Publications by authors named "I Böckelmann"

38 Publications

[Assessment of Psychological Stress in Kindergarten Teachers with Varying Degrees of Overcommitment].

Psychiatr Prax 2021 Mar 27. Epub 2021 Mar 27.

Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg.

Objective: Nursery school teachers are exposed to psycho-emotional stress in their profession, which can lead to health problems. The aim of the study was to examine whether and to what extent increased work commitment (overcommitment, OC) affects the health of educators.

Methods: 163 nursery school teachers (age 44.5 ± 12.4 years) were recruited for the study. OC, mental health and the risk of burnout were assessed using standardized questionnaires. ECG recordings over 24 h served as a basis for the calculation of heart rate variability (HRV).

Results: 121 teachers showed normal OC and 42 teachers increased OC. In nursery school teachers with elevated OC, self-reported mental health is impaired and vagal mediated HRV (RMSSD and HF) is reduced.

Conclusion: Since the subjectively assessed mental health of nursery school teachers with elevated OC deteriorates and HRV is reduced, preventive measures must be taken to maintain the health of nursery school teachers.
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http://dx.doi.org/10.1055/a-1403-5421DOI Listing
March 2021

[Relationship between Burnout Risk and Individual Stress Processing Strategies in Kindergarten Teachers].

Psychother Psychosom Med Psychol 2021 Mar 5. Epub 2021 Mar 5.

Medizinische Fakultät, Bereich Arbeitsmedizin, Otto-von-Guericke-Universität Magdeburg, Deutschland.

Kindergarten teachers are exposed to a variety of stresses that can lead to psychological impairments and illnesses. A balance between stress and resources is necessary for performance and well-being. The aim of the study was to examine correlations between the risk of burnout and human resources in order to derive approaches for preventive measures. A total of 200 teachers from Magdeburg and the surrounding area took part in the study (age: 43.6±12.6 years). The MBI-GS inventory was used to determine the burnout risk. Stress processing strategies as personal resources were recorded using the stress processing form (SVF). A risk of burnout was found in nine (4.5%) teachers, 68 (34%) suffered from at least some burnout symptoms. There were significantly more negative stress processing strategies among educators at risk of burnout. As a preventive measure, a resource-oriented approach should be strengthened in order to maintain the health of the teachers and to prevent development of burnout syndrome.
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http://dx.doi.org/10.1055/a-1376-6962DOI Listing
March 2021

[Relationship Between Stress Experience and Stress Behavior - Measured with the Differential Stress Inventory and Burnout Symptoms in the MBI].

Psychiatr Prax 2021 Feb 24. Epub 2021 Feb 24.

Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität.

Objective: The aim of the study was to determine the relationship of the different DSI categories and stress types of stressor behaviour and experience on burnout in an occupational group.

Methods: The Maslach Burnout Inventory (MBI) and the Differential Stress Inventory (DSI) were presented to 185 subjects. As a result, a classification into DSI types and the comparison of the MBI categories were performed.

Results: Different types of stress behavior show differences in burnout dimensions. Four subjects (2.2 %) offered a high burnout. DSI type II is especially vulnerable to suffering from burnout symptoms.

Conclusion: Individuals with different degrees of stress triggers and manifestations as well as available coping strategies or risks of stress stabilization have different levels of MBI dimensions and thus different risks for burnout. Knowledge about the type of DSI could be included in the design of prevention interventions to reduce the risk of mental health impairment.
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http://dx.doi.org/10.1055/a-1360-9207DOI Listing
February 2021

Subjective and objective demands on different types of differential stress inventory.

Int Arch Occup Environ Health 2021 Jan 13. Epub 2021 Jan 13.

Institute of Occupational Medicine, Medical Faculty, Otto von Guericke University, Leipziger Straße 44 (Building 20), 39120, Magdeburg, Germany.

Purpose: To validate the differential stress inventory (DSI) by evaluating the objective and subjective stress differences in the five DSI types in the occupational setting.

Methods: A total of 119 German participants working as medical assistants (n = 40) or in a bank (n = 79) were recruited. They completed the Maslach Burnout Inventory-General Survey, the DSI, and wore ECG measuring devices for 24 h to measure heart rate variability. The DSI was used to group people into one of five types according to how they perceived and coped with stress: normal, overstressed, stress-resistant, low stress/high coping, or high stress/high coping.

Results: The overstressed type had significantly more burnout symptoms than the other types. The high stress/high coping type also had more symptoms of emotional exhaustion and total burnout compared to the other types, while the low stress/high coping and the stress-resistant types generally had the lowest levels of burnout. There were no differences on the HRV parameters among the DSI types.

Conclusion: Categorising people into types like in the DSI can help make workers aware of unhealthy stress and coping patterns before they turn into more severe pathology. Proper application and targeted preventive measures can save the individual's health and the company's budget. While the DSI picked up on differences in burnout symptoms as a long-term consequence of stress, there is evidence that it cannot pick up on short-term stress or physical stress as measured by HRV from the 24 h recording.
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http://dx.doi.org/10.1007/s00420-020-01632-4DOI Listing
January 2021

[The Role of Personal Resources in Coping].

