim T.}, title = {Walking ability during daily life in patients with osteoarthritis of the knee or the hip and lumbar spinal stenosis}, series = {BMC Musculoskeletal Disorders}, volume = {11}, journal = {BMC Musculoskeletal Disorders}, number = {233}, doi = {10.25974/fhms-16867}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-168673}, pages = {1 -- 7}, year = {2010}, abstract = {Background Degenerative musculoskeletal disorders are among the most frequent diseases occurring in adulthood, often impairing patients' functional mobility and physical activity. The aim of the present study was to investigate and compare the impact of three frequent degenerative musculoskeletal disorders -- knee osteoarthritis (knee OA), hip osteoarthritis (hip OA) and lumbar spinal stenosis (LSS) -- on patients' walking ability. Methods The study included 120 participants, with 30 in each patient group and 30 healthy control individuals. A uniaxial accelerometer, the StepWatch™ Activity Monitor (Orthocare Innovations, Seattle, Washington, USA), was used to determine the volume (number of gait cycles per day) and intensity (gait cycles per minute) of walking ability. Non-parametric testing was used for all statistical analyses. Results Both the volume and the intensity of walking ability were significantly lower among the patients in comparison with the healthy control individuals (p < 0.001). Patients with LSS spent 0.4 (IQR 2.8) min/day doing moderately intense walking (>50 gait cycles/min), which was significantly lower in comparison with patients with knee and hip OA at 2.5 (IQR 4.4) and 3.4 (IQR 16.1) min/day, respectively (p < 0.001). No correlations between demographic or anthropometric data and walking ability were found. No technical problems or measuring errors occurred with any of the measurements. Conclusions Patients with degenerative musculoskeletal disorders suffer limitations in their walking ability. Objective assessment of walking ability appeared to be an easy and feasible tool for measuring such limitations as it provides baseline data and objective information that are more precise than the patients' own subjective estimates. In everyday practice, objective activity assessment can provide feedback for clinicians regarding patients' performance during everyday life and the extent to which this confirms the results of clinical investigations. The method can also be used as a way of encouraging patients to develop a more active lifestyle.}, language = {en} } @article{MuellerWinterKleinetal.2010, author = {M{\"u}ller, Carsten and Winter, Corinna and Klein, Dieter and Fuchs, Katharina and Schmidt, Carolin and Schulte, Tobias L. and Bullmann, Viola and Rosenbaum, Dieter}, title = {Objective assessment of brace wear times and physical activities in two patients with scoliosis}, series = {Biomedizinische Technik}, volume = {55}, journal = {Biomedizinische Technik}, number = {2}, doi = {10.1515/BMT.2010.026}, pages = {117 -- 120}, year = {2010}, abstract = {Conservative treatment of adolescent idiopathic scoliosis consists of therapeutic exercise and the application of braces. The effectiveness of bracing mainly depends on patient compliance, which can be determined by means of temperature sensors. This methodological paper describes the feasibility of objectively determining compliance and daily physical activities before and during conservative scoliosis treatment, being a relevant indicator for quality of life in children and adolescents. One patient with low compliance (61.4±24.9\%) reduced her activity level during bracing by 50.1\%, whereas another patient with a satisfactory compliance (85.7±19.5\%) increased her daily activity level by 33.7\% during conservative treatment.