Background: Because of discrepant published results, there is a need to systematically analyze the literature that has evaluated the effectiveness of harmonic whole-body vibration (WBV) and randomized WBV in patients with Parkinson disease (PD). Objective: To evaluate the effectiveness of harmonic versus randomized WBV on motor symptoms, balance, gait, and mobility in people with PD. Type: Meta-analysis. Literature Survey: Established databases PubMed, EMBASE, CINAHL, Cochrane, Trip, and PEDro; library of the Saarland University; and electronic library of journals, including publications from 1960 to November 2017, were scanned by using "Parkinson" and "vibration" as combined search terms. Methodology: First, data were extracted from the full-text version, including number of participants, severity of disease, medication status, study design, use of vibration treatment, duration of study, number of treatment sessions and trials per session, vibration frequency and amplitude, duration of trials and rest periods, and pre-and posttest data. Qualitative analysis was performed by using the PEDro score. Standardized mean differences (SMD) with 95% confidence intervals (CI) were used to verify the efficacy of harmonic versus randomized WBV on mobility, balance, gait, and motor symptoms. Synthesis: From 244 publications found in online databases, 17 eligible studies fulfilled eligibility criteria and were further analyzed qualitatively. Out of those, 7 studies attained moderate to high quality (mean PEDro score 4.6 points, SD 2.9) and were then further analyzed quantitatively. A large variation, between no effects (SMD = 0.06, 95% CI = −0.78 to 0.90) and weak effects (SMD = 0.46, 95% CI = −0.51 to 1.43), was found for motor symptoms, balance, gait, and mobility. Conclusions: There is no clear evidence of a PD symptom-reducing effect (motor symptoms, balance, gait, and mobility) of WBV compared with respective control conditions. Only a few studies found significant group differences for mobility and motor symptoms. Therefore, the overall effects of vibration therapy on PD remain somewhat inconsistent. Further high-quality studies should determine the efficacy of harmonic versus randomized WBV.

El presente estudio tiene como objetivo analizar y comparar las actitudes hacia la educación física de escolares chilenos y alemanes, centrándose en el grado de importancia que ellos le otorgan a la asignatura y en el grado de conformidad que tienen con las clases que están recibiendo, según país, género y curso. Fueron encuestados 2.748 escolares de las regiones de la Araucanía en Chile (50%), y del Sarre en Alemania (50%). Se utilizó el “Cuestionario de Actitudes de los Escolares hacia la Educación Física”, elaborado y validado por el Instituto de Ciencias del Deporte de la Universidad del Sarre de Alemania. Los resultados indican que la mayoría de los escolares presentan actitudes positivas hacia la educación física. Se encontraron diferencias significativas entre el alumnado de ambos países, en donde los escolares de Chile le otorgan un mayor grado de importancia a la educación física que los escolares de Alemania, mientras que los escolares alemanes manifiestan un mayor grado de conformidad hacia la educación física que los escolares chilenos. Se establece que los varones le otorgan mayor importancia a la educación física que las damas, mientras que en el grado de conformidad estas diferencias según sexo no se presentan. Por último, se confirma que a medida que va aumentando la edad estas apreciaciones favorables hacia la educación física disminuyen. Los resultados de esta investigación indican que existe una favorable disposición del alumnado hacia la educación física, la cual se debe aprovechar para lograr mejores aprendizajes.Abstract: The object of the present study was to analyze and compare attitudes towards physical education among Chilean and German schoolchildren, concentrating on the degree of importance that they attribute to the subject and their degree of conformance with the classes that they receive, by country, gender, and school grade. A survey was applied to 2,748 schoolchildren in the Araucanía Region of Chile (50%) and the federal state of Saarland in Germany (50%). The survey used the “Questionnaire on Schoolchildren's Attitudes to Physical Education”, drafted and validated by the Institute of Sport Sciences of the University of Saarland in Germany. Results indicate that the majority of schoolchildren present positive attitudes towards physical education. Significant differences were found between pupils from the two countries: schoolchildren in Chile attribute a greater degree of importance to physical education than those in Germany, while German schoolchildren express a greater degree of conformance with physical education than Chileans. It was found that boys attribute greater importance to physical education than girls, but that no gender differences exist regarding the degree of conformance. Finally, it was found that as children advance in age, favorable opinions on physical education diminish. The results of this work indicate that pupils have a favorable disposition towards physical education, which should be exploited to increase learning.