Psychother Psychosom Med Psychol 2021 Mar 21;71(3-04):107-115. Epub 2020 Aug 21.

Medizinische Fakultät, Bereich Arbeitsmedizin, Otto-von-Guericke-Universität Magdeburg.

Background: Stress reactions can be a result of occupational and everyday stress, which are perceived individually. The insufficient compensation of stress can lead to various diseases. Personality traits play an important role in this. Stress reactions can lead to health problems and diseases. Therefore it is important to reduce stress. The aim of this study was to examine the role of personality traits in dealing with stress perception and coping.

Material And Method: The questionnaire on Differential stress inventory (DSI) differentiated 217 subjects into 5 types of DSI. The survey compared these 5 types along their personality traits via the Freiburg Personality Inventory (FPI-R).

Results: The DSI types showed significant differences in the expression of the personality traits. This applies the everyday stress, professional and private interactions with other people and the existential and future fears. People with pronounced physical disorders in the FPI showed physical and/or emotional-cognitive stress manifestation as well as a sense of helplessness. Life satisfaction is negatively related to stressors, for example through everyday life.

Conclusion: The survey revealed the importance of personality traits in coping with job strain. Occupational health diagnostics should be integrated in occupational health care and prevention. The occupational physician or the prevention team appear here to be significant, as they see workers falling through the classic family doctor model. In the prevention team, personality traits can be supplemented by psychologists. Personal resources can be imparted or reinforced to prevent physical disorders.
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http://dx.doi.org/10.1055/a-1208-5333DOI Listing
March 2021

Effort-Reward Imbalance, Mental Health and Burnout in Occupational Groups That Face Mental Stress.

J Occup Environ Med 2020 10;62(10):847-852

Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke-University, Magdeburg, Germany (Diekmann, Prof Böckelmann, Karlsen, Dr Thielmann); Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway (Karlsen); Institute for Biometrics and Medical Informatics, Medical Faculty, Otto-von-Guericke-University, Magdeburg, Germany (Lux).

Objective: The aim of this study was to investigate the interactions between mental health, effort-reward imbalance, intrinsic overcommitment and burnout in occupational groups that face mental stress.

Methods: Three hundred forty-six people aged 43.8 ± 9.9 years in professions characterized by mental strain (medical assistants, nurses, bank employees, teachers) were surveyed. The Effort-Reward Imbalance Questionnaire, overcommitment, General Health Questionnaire and Maslach Burnout Inventory were used.

Results: There were occupational group-specific differences. Nurses showed the highest effort-reward imbalance, the highest impaired mental health and risk of burnout. The intrinsic overcommitment was highest among teachers. Gender and work experience had no influence, but there were some differences in age.

Conclusions: The occupational groups we studied experience stress differently. They would benefit from the establishment of general conditions to improve the management of stress in the workplace. The focus should be on improving mental health.
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http://dx.doi.org/10.1097/JOM.0000000000001978DOI Listing
October 2020

Vaccination coverage rates of military personnel worldwide: a systematic review of the literature.

Int Arch Occup Environ Health 2021 Jan 19;94(1):1-8. Epub 2020 Jun 19.

Occupational Medicine, Otto-Von-Guericke University Magdeburg, Magdeburg, Germany.

Objectives: Due to the professionally specific risk of infection in the armed forces, recommendations for vaccination are usually adapted for soldiers and are subject to special regulations. Little data is available on scientifically measured vaccination coverage of soldiers.

Methods: A systematic literature research was carried out in the PubMed database using the search terms "army" or "military" or "Bundeswehr" and "vaccination" or "vaccine". Studies covering the period from 1990 to 2018 that contain statements on vaccination coverage rates of soldiers were identified. Twenty-two out of the initially found 1801 results were used.

Results: The studies found were conducted in nine different countries with eight out of the 22 studies originating from the USA. The size of study was between 180 and 32,502 subjects. On average, the vaccination rates determined in the studies were between 26.8 and 94.7%. Hepatitis A coverage was lowest (a minimum of 11.3%) and tetanus vaccination coverage was highest (with a maximum of 94.7%). Vaccination rates decreased with increasing age and coverage tended to be lower for men than for women. The term of service did not have a significant effect on vaccination rates.

Conclusions: On the whole, most studies referred to recruits. They showed high vaccination rates for standard vaccinations and lower vaccination rates for indication and seasonal vaccinations. However, there were also vaccination gaps of temporary-career volunteers. This leads to a considerable effort at the armed forces to complete vaccine protection in case of a short-term operational commitment.
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http://dx.doi.org/10.1007/s00420-020-01559-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7826299PMC
January 2021

EEG correlates of cognitive load in a multiple choice reaction task.

Acta Neurobiol Exp (Wars) 2020 ;80(1):76-89

Otto von Guericke University of Magdeburg, Germany.