}, language = {en} } @article{WinterMuellerHoffmannetal.2010, author = {Winter, Corinna and M{\"u}ller, Carsten and Hoffmann, Christiane and Boos, Joachim and Rosenbaum, Dieter}, title = {Physical activity and childhood cancer}, series = {Pediatric Blood \& Cancer}, volume = {54}, journal = {Pediatric Blood \& Cancer}, number = {4}, doi = {10.1002/pbc.22271}, pages = {501 -- 510}, year = {2010}, abstract = {This review provides a survey of studies investigating physical activity and exercise interventions in patients during tumor treatment and survivors of childhood cancer. PubMed and Medline databases were searched using relevant terms. References of selected papers were tracked. A total of 28 studies could be identified. Seventeen studies investigated physical activity, 11 studies determined the effect of activity enhancing interventions during and after therapy. Even though most studies showed limitations and results were not consistent, considerably reduced physical activity is highly probable in patients during and after therapy. Studies on interventions provided promising results and revealed challenges to be faced. Pediatr Blood Cancer}, language = {en} } @article{MuellerWinterRosenbaum2010, author = {M{\"u}ller, Carsten and Winter, Corinna and Rosenbaum, Dieter}, title = {Aktuelle objektive Messverfahren zur Erfassung k{\"o}rperlicher Aktivit{\"a}t im Vergleich zu subjektiven Erhebungsmethoden}, series = {Deutsche Zeitschrift f{\"u}r Sportmedizin}, volume = {61}, journal = {Deutsche Zeitschrift f{\"u}r Sportmedizin}, number = {1}, pages = {11 -- 18}, year = {2010}, abstract = {Die Erfassung von Alltagsaktivit{\"a}ten (activities of daily life, ADL) ist unerl{\"a}sslich, wenn der Zusammenhang von k{\"o}rperlicher Aktivit{\"a}t und Gesundheit aufgezeigt oder die Effizienz von Interventionen zur Steigerung der k{\"o}rperlichen Aktivit{\"a}t evaluiert werden soll. Derzeit existiert keine Methode, die pr{\"a}zise alle Formen der Alltagsaktivit{\"a}ten erfassen kann. Diese {\"U}bersichtsarbeit beschreibt und vergleicht auf Basis einer umfassenden Literaturrecherche moderne Messverfahren zur Erfassung k{\"o}rperlicher Aktivit{\"a}ten im Alltag, bei der die Darstellung objektiver Verfahren einen Schwerpunkt bildet. Subjektive Erhebungsmethoden wie Frageb{\"o}gen und objektive Aktivit{\"a}tsmonitore, zu denen Schrittz{\"a}hler und Akzelerometer z{\"a}hlen, sowie kombinierte Verfahren von Akzelerometrie und Herzfrequenz, sind derzeit die g{\"a}ngigsten Methoden, Alltagsaktivit{\"a}ten zu erfassen. Daneben existieren weitere M{\"o}glichkeiten wie Doubly Labeled Water, Kalorimetrie oder direkte Beobachtungen der Testperson, die als Goldstandard des Activity Assessments angesehen und zur Validierung oben genannter Verfahren genutzt werden k{\"o}nnen. Obwohl diese Methoden das gr{\"o}ßte Potential bei der Erfassung k{\"o}rperlicher Aktivit{\"a}ten hinsichtlich der Messpr{\"a}zision haben, muss bei der Auswahl der Erhebungsmethode angesichts der Vielzahl an M{\"o}glichkeiten auch ihre Anwendbarkeit ber{\"u}cksichtigt werden. Die technischen Entwicklungen insbesondere im Bereich des Aktivit{\"a}tsmonitorings machen eine st{\"a}ndige Auseinandersetzung mit seinen vielf{\"a}ltigen M{\"o}glichkeiten unerl{\"a}sslich. Diese {\"U}bersicht soll f{\"u}r den Anwender eine Hilfestellung bei der Studienkonzipierung darstellen.}, language = {de} } @article{WinterMuellerBrandesetal.2009, author = {Winter, Corinna and M{\"u}ller, Carsten and Brandes, Mirko and Brinkmann, Anja and Hoffmann, Christiane and Hardes, Jendrik and Gosheger, Georg and Boos, Joachim and Rosenbaum, Dieter}, title = {Level of activity in children undergoing cancer treatment}, series = {Pediatric Blood \& Cancer}, volume = {53}, journal = {Pediatric Blood \& Cancer}, number = {3}, doi = {10.1002/pbc.22055}, pages = {438 -- 443}, year = {2009}, abstract = {Background The diagnosis of cancer bears severe implications for pediatric patients. One immense restriction consists in a reduced level of activity due to different factors. Physical activity affects various aspects of development and can be regarded as an essential part of a child's life. In the present study physical activity in patients undergoing cancer therapy was quantified in order to determine the extent of the restriction and to provide baseline information for the assessment of possible interventions. Procedure Physical activity in 80 patients and 45 healthy children matched for age and gender was measured using the StepWatch 3™ Activity Monitor (SAM, OrthoCare Innovations). Results Pediatric cancer patients, at 2,787 