Problem: Pulley-lesions of the fingers are typical injuries in climbing sports. In general, a rupture of the A2-pulley is found, without significant medical impact. Complex pulley-lesions may be devastating for a high-level career in sports climbing. Standard MRI in stretched finger position is not able to evaluate the A3- pulley, which is crucial for graduation of complex pulley lesions. Methods: We introduce stress MRI in a flexed finger position. This allows quantification of the distance between the palmar plate and the deep flexor tendon (A3-distance). Results: According to our data following MRI-examinations of 24 high-level sports climbers an A3-distance of 4 mm or more indicates rupture. An A3- distance up to 1 mm seems to be normal in high-level sports climber. However, due to the small sample number we did not find a clear cut-off point between strain and rupture. Discussion: The rather small and elastic A3-pulley defines the complexity of pulley-lesions. Conservative treatment is preferable if there is still continuity of the A3-pulley. Beside diagnostic imaging, Stress MRI of the fingers give some functional information about an inured A3-pulley in addition. Conclusion: Stress MRI of the fingers is an easy to perform tool for evaluation of the A3-pulley in every MRI-scanner available.

Background : Active commuting is a practical way to increase Physical Activity (PA). E-cycling elicits Moderate-To-Vigorous Intensity PA (MVPA) with experimental health benefits. Less is known about real-life commuter e-cycling impact on changes in MVPA, total sedentary time (SED-time), fitness and perceived health.

Methods : 33 subjects (min-max: 27-70 years) imminently starting commuter e-cycling were monitored for 3 to 5 months. Declarative measurements in MVPA and SED-time were analyzed by multilevel modeling. Fitness (stress test and adiposity), SF12-v2 and EMAPS scores were pre-post compared.

Results : High and stable adherence to commuter e-cycling averaged 84% (95%CI, 75-91). Mean MVPA increased and plateaued after e-cycling onset, reaching 56.7 MET-h/week (95%CI 49.9-64.3) (+21 MET-h/week over baseline). Larger increases were associated with age and e-cycling volume. High SED-time persisted over time, averaging 8.6 hours/day (95%CI, 8.1-9.) though decreasing for older and initially most sedentary subjects. Cardiorespiratory fitness improved (+0.48 METs, p=0.001) as well as effort perception, heart-rate response, waist-to-height ratio and SF12-v2 Mental Score.

Conclusions : New commuter e-cyclists experience a major increase in MVPA and a persistent high sedentary behavior, associated with benefits in fitness, adiposity and perceived mental health. Results from this pilot study need to be confirmed in larger cohorts overtime.