The present study aimed to examine EEG correlates of cognitive load in a task, in which multiple stimulus‑response mappings have to be maintained in working memory (WM) combined with selective inhibition of irrelevant stimulus‑response mappings on every trial. Twenty‑four healthy younger adults had to perform choice reaction tasks differed in the number of S‑R mappings and motor response requirements. Performance was lower in the high load than in the low load condition. Performance decline at higher WM loads was accompanied by an increase of EEG power in delta, theta, and beta frequency bands and by a reduction in alpha band. The effect on alpha was generalized across all the electrodes. Correlations between EEG and performance were observed in the high load condition but not in the low load condition. Theta activity negatively correlated with reaction time, whereas positive correlations between beta activity and reaction time were found. The two frequency bands negatively correlated with each other at all electrodes. The results suggest that changes in alpha and theta power may be considered as the most sensitive indicators of cognitive load. The alpha reduction may be related to activation of widespread cortical areas which were recruited for performance of complex WM tasks. The beta increase, especially in the beta‑2 range, may partly be associated with activation of motor cortex due to difficulties in preparation and execution of motor responses. Theta increases may be considered as an index of facilitation of information processing in WM and improvements in higher‑order executive control, which in turn facilitates motor processes.
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December 2020

Workplace-related risk of tick bites in military personnel stationed in Northern Germany.

Int Arch Occup Environ Health 2019 10 28;92(7):1061-1065. Epub 2019 May 28.

Occupational Medicine, Faculty of Medicine, Otto von Guericke University of Magdeburg, Magdeburg, Germany.

Purpose: There are more than 500,000 employees in Germany alone who are at risk of being bitten by a tick at their workplace and thus also at risk of being infected with Borrelia burgdorferi s.l. or the tick-borne meningoencephalitis virus. So far, there are only a small number of studies on the risk of tick bites in Central Europe, in particular, for military personnel during relevant training activities.

Methods: During a total of 36 months of training in 2008/2009 and from 2012 to 2014, the number of tick bites and any resulting diseases of 1156 recruits under comparable conditions of exposure and prevention were documented based on their medical records. The incidence of tick bites was calculated with each recruit's individual exposure time for field training.

Results: There were a total of 66 tick bites during an exposure time of 317,059 h of field training (0.21 tick bites per 1000 h of training). The risk of tick bites was found to have a seasonal dependency. In 6 out of the 66 cases in which someone was bitten, the patients consulted a physician for a follow-up examination, and in one of these cases the bite resulted in an infection requiring treatment.

Conclusions: It turns out that there is a rather low but relevant risk of being exposed to tick bites for military personnel during their field training. Under the given study conditions, months with a high risk of tick bites can be distinguished from months with a low risk of tick bites, which is of vital importance, in particular, for guidance and prevention.
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http://dx.doi.org/10.1007/s00420-019-01445-0DOI Listing
October 2019

[Associations of Work-Related Strain with Subjective Sleep Quality and Individual Daytime Sleepiness].

Dtsch Med Wochenschr 2019 09 8;144(19):e121-e129. Epub 2019 May 8.

Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Magdeburg.

Introduction: Mental strain at the work place involves high potential hazard for health and quality of life. The aim of this study was to examine the relationships between strain consequences of psychological strain and subjective sleep quality as well as daytime sleepiness.

Methods: A cross-sectional study with 84 included participants was conducted. Work-related strain consequences were evaluated by means of the 3 scales Cognitive Irritation (CI), Emotional Irritation (EI) and Global Irritation (GI) of the Irritation Scale for Assessing Work-Related Strain Consequences (IS), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness was measured with the Epworth Sleepiness Scale (ESS).

Results: Regarding the assessed socio-demographical and medical data subjects with good sleep quality did not differ from subjects with poor sleep quality. In all 3 scales of the IS and in the ESS poor sleepers reached unfavourable higher scores, but the difference with respect to the ESS was not significant. Higher scores in all 3 scales of the IS correlated with higher PSQI scores but only higher scores in the EI of the IS correlated with higher ESS scores as well.

Discussion, Conclusions: Work-related strain consequences and subjective sleep quality have an interrelationship with great importance in today's world of work. Considerable aspects here are job insecurity and constant availability.
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http://dx.doi.org/10.1055/a-0873-7196DOI Listing
September 2019

Physical fitness as a risk factor for injuries and excessive stress symptoms during basic military training.

Int Arch Occup Environ Health 2019 08 20;92(6):837-841. Epub 2019 Mar 20.

Department of Occupational Medicine, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany.

Purpose: The purpose of basic military training (BMT) is to enable the recruited soldiers to acquire basic military skills and develop the required physical fitness. This training is accompanied by heightened physical stress and the risk of injury and excessive stress symptoms (I&ESS). The objective of this study was to examine the extent to which the level of physical fitness at the beginning of BMT affects the incidence of I&ESS and resultant absence from duty.

Methods: The data of a total of 774 subjects (age 20.5 ± 2.2) from 8 subsequent BMT quarters were analysed. The medical diagnoses made during the consulting hours of the unit physicians were reviewed for I&ESS and the kinds of injuries incurred and the sick leave pronounced were documented. The level of physical fitness per quarter was then categorised by means of the total numbers of points achieved during the standard basic fitness test (BFT). This categorisation was finally used as a basis for an analysis of the lost days in relation to the level of physical fitness.