gait cycles (gcs) per day, were significantly less active than their healthy counterparts (8,096 gcs). Patients were significantly more active at home than during inpatient stays (3,185 gcs compared to 1,830 gcs), and patients with bone tumors were less active than those with leukemia regarding both, the amount (1,849 gcs vs. 2,992 gcs) and the intensity of activity. Conclusion The present study quantified an often observed but so far hardly assessable problem. Activity in cancer patients is considerably reduced and patients with bone tumors are at increased risk from the detrimental effects of prolonged inactivity. Both our findings and the accepted fact that activity is an essential element of child development confirm the need for interventions tailored to a patient's needs and abilities during the course of treatment.}, language = {en} } @article{MuellerWinterRosenbaumetal.2015, author = {M{\"u}ller, Carsten and Winter, Corinna and Rosenbaum, Dieter and Boos, Joachim and Gosheger, Georg and Hardes, Jendrik and Vieth, Volkier}, title = {Sport- und Bewegungstherapie mit Kindern und Jugendlichen w{\"a}hrend der Akuttherapie eines Knochentumors der unteren Extremit{\"a}t. Entwicklung des Aktivit{\"a}tsniveaus und Einfluss auf die Knochendichte}, series = {P{\"a}diatrische Praxis}, volume = {83}, journal = {P{\"a}diatrische Praxis}, number = {4}, issn = {0030-9346}, pages = {673 -- 683}, year = {2015}, abstract = {Tumorerkrankungen im Kindes- und Jugendalter haben w{\"a}hrend der Akuttherapie und dar{\"u}ber hinaus einen signifikanten Einfluss auf das Aktivit{\"a}tsniveau und den Knochenstoffwechsel. Dieser Beitrag untersucht, inwiefern bewegungstherapeutische Interventionen das Aktivit{\"a}tsniveau und damit auch die Entwicklung der Knochendichte w{\"a}hrend der Akuttherapie von Patienten mit Knochentumoren der unteren Extremit{\"a}t beeinflussen k{\"o}nnen. 21 Kinder und Jugendliche im Alter von 13,6 Jahren konnten in die Untersuchung aufgenommen werden und wurden einer Interventions- (IG, n=10) oder einer Kontrollgruppe (KG, n=11) zugeordnet. S{\"a}mtliche Patienten erhielten die standardisierte physiotherapeutische Behandlung. Der IG wurde zus{\"a}tzlich ein Sportprogramm angeboten, das an jedem zweiten Tag w{\"a}hrend der Akuttherapie absolviert werden sollte. Die Knochendichte der Lendenwirbels{\"a}ule und des nicht betroffenen Schenkelhalses wurde mittels Dual-R{\"o}ntgen-Absorptiometrie (DXA) w{\"a}hrend der Lokaltherapie, sowie nach sechs und nach zw{\"o}lf Monaten erfasst. Die Alltagsaktivit{\"a}ten wurden zeitgleich nach sechs und zw{\"o}lf Monaten im heimischen Umfeld objektiv mit einem Beschleunigungsaufnehmer {\"u}ber einen Zeitraum von sieben Tage erhoben. In beiden Patientengruppen wurde w{\"a}hrend der Akuttherapie eine deutliche Reduktion der Knochendichte beobachtet. Im Gruppenvergleich zeigten sich in der Entwicklung der Knochendichte zwischen den Messzeitpunkten kleine bis große Effekte zugunsten der bewegungstherapeutischen Intervention. Zudem weist die Interventionsgruppe im Vergleich zur Kontrollgruppe durchweg signifikant h{\"o}here Alltagsaktivit{\"a}ten (durchschnittliche Schrittzahl pro Tag und Phasen hoher k{\"o}rperlicher Aktivit{\"a}t) auf. Die Ergebnisse belegen die Durchf{\"u}hrbarkeit und den Nutzen eines therapiebegleitenden Sportprogramms f{\"u}r Kinder und Jugendliche w{\"a}hrend der Akutphase der Behandlung einer Knochentumorerkrankung der unteren Extremit{\"a}t.}, language = {de} } @article{KoestersBockholtMuelleretal.2014, author = {K{\"o}sters, Clemens and Bockholt, Sebastian and M{\"u}ller, Carsten and Winter, Corinna and Rosenbaum, Dieter and Raschke, Michael J. and Ochmann, Sabine}, title = {Comparing the outcomes between Chopart, Lisfranc and multiple metatarsal shaft fractures}, series = {Archives of Orthopaedic and Trauma Surgery}, volume = {134}, journal = {Archives of Orthopaedic and Trauma Surgery}, doi = {10.1007/s00402-014-2059-8}, pages = {1397 -- 1404}, year = {2014}, abstract = {Objectives Complex midfoot injuries could lead to severe functional impairment of mobility and quality of daily living. Aim of this study was to compare the clinical and functional outcomes of Chopart, Lisfranc fractures and multiple metatarsal shaft fractures. Design Retrospective case series. Setting Level one trauma center. Intervention Open or closed reduction and internal fixation with screws, K-wires, plates, external fixation or combination of different technics. Main outcome measurements The American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Score and the Maryland Foot Score were used to assess pain and functional outcome. 