TY - JOUR A1 - Müller, Carsten A1 - Winter, Corinna A1 - Rosenbaum, Dieter A1 - Boos, Joachim A1 - Gosheger, Georg A1 - Hardes, Jendrik A1 - Vieth, Volker T1 - Early decrements in bone density after completion of neoadjuvant chemotherapy in pediatric bone sarcoma patients JF - BMC Musculoskeletal Disorders N2 - 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. KW - Bone Mineral Density KW - Lumbar Spine Bone Mineral Density KW - Areal Bone Mineral Density KW - Osteosarcoma Patient KW - Bone Mineral Density Loss Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:hbz:836-opus-168661 VL - 11 IS - 287 SP - 1 EP - 8 ER - TY - JOUR A1 - Winter, Corinna A1 - Brandes, Mirko A1 - Müller, Carsten A1 - Schubert, Tim A1 - Ringling, Michael A1 - Hillmann, Axel A1 - Rosenbaum, Dieter A1 - Schulte, Tim T. T1 - Walking ability during daily life in patients with osteoarthritis of the knee or the hip and lumbar spinal stenosis JF - BMC Musculoskeletal Disorders N2 - 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. KW - Gait Cycle KW - Lumbar Spinal Stenosis KW - Walking Ability KW - Healthy Control Individual KW - Zygapophyseal Joint Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:hbz:836-opus-168673 VL - 11 IS - 233 SP - 1 EP - 7 ER - TY - JOUR A1 - Müller, Carsten A1 - Winter, Corinna A1 - Klein, Dieter A1 - Fuchs, Katharina A1 - Schmidt, Carolin A1 - Schulte, Tobias L. A1 - Bullmann, Viola A1 - Rosenbaum, Dieter T1 - Objective assessment of brace wear times and physical activities in two patients with scoliosis JF - Biomedizinische Technik N2 - 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. KW - bracing KW - compliance KW - conservative scoliosis treatment KW - physical activity KW - thermobutton Y1 - 2010 U6 - http://dx.doi.org/10.1515/BMT.2010.026 VL - 55 IS - 2 SP - 117 EP - 120 ER - TY - JOUR A1 - Winter, Corinna A1 - Müller, Carsten A1 - Hoffmann, Christiane A1 - Boos, Joachim A1 - Rosenbaum, Dieter T1 - Physical activity and childhood cancer JF - Pediatric Blood & Cancer N2 - 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 KW - activity promotion KW - childhood cancer KW - exercise interventions KW - physical activity Y1 - 2010 U6 - http://dx.doi.org/10.1002/pbc.22271 VL - 54 IS - 4 SP - 501 EP - 510 ER - TY - JOUR A1 - Müller, Carsten A1 - Winter, Corinna A1 - Rosenbaum, Dieter T1 - Aktuelle objektive Messverfahren zur Erfassung körperlicher Aktivität im Vergleich zu subjektiven Erhebungsmethoden JF - Deutsche Zeitschrift für Sportmedizin N2 - Die Erfassung von Alltagsaktivitäten (activities of daily life, ADL) ist unerlässlich, wenn der Zusammenhang von körperlicher Aktivität und Gesundheit aufgezeigt oder die Effizienz von Interventionen zur Steigerung der körperlichen Aktivität evaluiert werden soll. Derzeit existiert keine Methode, die präzise alle Formen der Alltagsaktivitäten erfassen kann. Diese Übersichtsarbeit beschreibt und vergleicht auf Basis einer umfassenden Literaturrecherche moderne Messverfahren zur Erfassung körperlicher Aktivitäten im Alltag, bei der die Darstellung objektiver Verfahren einen Schwerpunkt bildet. Subjektive Erhebungsmethoden wie Fragebögen und objektive Aktivitätsmonitore, zu denen Schrittzähler und Akzelerometer zählen, sowie kombinierte Verfahren von Akzelerometrie und Herzfrequenz, sind derzeit die gängigsten Methoden, Alltagsaktivitäten zu erfassen. Daneben existieren weitere Möglichkeiten 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 können. Obwohl diese Methoden das größte Potential bei der Erfassung körperlicher Aktivitäten hinsichtlich der Messpräzision haben, muss bei der Auswahl der Erhebungsmethode angesichts der Vielzahl an Möglichkeiten auch ihre Anwendbarkeit berücksichtigt werden. Die technischen Entwicklungen insbesondere im Bereich des Aktivitätsmonitorings machen eine ständige Auseinandersetzung mit seinen vielfältigen Möglichkeiten unerlässlich. Diese Übersicht soll für den Anwender eine Hilfestellung bei der Studienkonzipierung darstellen. KW - Aktivitätserfassung KW - Körperliche Aktivität KW - Akzelerometrie Y1 - 2010 UR - https://www.germanjournalsportsmedicine.com/archive/archive-2010/heft-1/aktuelle-objektive-messverfahren-zur-erfassung-koerperlicher-aktivitaet-im-vergleich-zu-subjektiven-erhebungsmethoden/ VL - 61 IS - 1 SP - 11 EP - 18 ER -