Results: 255 of the 774 subjects (32.9%) suffered an I&ESS. 60% of all the I&ESS were located at lower extremity. There was a significant increase in the length of absence from duty among the group with the lowest level of physical fitness.

Conclusions: The analysis revealed that the level of physical fitness at the beginning of BMT has a significant influence on the length of absence from duty due to I&ESS. Moreover, 60% of the injuries were lower extremity injuries, which show the specific significance they have for limitations during BMT. Overall, this reveals the necessity for appropriate preventive measures (additional fitness training, adjustment of requirements) to be implemented so that recruits with a low level of fitness can complete BMT with as few injuries as possible.
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http://dx.doi.org/10.1007/s00420-019-01423-6DOI Listing
August 2019

[Influence of Sex and Age on Contrast Sensitivity Subject to the Applied Method].

Klin Monbl Augenheilkd 2018 Feb 9;235(2):212-218. Epub 2017 Jun 9.

Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität, Magdeburg.

Aim: The aim of the study was to detect gender and age differences in both photopic and mesopic contrast sensitivity with different methods in relation to German driver's license regulations (Fahrerlaubnisverordnung; FeV).

Methods: We examined 134 healthy volunteers (53 men, 81 women) with an age between 18 and 76 years, that had been divided into two groups (AG I < 45 years old, AG II ≥ 45 years old). Mesopic contrast sensitivity was determined with the Mesotest II. Optovist EU and Rodatest 302 as test devices and VISTECH and Mars charts under standardized illumination were applied for photopic contrast sensitivity.

Results: We could not find any gender differences. When evaluating age, there were no differences between the two groups for the Mars charts nor in the Rodatest. In all other tests, the younger volunteers achieved significantly better results.

Conclusion: For contrast vision, there exists age-adapted cut-off-values. Concerning the driving safety of traffic participants, sufficient photopic and mesopic contrast vision should be focused on, independent of age. Therefore, there is a need to reconsider the age-adapted cut-off-values.
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http://dx.doi.org/10.1055/s-0043-109691DOI Listing
February 2018

New reference values of heart rate variability during ordinary daily activity.

Heart Rhythm 2017 02 14;14(2):304-307. Epub 2016 Dec 14.

Occupational Medicine, Faculty of Medicine, Otto-von-Guericke-University, Magdeburg, Germany.

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http://dx.doi.org/10.1016/j.hrthm.2016.12.016DOI Listing
February 2017

Comparing the effectiveness of karate and fitness training on cognitive functioning in older adults-A randomized controlled trial.

J Sport Health Sci 2016 Dec 21;5(4):484-490. Epub 2015 Sep 21.

Department Occupational Medicine, Otto-von-Guericke-University, Magdeburg 39120, Germany.

Background: Recent studies demonstrate a slowdown in deterioration of cognitive functioning in old age through aerobic training. There is evidence that the combination of aerobic, balance, and coordination exercises leads to an improvement or maintenance of cognitive functions. Such age-related exercises can especially be found in East Asian martial arts. The purpose of the current study is to verify whether karate training for older adults improves cognitive functioning and, if an improvement can be found, which cognitive fields are influenced.

Methods: Eighty-nine older women and men (mean age: 70 years) participated in this study. The participants were randomized into 2 intervention groups (karate group and fitness group, duration of intervention: 5 months) and a control group. All participants had to accomplish a cognitive test battery before and after the intervention. In a secondary study the karate group had an additional intervention for another 5 months.

Results: The results show that there is a significant improvement in motor reactivity, stress tolerance, and divided attention only after the 5-month karate training period. Additionally, the results of the secondary study indicate further improvements after 10 months.

Conclusion: The 5-month karate training can help to enhance attention, resilience, and motor reaction time, but a training period of 10 months is even more efficient.
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http://dx.doi.org/10.1016/j.jshs.2015.09.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188869PMC
December 2016

[Hazard assessment and occupational safety measures in surgery : Relevant knowledge on occupational medicine].

Chirurg 2016 Nov;87(11):948-955

Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität, Leipziger Str. 44, 39120, Magdeburg, Deutschland.

Surgeons routinely work in an environment with occupational risks and hazards about which they are often uninformed. Based on the currently available scientific literature this review article describes the various hazards in the operating theater and their effects on personnel, particularly from the surgical perspective. A further aim of this article is to describe the occupational safety measures to reduce the burdens and to maintain the long-term health of personnel. Ultimately, surgeons should be equipped with the necessary knowledge for implementing hazard assessments according to the German Occupational Health and Safety Act. Surgeons are exposed to increased risks and hazards by working in awkward positions with a high risk for musculoskeletal pain and injuries. They are also commonly exposed to inhalational anesthetics, surgical smoke, radiation, noise and infectious agents. Furthermore, the mental and emotional stress associated with these activities is also high. Meaningful occupational safety measures for reduction of burdens are from a technical aspect the installation of effective air extraction systems, measures to reduce exposure to radiation and noise and the use of safer instruments to prevent needle stick injuries. Furthermore, individual occupational safety measures, such as the use of personal protective equipment (e.g. radiation protective clothing and double gloves) must be observed. The consistent implementation and also adherence to these described occupational safety measures and regulations can reduce the burden on operating theater personnel and contribute to maintaining health. Furthermore, periodic preventive healthcare controls and health checks by the company medical officer and individually initiated additional prevention measures can be a sensible augmentation to these safety measures.
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http://dx.doi.org/10.1007/s00104-016-0205-2DOI Listing
November 2016

[Measurement of contrast vision: mesopic or photopic vision? : Comparison of different methods for measuring contrast sensitivity within the framework of driving licence regulations].