3D gait analysis, pedobarographic analysis and radiologic examinations were performed. The activity level was measured by a step counting accelerometer. All results were compared to an age-matched healthy control group. Results 24 patients with a median age of 44 years (16-72) were included: 12 patients with multiple metatarsal shaft fractures, 6 patients with Chopart and 6 patients with Lisfranc fractures. The median follow-up was 2.6 years. The pedobarographic analysis reports reduced contact time of the total foot (p = 0.08), the forefoot (p = 0.008) and the hallux (p = 0.015) for the injured foot. A median score of 64 for the SF-36, 64 for the AOFAS Midfoot Score and 73 for the Maryland Foot Score indicated a poor restoration of foot function. Multiple metatarsal shaft fractures presented a significantly lower walking speed (p = 0.03) and cadence (p = 0.04). Conclusion The worst results were reported for multiple metatarsal shaft fractures on outcome scores, pedobarography, gait analysis and activity. Metatarsal serial fractures should not be underestimated as well as Chopart and Lisfranc fractures.}, language = {en} } @article{MuellerWinterBoosetal.2014, author = {M{\"u}ller, Carsten and Winter, Corinna and Boos, Joachim and Gosheger, Georg and Hardes, Jendrik and Vieth, Volker and Rosenbaum, Dieter}, title = {Effects of an exercise intervention on bone mass in pediatric bone tumor patients}, series = {International Journal of Sports Medicine}, volume = {35}, journal = {International Journal of Sports Medicine}, number = {08}, doi = {10.1055/s-0033-1358475}, pages = {696 -- 703}, year = {2014}, abstract = {The aim was to evaluate the effects of additional exercises during inpatient stays on bone mass in pediatric bone tumor patients. 21 patients were non-randomly allocated either to the exercise group (n=10) or the control group (n=11). DXA of the lumbar spine, the non-affected femur and both calcanei was performed after completion of neoadjuvant chemotherapy (baseline), as well as 6 and 12 months after baseline. Bone mineral content (BMC), bone mineral density (BMD) and height-corrected lumbar spine Z-scores were determined. Group changes after 6 and 12 months were compared by covariance analyses. Additionally, daily physical activities (PA) were assessed by means of accelerometry. After adjusting for initial age, height and weight, mean reductions in lumbar spine and femoral BMC were lower in the exercise group (not significant). Effect sizes during the observational period for lumbar spine and femur BMC were generally small (partial η²=0.03). The exercise group demonstrated substantially higher PA levels in terms of gait cycles per day, per hour and moderate PA (activities above 40 gait cycles per minute). Additional exercises for bone tumor patients are feasible during hospitalization. Though the intervention did not influence BMC, it appeared beneficial regarding PA promotion with respect to volume and intensity.}, language = {en} } @article{CorinnaCarstenHardesetal.2013, author = {Corinna, Winter and Carsten, M{\"u}ller and Hardes, Jendrik and Boos, Joachim and Gosheger, Georg and Rosenbaum, Dieter}, title = {The effect of individualized exercise interventions during treatment in pediatric patients with a malignant bone tumor}, series = {Supportive Care in Cancer}, volume = {21}, journal = {Supportive Care in Cancer}, doi = {10.1007/s00520-012-1707-1}, pages = {1629 -- 1636}, year = {2013}, abstract = {Background While research on exercise interventions during anticancer treatment is well-established in adults, only very few studies exist in children. However, pediatric patients experience great limitations to being physically