@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{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} } @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{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{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{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{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{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{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{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} }