Ophthalmologe 2016 Oct;113(10):844-851

Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland.

Background: Since 2011 the regulations for occupational driving licences make the examination of contrast vision sensitivity obligatory; however, apart from mesopic procedures no uniform regulations are available for methods and minimum requirements.

Objective: By comparing different mesopic and photopic contrast sensitivity tests this study analyzed whether these could be equivalently used and lead to the same results.

Material And Methods: Contrast vision sensitivity was determined in 150 subjects with emmetropia using five different methods, i.e. the mesopic test device Mesotest II as the reference method, Rodatest 302 and Optovist as photopic test devices and two photopic test charts (Vistech chart and Mars charts). The results of passing the tests were compared and Cohens κ was determined to quantify the conformity between the tests.

Results: Poor agreement was found between Mesotest II and Optovist as well as between Mesotest II and the Vistech chart. There was no agreement between Rodatest 302 or Mars charts and Mesotest II; nevertheless, the contrast vision sensitivity measured with Optovist, Rodatest 302 and the Vistech chart showed good correlation (0.46 ≤ r ≤ 0.69).

Conclusion: Apart from a few limitations, the reference method Mesotest II as well as Optovist and the Vistech chart are suitable for testing contrast vision sensitivity, whereas Rodatest 302 and Mars charts cannot be recommended based on the current criteria for minimum requirements. The minimum requirements must be urgently adapted and strict regulations for measurement must be formulated. In addition, due to the poor agreement between the methods an amendment of the driving licence regulations should be considered, which requires examination of both mesopic and photopic contrast vision or alternatively mesopic contrast vision alone.
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http://dx.doi.org/10.1007/s00347-016-0261-5DOI Listing
October 2016

Correlation between the results of three physical fitness tests (endurance, strength, speed) and the output measured during a bicycle ergometer test in a cohort of military servicemen.

Mil Med Res 2016 23;3:12. Epub 2016 Apr 23.

Otto von Guericke University Magdeburg, Medical Faculty, Department of Occupational Medicine, Magdeburg, Germany.

Background: Physical fitness tests are widely used to assess endurance, sprint ability, coordination and/or strength. The objective of the present study was to analyze the degree to which the results of the Bundeswehr Basis Fitness Test (BFT)--a physical fitness test comprising a sprint test (11 × 10-m shuttle test), a flexed-arm hang test and a 1000-m run--are consistent with the output measured during a bicycle ergometer test. The number of false-positive and false-negative results with regard to the assessment of physical fitness were also examined.

Methods: As part of a retrospective study, health assessments from 323 reenlistment examinations were evaluated regarding the output measured during a bicycle ergometer test and compared with the BFT results of the candidates.

Results: Overall, a good correlation was shown between the bicycle ergometer test results and the results achieved in the BFT disciplines. All three disciplines of the BFT showed a highly significant correlation with the relative output achieved during the bicycle ergometer test (P < 0.001), and also, the overall BFT score was highly significantly correlated (P < 0.001). The overall rate of false-positive and false-negative results was 4.0 %.

Conclusions: The BFT results measured in the three physical fitness test items were highly correlated with the output measured during the bicycle ergometer tests. The rate of false-positive and false-negative results was low. The test items thus represent an appropriate measurement instrument because the test items require few equipment and less time. Additionally, a large number of subjects can be assessed. We suggest that it would be more useful to assess the physical fitness of this special group exclusively on the basis of the BFT instead of using the bicycle ergometer test.
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http://dx.doi.org/10.1186/s40779-016-0083-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842291PMC
April 2016

Injuries caused during military duty and leisure sport activity.

Work 2016 Apr;54(1):121-6

Occupational Medicine, Faculty of Medicine, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany.

Background: Physical demands on soldiers in mission have increased in the past decades. Physical fitness training is included into duty schedules in most armies in order to achieve and maintain a high physical fitness level, but at the same time involving the risk of sport injuries and subsequent sick days.

Objective: Due to missing data concerning soldiers' sport injuries during duty and leisure time, epidemiology data is required for adequate prevention and therapy.

Methods: A prospective and descriptive epidemiology study has been conducted. All soldiers with sport injuries caused by duty sport (DS) or by sport during leisure time (LTS) were recorded over three years in a German Army tank brigade.