active, and appropriate interventions are desired. Procedure The present study aimed at investigating the effects of individualized exercise interventions during inpatient stays on pediatric patients with a malignant bone tumor. The parameter of interest was physical activity (PA). Patients' PA during home stays was assessed 6 weeks as well as 3, 6, 12, and 18 months post-surgery. Patients were distinguished into an intervention group and a control group. All patients received endoprosthetic replacement of the affected bone in the same institution. Results A constant increase in all PA parameters was observed during follow-up. Exercise interventions were possible and appeared worthwhile. The intervention group showed better PA results at all measurements; however, no significant differences between groups were found. Furthermore, differences decreased especially after the cessation of the intervention. General problems in reaching appropriate power and compliance were observed. Conclusions Individualized exercise interventions in pediatric bone tumor patients are possible and appear to be beneficial. Such interventions should be implemented in adjuvant care; however, future research is needed to understand more about the effects of different interventions.}, language = {en} } @article{MuellerFuchsWinteretal.2011, author = {M{\"u}ller, Carsten and Fuchs, Katharina and Winter, Corinna and Rosenbaum, Dieter and Schmidt, Carolin and Bullmann, Viola and Schulte, Tobias}, title = {Prospective evaluation of physical activity in patients with idiopathic scoliosis or kyphosis receiving brace treatment}, series = {European Spine Journal}, volume = {20}, journal = {European Spine Journal}, doi = {10.1007/s00586-011-1791-9}, pages = {1127 -- 1136}, year = {2011}, abstract = {Bracing is an established method of conservative treatment for adolescent idiopathic scoliosis and kyphosis. Compliance among adolescents is frequently inadequate due to the discomfort of wearing a brace, cosmetic issues, and fear on the part of patients and parents that bracing may reduce everyday physical activities. The aim of this prospective, controlled study was to objectify the impact of spinal bracing on daily step activity in patients receiving conservative treatment for adolescent idiopathic scoliosis (AIS) or adolescent kyphosis (AK). Forty-eight consecutive patients (mean age 13.4 ± 2.3 years), consisting of 38 AIS patients (33 girls, 5 boys) and 10 AK patients (6 girls, 4 boys) were included. Once the decision to carry out bracing had been taken and while the patients were waiting for the individual brace to be built, step activity was assessed without braces by means of step activity monitoring (SAM) for seven consecutive days. After 8 weeks of brace wearing, step activity was assessed during regular brace treatment, again for seven consecutive days. In addition, brace-wearing times were simultaneously recorded using temperature probes implanted in the braces to measure compliance. Before and during brace treatment, patients completed the Scoliosis Research Society (SRS-22) questionnaire. The SAM was worn for an average of 12.7 ± 1.5 h/day during the first measurement and 12.3 ± 1.9 h on average during the second measurement. The mean gait cycles (GCs) per day and per hour before treatment were 5,036 ± 1,465 and 395 ± 105, respectively. No significant reduction in step activity was found at the follow-up measurement during bracing, at 4,880 ± 1,529 GCs/day and 403 ± 144 GCs/h. Taking the 23-h recommended time for brace wearing as a basis (100\%), patients wore the brace for 72.7 ± 27.6\% of the prescribed time, indicating an acceptable level of compliance. Girls showed a higher compliance level (75.6 ± 25.6\%) in comparison with boys (56.7 ± 31.9\%), although the difference was not significant (P = 0.093). The SRS-22 total score showed no differences between the two measurements (2.57 ± 0.23 vs. 2.56 ± 0.28). Implementing a simultaneous and objective method of assessing step activity and brace-wearing times in everyday life proved to be feasible, and it expands the information available regarding the impact of bracing on patients' quality of life. The results clearly show that brace treatment does not negatively interfere with daily step activity in AIS and AK patients. This is an important finding that should help reduce patients' and parents' worries concerning bracing.