Background Parkinson’s disease is the second most common neurodegenerative disease. Symptoms are treated by medication, physio-, exercise, and occupational therapy. Alternative methods have been used in exercise therapy for a few years now. The effect of whole-body vibration as an alternative training method has been investigated for several symptoms in Parkinson’s disease. Since freezing and flexibility have not yet been investigated, the aim of this study was to evaluate the efficacy of different frequencies of application for these two symptoms. Methods Patients were randomly assigned to a frequency (6, 12, or 18 Hz) or the control group. Before and after the treatment of 5 × 60 s with a rest of 60 s each, the Sit and Reach test (flexibility) and the 360° turn test (freezing) were performed. Results Only the Sit and Reach test showed a significant improvement at 18 Hz (improvement from − 5.75 to − 1.89 cm, F(3,30) = 5.98**). At 360° turn, no significant differences were found. Weak to high effect sizes (standardized mean differences) were determined for the different frequencies, both for the Sit and Reach (from .01 to .64) and for the 360° turn (from − .72 to − 1.25). The highest effect size is observed for 18 Hz and the lowest for 6 Hz. Conclusions Higher frequencies seem to be more effective than lower ones. Freezing, age, and gender also seem to play a role. Therefore, this should be investigated in further studies.

ZusammenfassungBei der Darstellung von Testverfahren für den Gesundheitssport und die Sporttherapie erfolgt weitestgehend eine Orientierung an den Haupt- und Nebengütekriterien: Objektivität, Reliabilität und Validität bzw. Normierbarkeit und Ökonomie. In der Medizin und auch in der Physiotherapie werden darüber hinaus auch Maßzahlen der diagnostischen Güte genannt. Es geht um die Frage, wie gut ein Testverfahren Personen mit bzw. ohne Auffälligkeiten oder Schwierigkeiten unterscheiden kann. Dies zu klären, ist die Aufgabe von Diagnosestudien. In der einschlägigen eher sozialwissenschaftlich orientierten Testliteratur werden Maße der diagnostischen Güte im Gegensatz zum medizinisch-therapeutischen Milieu kaum thematisiert.Am Beispiel des FAHW-12, eines Screening-Tests zur Beurteilung des Wohlbefindens, wird aufgezeigt, welche Maße der diagnostischen Güte von Bedeutung sind und wie sie bestimmt werden können.Am häufigsten werden die Sensitivität und Spezifität genannt. Diese Werte werden über sog. Vierfeldertafeln berechnet. Beide Werte bedingen sich gegenseitig negativ. Eine Erhöhung der Sensitivität geht immer zu Lasten der Spezifität und umgekehrt. Bei einer maximalen Sensitivität eines Tests werden fast alle Patienten als krank klassifiziert. Dann werden aber auch sehr viele Gesunden als krank eingestuft. Die Diagnose hat also eine sehr geringe Spezifität. Wird hingegen umgekehrt fast niemand als krank eingestuft, dann werden aber auch sehr viele Kranke als gesund eingestuft. Die Diagnose hat also eine sehr geringe Sensitivität. Diese gegenseitige Abhängigkeit von Sensitivität und Spezifität wird vor allem bei einer grafischen Darstellung deutlich.Da bei der Beurteilung von Sensitivität und Spezifität jeweils nur Auffällige oder Unauffällige in den Blick genommen werden, werden auch andere komplexere Gütemaße, wie z. B. der RATZ-Index, beleuchtet.Eine weitere wichtige Aufgabe von Diagnosestudien besteht darin, den sog. Trennpunkt zu bestimmen. Das ist der Testwert, der optimal Personen mit von solchen ohne Störung bzw. Krankheit differenziert. Eine Möglichkeit hierfür stellt der Youden-Index dar. Des Weiteren kann die ROC-Kurve zur Beantwortung dieser Frage herangezogen werden.Spezielle Probleme ergeben sich, wenn die Referenzwerte, der sog. Goldstandard, nicht in dichotomer Form, sondern als Ordinal- oder Intervallskalen vorliegen. Dann müssen die Personen anhand definierter Cut-Off-Werte als auffällig bzw. unauffällig klassifiziert werden.

Total knee replacement (TKR) is a highly standardized procedure. However; many patients are not satisfied with the functional results. Surgery focuses initially on restoration of joint function. Based on the ICF classification (WHO) rehabilitation adds individual and social perspectives. The focus is not limited to body functions but includes abilities and participation. After surgery the patient suffers from pain, swelling, restricted blood circulation and a dramatic impairment of motor function. To prepare patients for activities of daily living it is important to analyze and understand the demands after TKR. Key qualities are the range of motion of the knee joint, functional joint stability, postural stability and muscle coordination. The paper describes a comprehensive rehabilitation protocol which is mainly based on the concept of functional training which consists of purposeful training preparing patients for activities of daily living and participation. It attempts to focus on multijoint movement as much as possible using closed chain muscle action (leg press, indoor cycling, gait training) and on sensorimotor training. A second focus is on postural stability (balance training). For clinical evaluation standardized scores are widely used (e.g. knee society score, HSS score). These scores were adapted for evaluation of the rehabilitation process (e.g. Staffelstein score, EVA-Reha score). However; these are not specific enough to analyze the effects of sensorimotor training and balance training. More detailed assessments should be used to evaluate the benefits of functional based rehabilitation concepts.