Results: 673 injuries during DS and 600 injuries during LTS were analysed. While on duty, most of the injuries occurred during soccer (35.2%) and long distance running (30.2%). Ankle joint (27.3%) and knee (24.1%) were most affected. Soldiers with injuries to knee, ankle joint, shoulder or hand were absent from duty for a longer period of time. Similar results were found during LTS: Soccer (66.0%) was the most frequent cause for injuries and ankle joint (22.8%) and knee (20.3%) were the most affected body parts.

Conclusions: Duty and leisure time sport mainly caused injuries to the lower limb. These injuries caused long absence from duty. Therefore, profound knowledge of physical examination, medical treatment and rehabilitation is necessary for the military physician in order to provide an adequate therapy.
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http://dx.doi.org/10.3233/WOR-162294DOI Listing
April 2016

Prevalence of Cardiac Arrhythmia Under Stress Conditions in Occupational Health Assessments of Young Military Servicemen and Servicewomen.

Mil Med 2016 Apr;181(4):369-72

Occupational Medicine, Faculty of Medicine, Otto-von-Guericke-University of Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany.

Objectives: In health assessments of young temporary-career volunteers who are up for re-enlistment, cardiac stress tests are mandatory to detect cardiac diseases and to confirm physical fitness. So far, there is no information available regarding the extent to which this time-consuming examination contributes to the diagnosis of pathological cardiac arrhythmia in this young, preselected patient collective.

Methods: In a retrospective data analysis, health assessments of 1919 temporary-career volunteers conducted between 2007 and 2012 were examined with regard to pathological findings provided by resting electrocardiograms (ECGs) and exercise ECGs.

Results: Only five subjects showed signs of heart disease during the resting ECG; none of the exercise ECGs revealed any abnormalities, even after further cardiological examinations.

Conclusions: In health assessments of young temporary-career volunteers, the exercise ECG as a mandatory examination should be replaced by the resting ECG. In addition to avoiding unnecessary examinations and associated risks, quite a large number of working years could be saved both for medical personnel and the persons examined.
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http://dx.doi.org/10.7205/MILMED-D-15-00121DOI Listing
April 2016

Reference values for time- and frequency-domain heart rate variability measures.

Heart Rhythm 2016 06 12;13(6):1309-16. Epub 2016 Feb 12.

Occupational Medicine, Faculty of Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany.

Background: The analysis of heart rate variability (HRV) has become an established procedure in recent decades. Because there are no appropriate reference values available, HRV findings can still only be compared within a group or in individuals in longitudinal studies.

Objective: The objectives of the present study were to examine a group of healthy subjects of different ages and sexes and to identify reference values for common HRV parameters.

Methods: Long-term 24-hour electrocardiograms of 695 voluntary subjects were recorded by using a 2-channel Holter system over a period of 24 hours during daily activities.

Results: Reference values for men and women in 10-year age groups were calculated for standard deviation of NN intervals, root mean square of successive differences of NN intervals, standard deviation of the average of all consecutive 5-minute NN intervals, percentage of consecutive NN intervals that deviate from one another by more than 50 ms, low-frequency power normalized unit, high-frequency power normalized unit, low frequency/high frequency ratio, SD1, and SD2. The 5th and 95th percentiles were given for each sex and for the age groups 20-30, 30-40, 40-50, and 50-60 years. We observed a consistent decrease in HRV measures with increasing age as well as a sex dependency of HRV findings.

Conclusion: We studied a large group of healthy subjects and identified reference values for commonly used HRV measures for 24-hour ECG measurements. The reference values differed considerably from the values published in 1996 in the Guidelines of the Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. In the future, steps should be taken to expand the database and define reference values for the age groups under 20 and over 60 years. It would be desirable to obtain reference values for short-term recordings (eg, 5-minute recordings) as well.
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http://dx.doi.org/10.1016/j.hrthm.2016.02.006DOI Listing
June 2016

[Options and limitations of heart rate measurement and analysis of heart rate variability by mobile devices: A systematic review].

Herzschrittmacherther Elektrophysiol 2016 Mar 10;27(1):38-45. Epub 2016 Feb 10.

Bereich Arbeitsmedizin der Medizinischen Fakultät der Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland.

Background: Heart rate (HR) and heart rate variability (HRV) have been established in the last few years as a non-invasive method for recording the demands on the cardiovascular system. The development enables us today to measure the interbeat intervals with different technologies for calculating HR and HRV.

Materials And Methods: This review is based on a systematic literature search in PubMed for validity of different measurement techniques and their pros and cons for the measurement of HR and the analysis of HRV.

Results: Measurement equipment for recording of interbeat intervals should have a high storage capacity and a sampling rate of 1000 Hz ideally. The quality criteria of freedom of feedback (small, little disruptive), robustness and a non-invasive measurement (e. g. freeze-electrodes or sensors) have to be fulfilled. In addition to the Holter ECG, several portable heart rate watch and chest belt systems provide adequate validity and good applicability.