}, language = {en} } @article{MuellerWinterMogwitzetal.2011, author = {M{\"u}ller, Carsten and Winter, Corinna and Mogwitz, Marie Sophie and Rosenbaum, Dieter}, title = {Validierung von neun Bewegungssensoren bei Kindern und Erwachsenen}, series = {Sportwissenschaft}, volume = {41}, journal = {Sportwissenschaft}, number = {1}, doi = {10.1007/s12662-011-0167-y}, pages = {8 -- 15}, year = {2011}, abstract = {Zur Bestimmung der Messgenauigkeit handels{\"u}blicher Bewegungssensoren wurden ein Akzelerometer und acht Pedometer von Schulkindern und jungen Erwachsenen unter kontrollierten Bedingungen und unter Alltagsbedingungen im Rahmen einer 24-st{\"u}ndigen Aktivit{\"a}tsmessung getragen. Die pr{\"a}zisesten Ergebnisse unter kontrollierten Bedingungen wurden mit einem piezoelektrischen Pedometer erzielt. Die absoluten Abweichungen (Median) lagen f{\"u}r diesen Schrittz{\"a}hler bei den Kindern zwischen 0,2 und 1,0\%, bei den Erwachsenen zwischen 0,2 und 1,4\%. Die absoluten Abweichungen f{\"u}r den Akzelerometer lagen zwischen 0,8 und 3,1\% f{\"u}r die Schulkinder sowie zwischen 0,6 und 3,2\% f{\"u}r die Erwachsenen. Die Messpr{\"a}zision stieg unter kontrollierten Bedingungen mit zunehmender Bewegungsgeschwindigkeit an. Besonders bei den Schulkindern wiesen einige Schrittz{\"a}hler mit Pendelarm-Mechanismus hohe absolute Abweichungen von {\"u}ber 50\% auf. Die Unterschiede unter Alltagsbedingungen verdeutlichen, dass Schrittzahlangaben diverser Monitore nicht direkt miteinander verglichen werden k{\"o}nnen. In jedem Fall sollten Schrittz{\"a}hler vor ihrem Einsatz in wissenschaftlichen Untersuchungen auf G{\"u}tekriterien wie Validit{\"a}t und Reliabilit{\"a}t gestestet werden.}, language = {de} } @article{WinterMuellerHardesetal.2011, author = {Winter, Corinna and M{\"u}ller, Carsten and Hardes, Jendrik and Boos, Joachim and Gosheger, Georg and Rosenbaum, Dieter}, title = {Pediatric patients with a malignant bone tumor: when does functional assessment make sense?}, series = {Supportive Care in Cancer}, volume = {20}, journal = {Supportive Care in Cancer}, doi = {10.1007/s00520-010-1077-5}, pages = {127 -- 133}, year = {2011}, abstract = {Purpose The diagnosis of a malignant bone tumor in the lower limb is a risk factor for physical disability, limiting physical performance. Walking ability especially, which is essential for most activities of daily living, is limited in those patients. In the present study, the extent of limitations during the course of treatment was investigated to determine when the assessment of functional parameters is meaningful in those patients. Methods In the present study, activity levels were determined in 20 patients with a malignant bone tumor in the lower limb who received endoprosthetic replacement of the affected bone and in 20 healthy individuals. A uniaxial accelerometer was used to investigate patients at five different time points after surgery. Results Patients performed significantly less amounts and intensities of activity than control individuals at all measurements. Significant increases in the volume of activity were observed after cessation of treatment. However, the intensity of activity only showed minor increases. Patients experiencing complications of surgery revealed greater restriction than those without even 18 months after surgery. Conclusions After cessation of treatment for their disease, patients recovered markedly and showed great improvements in physical activity. However, some limitations appeared to persist. Comparisons with patients with longer follow-up revealed that meaningful functional assessment does not make sense within the first 12 months after surgery. More research is needed to show if longer follow-up periods reveal further improvements. Based on such information, it should be more promising to develop individually tailored activity recommendations and intervention programs.}, language = {en} }