The Professorship of Biomechanics in Sport under the direction of Prof. Dr. Ansgar Schwirtz has acquired funds for a prestigious third-party project. With a total of 1.77 million euros, the German Ministry of the Interior, represented by the Innovative Committee of the "Joint National Committee" will be promoting the current study on "The value of the movement diagnostics for promoting early physical and sport activity in children with rheumatism" (BEWARE) from February 2019 until January 2023. Hereby, the Department of Biomechanics in Sport will be cooperating with their long-term partner of many years, the "German Center for Pediatric and Adolescent Rheumatology" (DZKJR) in Garmisch-Partenkirchen.
Childhood rheumatism: 1,500 children affected each year – Relieving postures following therapy
More than 1,500 children and young people fall ill from juvenile idiopathic arthritis (JIA) each year in Germany. As is the case for adult rheumatism, the illness expresses itself from the outset through inflamed joints with pain, swelling, a sense of warming and restrictions in movement. As a consequence, the children develop substantial impairments in the functionality of everyday life and in their quality of life. In this period, for example, many can only participate in sports to a very limited degree.
The therapy takes place in a multimodal manner and consists of a combination of medicinal and physiotherapeutic measures, as well as of individual sport programs. After the swelling of the joints has subsided, the phase of an inactive state of the illness begins. However, in about 60% of the patients functional deficits remain, like the persistence of habitual relieving postures – which, in the further life process¸ then leads to new problems and restrictions.
Individual sport consultation for the prevention of long-term functional restrictions
"We will be examining children with JIA in the research project using, among other things, a 3D-analysis and a motor skills test to provide us with an accurate profile of their movements during the therapy," describes Prof. Schwirtz. Based on this, an individual sport consultation will then be offered, the intent of which is to, among other things, help in the prevention of long-term functional restrictions and subsequent damage. "In this way, we want to demonstrate that the biomechanical movement analysis and the functional analysis can lead to a reduction in costs so that the health insurance companies themselves consider this to be worthwhile. In this way, future patients will be able to profit from a sport consultation," explains Professor Schwirtz.
"A great problem of the therapy is that malfunctions are frequently analyzed insufficiently involving everyday life movements in the classical clinical setting. Thus, uncertainty develops for the most suitable functional methods and the consultation which thereby results involving sport activity," says Dr. Josephine Merker. The scientific staff member at the Department of Biomechanics in Sport supports the implementation of the project at the DZKJR in Garmisch-Partenkirchen. "We are convinced that early sport activity during the therapy can help to avoid functional restrictions. In addition, we want to find out which patients develop functional restrictions and which methods are necessary to estimate of this," says Dr. Merker.
Investigation on 200 children and young people who have newly become ill
For the intervention, 200 children and juveniles who have newly become ill are followed-up for up to two years and thereby undergo three examinations. A 3D-analysis of the movements is made and the fitness and the motor abilities are examined. In addition, the quality of life at home is determined by means of a questionnaire during the hospital stay and through an app at home. The test subjects will be divided into two groups: One of which receives the detailed and individualized sport consultation, while the other group receives the standard recommendations used to date. After conclusion of the randomized, controlled study the results of both groups will then be compared.
Based on the information collected, and in cooperation with the local health insurance company (AOK), recommendations for the supply landscape will be formulated. A sport-consultation software will also be developed. Which sport activity is recommended for which symptoms and which functional diagnostics are necessary for the safe participation of the patient in sport? This information should be made available to physicians as close in time and as comprehensively as possible.
Post-doc position for four year
The project will be carried out by the Professorship Biomechanics in Sport, together with the DZKJR (Prof. Dr. Johannes-Peter Haas) in Garmisch-Partenkirchen, and supported also by the aQua Institute for the applied promotion of quality and research in the healthcare services. Furthermore, the project will in part be supported by the University Hospital of Basel (Prof. Ulrich Walker), the German Rheumatism Research Centre Berlin (Dr. Jens Klotsche, Prof. Kirsten Minden) and through the software development by Soliance GmbH. In addition, the German Children Rheumatism Foundation is a cooperative partner for this project. From the total sum for the project approximately €600,000 will be invested at the Department of Biomechanics in Sport, from which, among other things, a post-doc position for four years will be financed. Approximately 1 million euros will go from the TUM to the DZKJR in Garmisch-Partenkirchen for the equipment of the movement laboratory with current measuring techniques as well as for the staff who execute the investigations on the patients.
"BEWARE incorporates the two substantial pillars of our faculty, i.e. sport and health. We will concretely anchor prevention into everyday life," says Prof. Schwirtz.
To the Homepage of the German Center for Pediatric and Adolescent Rheumatology
Prof. Dr. Ansgar Schwirtz
Department of Biomechanics in Sport
Telephone: 089 289 24580
Dr. Josephine Merker
Department of Biomechanics in Sport
Telephone: 089 289 24648
Text: Dr. Fabian Kautz
Photos: DZKJR/Matthias Hartmann, TUM/Josephine Merker