Discussion: The Holter ECG is still the gold standard for the measurement of NN intervals and for the analysis of HRV. Modern heart rate watches show a good correlation with the conformance of freedom from discomfort, robustness and non-invasive measurement and are a good alternative due to the lower disturbance of test persons.
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http://dx.doi.org/10.1007/s00399-016-0419-5DOI Listing
March 2016

[Influence of post-traumatic stress disorder on heart rate variability as marker of the autonomic nervous system - a systematic review].

Fortschr Neurol Psychiatr 2015 Jan 20;83(1):30-7. Epub 2015 Jan 20.

Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg.

Introduction: PTSD is associated with comprehensive disruption of several neurobiological regulation mechanisms and with a disruption in the parasympathetic-sympathetic balance. This can be measured with the heart rate variability (HRV).

Methods: A systematic review in PubMed using the keywords "hrv" or "heart rate variability" and "PTSD" or "posttraumatic stress disorder" was performed.

Results: Overall 15 original studies were identified. In most cases a significant relationship of PTSD for reduction of HRV was demonstrated (9 studies) or, respectively, a reduction by trends was shown in 3 studies. Limitations were discussed.

Discussion: In spite of the limitations, most of the studies have shown a relationship between PTSD and HRV. However, an assessment of this potential marker as a supplement for clinical diagnosis and therapy follow-up in patients with PTSD seems to be premature on the basis of the data obtained so far. Further research is required.
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http://dx.doi.org/10.1055/s-0034-1398779DOI Listing
January 2015

[Analysis of heart rate variability. Mathematical description and practical application].

Herz 2015 Mar 10;40 Suppl 1:76-84. Epub 2014 Oct 10.

Bereich Arbeitsmedizin der Medizinischen Fakultät, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39190, Magdeburg, Deutschland,

The analysis of heart rate variability (HRV) has recently become established as a non-invasive measurement for estimation of demands on the cardiovascular system. The HRV reflects the interaction of the sympathetic and parasympathetic nervous systems and allows the influence of the autonomic nervous system on the regulation of the cardiovascular system to be mathematically described. This review explicates the analysis method of HRV for time, frequency and non-linear methods as well as the range of parameters and the demand on acquisition time. The necessity and possibilities of artefact correction and advice for the selection of a reasonable acquisition period are discussed and standard values for selected HRV parameters are presented.
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http://dx.doi.org/10.1007/s00059-014-4145-7DOI Listing
March 2015

[Prevalence of symptoms of posttraumatic stress disease in police officers in relation to job-specific requirements].

Psychother Psychosom Med Psychol 2014 Sep 26;64(9-10):393-6. Epub 2014 Sep 26.

Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg.

The professional activity of policemen is connected to psychological and physical stress. The aim of this study was to identify the work specific requirements and stress as well as to deter-mine the exact circumstances of the experience of traumatic events and their coping. Additionally the occurrence of potentially traumatising situations during operations and the prevalence of PTSD symptoms were investigated in detail using questionnaires. As traumatising events severe traffic accidents, use of firearms, but also non-specific operations resulting in death, e. g. the killing of a child, were listed by the policemen. The knowledge of the psychological stress and its sources as well as the analysis of the exact circumstances of traumatic events are helpful in preventing PTSDs more efficiently, e. g. by special trainings for coping with stress and conflicts, in faster identification and treatment using professional support.
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http://dx.doi.org/10.1055/s-0034-1387729DOI Listing
September 2014

[Risk factors for accidents during sports while serving in German armed forces].

Sportverletz Sportschaden 2012 Mar 29;26(1):45-8. Epub 2012 Feb 29.

Fachsanitätszentrum Augustdorf.

In the German Armed Forces sports activities should bring the benefits of good health and trained fitness which are the hallmarks of sportsmen. In order to achieve this aim it is important to avoid accidents which negate the benefit of sports. Until today there appear to be no studies in existence which demonstrate the risk factors of sports activities undertaken while in military service. Equivalent studies on civilian sport activities are scarcely comparable. To find out risk factors for accidents with any period of recovery we followed sports accidents while on duty in a German barracks with 4,300 soldiers over a two-year period. Additionally we asked about the time needed for recovery from each accident, parameters of lifestyle, the body mass index and the possibility of a nightshift before each accident. We examined a minimum of 410 accidents. We found associations between the accidents studied and particular risk factors, including doing sports more than two times a week, being active in a fitness or sports club, having the accident together with another sportsman and doing a nightshift before the day of the accident. Bad ground conditions contributed to a large number of accidents. A body mass index of 25 and higher had a significantly prolonged time for recovery. To avoid accidents, sport and ground conditions should be adapted to each other. In addition, overweight people are not only compromised for cardiovascular and neurological diseases but also have a higher risk of needing a prolonged time for recovery, thus it is important that overweight should be avoided and not only just be treated.
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http://dx.doi.org/10.1055/s-0031-1299107DOI Listing
March 2012

[Dynamic vision of sportsmen with different requirement profiles for the visual apparatus].

Klin Monbl Augenheilkd 2011 Dec 16;228(12):1103-7. Epub 2011 Aug 16.

Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg.

Aim Of Study: In particular, in the quick ball and racket games a good dynamic seeing is required . The afferent dynamic seeing occurs via the retiina which mediates the stimuli for efferent dynamic seeing . The aim of this study was to examine the dynamic visual acuity of sportsmen from sports with different demands on their dynamic seeing (DS).

Methods: 19 sports students took part in the study. 10 subjects participated in coached team sports (group I) and 9 remaining performed individual sports (group II). The DS was assessed by means of the Düsseldorfer test for dynamic seeing of Wist which was performed twice on one day.

Results: The DS of the two groups in the first study did not differ (right eye 95.7 ± 10.6 % in group I vs. 94.3 ± 6.9 % in group II and left eye 97.6 ± 4.8 % vs. 95.3 ± 5.6 %; p ≥ 0.05). Also the second study there was no different in DS for the two groups (right eye 98.3 ± 2.6 % vs. 93.8 ± 8.0 % and left eye 99.3 ± 1.2 % vs. 95.6 ± 7.0 %; p ≥ 0.05).

Discussion: Our hypothesis about a different DS in players of ball games compared with non-ball sport players could not be proved. It is to be critically noted that a generalization is not possible due to the small sample numbers. Because DS is a necessary precondition in ball games further studies should be concentrated on its trainability.
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http://dx.doi.org/10.1055/s-0031-1273401DOI Listing
December 2011

Early effects of long-term neurotoxic lead exposure in copper works employees.

J Toxicol 2011 29;2011:832519. Epub 2011 May 29.

Institute of Occupational Medicine, Otto-von-Guericke University, D-39120 Magdeburg, Germany.

The situation of exposure in a copper works facility in Germany enabled early lead-induced neurotoxic effects to be investigated in the workers. The aim of the investigation was to study the long-term effects of small doses of lead on psychometric/psychophysiological performance of workers. The study involved 70 male lead exposed workers and 27 male controls with no neurotoxic exposure. All test persons were subjected to the method of investigation involving performance data, physiological strain data, and the subjective state. It was found that of the psychometric performance parameters, only the mainly motor performance parameters had a potential for being neurotoxic early indicators. Preferably centrally influenced performance parameters were found to be less suitable early indicators. The lead-exposed subjects exhibited a slowed poststrain resetting behaviour of the vegetative nervous system, which correlated with the individual blood lead level. This was attributed to vagus depression, which had already started in the prevailing situation of exposure and was reflected by diminished cardiac phase duration variability. Our results indicate that it is necessary to more critically choose the lead level standards in the air on the working area. Heart rate variability may be affected even at small lead concentration.
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http://dx.doi.org/10.1155/2011/832519DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135313PMC
November 2011

[Color vision testing in patients with diabetes mellitus and arterial hypertension].

Ophthalmologe 2010 Oct;107(10):923-9

Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Deutschland.

Background: This study aimed to discover the influence of the chronic diseases diabetes mellitus and arterial hypertension on color vision.

Methods: The study included 96 voluntary participants age 19-65 years. They were divided into four groups. Group I consisted of patients with arterial hypertension; group II included those with both arterial hypertension and diabetes mellitus; those in group III had diabetes mellitus; and group IV consisted of healthy individuals.

Results: The duration of diabetes in group II correlated with the Rayleigh calculation. Those in group III showed significant differences when the maximum brightness setting (Moreland) and the minimum anomalous quotient (Raleigh) were used. The duration of diabetes had correlations at some parameters of the Rayleigh and Moreland calculation.

Conclusion: In conclusion, we are able to say that the all-color anomaloscope is useful for determining alterations in color vision in patients with diabetes mellitus.
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http://dx.doi.org/10.1007/s00347-010-2169-9DOI Listing
October 2010

[Sympatho-vagal balance and cardiac response to mental challenge].

Biomed Tech (Berl) 2009 Aug;54(4):197-203

Institut für Präventivmedizin, Universität Rostock, Rostock, Deutschland.

Background: Based on functional relations between the central autonomic network and cortical areas involved in motivational, attentional, affective, and executive function, autonomic regulation can mediate cognitive performance as well as cardiovascular and psychosomatic diseases. Our objective was to test the predictive value of resting heart rate variability (HRV), a measure of sympatho-vagal balance, with regard to the type and intensity of cardiovascular responses to mental challenge.

Materials And Methods: A total of 248 healthy subjects (85 females, aged 47.3+/-7.6 years; 163 males, aged 47.5+/-6.7 years) were included in the study. All participants underwent standardized psychometric testing (e.g., Stroop's color-word-conflict test).

Results: First, we found significant increases of heart rate and sympatho-vagal balance (low frequency/high frequency) and significant decreases of absolute LF- and HF-power in response to mental tasks. Second, there were significant differences in cardiovascular response to mental challenge when clustering our population on the basis of sympatho-vagal balance at rest.

Conclusions: We conclude that short-term recordings of HRV can provide health-related information of cardio-vascular response to mental challenge. However, there is no association between sympatho-vagal balance at rest and classical cardiovascular risk factors.
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http://dx.doi.org/10.1515/BMT.2009.023DOI Listing
August 2009