Cathedra of medical physical culture, sports

medicine and valeology

Lecture 1:

Theme: “Sports medicine. Medical

control. The methods of sportsmen
investigation. An Estimation of Physical
Development ”
Nekhanevich Oleg Borisovich
The health factors:

Incident 5%
medicine
5-10%

ekology
15% modus vitae

55-60%

genetic 15%
 Types of motor activity of the human

INSUFFICIENT hypokinesia decrease vital processes,

(hypodynamia) early aging of the body.

MINIMAL Don’t increase the

(1 time a week) healthy status

The range of the man’s

OPTIMAL Increase the man’s adaptation reactions
(4-6 times a week for
30-45 min.)
reserve abilities and risk factors
tolerant increase.

Prepathological changes
EXCESSIVE All systems overfatigue and pathological states
and overexertion are developing.
KINDS OF PHYSICAL TRAININGS:

• Professional sport

• Physical culture

• Physical therapy
 SPORTS MEDICINE -
is a clinical discipline, which studies
positive and negative influence of physical
loads of different intensity (from hypo- up
to hyperdinamy) on the body of a healthy
and sick person.
The purpose:

 optimisation of motor activity of the man

for improvement and strengthening of
health, increase of a functional condition
level, growth of sports achievement, and
also preventive maintenance and
treatment of diseases.
 The basic tasks:

1. Improvement and development of new methods in

definition of functional state and condition of the man’s
health.
2. Development of rational methods of physical and
intellectual work capacity restoration the man.
3. Diagnostics of health deviations, which arise at
inadequate improving or sports training and their
treatment.
4. Study of structure and features of diseases and injuries at
the persons, who are engaged in physical culture and
sports.
5. Development the preventive means of maintenance
prepathological conditions and pathological changes,
which arise at irrational occupation of physical culture
Cardiovascular Response to Acute Exercise

 Heart
. rate (HR), stroke volume (SV), and cardiac output
(Q) increase.
 Blood flow and blood pressure change.
 All result in allowing the body to meet the increased
demands placed on it efficiently.
HEART RATE AND INTENSITY
Steady-State Heart Rate

 Heart rate plateau reached during constant rate of

submaximal work
 Optimal heart rate for meeting circulatory demands at that
rate of work
 The lower the steady-state heart rate, the more efficient
the heart
Stroke Volume

 Determinant of cardiorespiratory endurance capacity at

maximal rates of work
 May increase with increasing rates of work up to
intensities of 40% to 60% of max
 May continue to increase up through maximal exercise
intensity, generally in highly trained athletes
 Depends on position of body during exercise
STROKE VOLUME
Stroke Volume Increases During Exercise

 Frank Starling mechanism—more blood in the ventricle

causes it to stretch more and contract with more force.
 Increased ventricular contractility (without end-diastolic
volume increases).
 Decreased total peripheral resistance due to increased
vasodilation of blood vessels to active muscles.
Cardiac Output

 Resting value is approximately 5.0 L/min.

 Increases directly with increasing exercise intensity to
between 20 to 40 L/min.
The magnitude of increase varies with body size and
endurance conditioning.
 When exercise. intensity exceeds 40% to 60%, further
increases in Q are more a result of increases in HR than
SV since SV tends to plateau at higher work rates.
CARDIAC OUTPUT
Changes in Heart Rate, Stroke
Volume, and Cardiac Output

Heart rate Stroke volume Cardiac output

Activity (beats/min) (ml/beat) (L/min)

Resting (supine) 55 95 5.2

Resting (standing 60 70 4.2
and sitting)
Running 190 130 24.7
Cycling 185 120 22.2
Swimming 170 135 22.9
Blood Pressure

Cardiovascular Endurance Exercise

 Systolic BP increases in direct proportion to increased
exercise intensity
 Diastolic BP changes little if any during endurance
exercise, regardless of intensity
Resistance Exercise
 Exaggerates BP responses to as high as 280/150 mmHg
 Some BP increases are attributed to the Valsalva
maneuver
 THE COMPLEX MEDICAL EXAMINATION

Common and sports anamnesis

Investigation of organs and systems under the

standard method of medical survey, including the
laboratory and instrumental tests (common
urinalysis, common analysis of blood ECG, X-ray
and other)
Investigation and estimation of physical
development and functional condition

Estimation of health condition

Pass to training

Recommendations
 The 12-element AHA recommendations for preparticipation
screening of athletes

Exertional chest pain/discomfort

1. Personal history Unexplained syncope
Unexplained dyspnoea/fatigue with
exercises
Prior recognition of heart murmur
Eleveted systemic blood pressure

Premature death (sudden and unexpected)

before age 50 years due to heart diseases.
2. Family history Disability from heart diseases in a close
relative
Specific conditions in family: HCP, long-QT
syndrome, other channelopathies, Marfan`s
syndrome, impotent arrhythmias
 The 12-element AHA recommendations for preparticipation
screening of athletes

Heart murmur
3. Physical Femoral pulses to exclude aortic
examination coarctation
Physical stigma of Marfan`s syndrome
Brachial artery blood pressure
KINDS OF THE COMPLEX MEDICAL
EXAMINATION

PRIMARY

CURRENT

ADDITIONAL
 Physiological deviations the cardiovascular
system in persons who are training

1. Sinus bradycardia (bradyarrhytmia) - is defined as

heart rate of < 60 beats per minute. It’s caused by
vagus tone increased and called “economisation
phenomenon” of the cardiac functions.
2. Physiological hypotension – is defined as SBP < 100
mmHg and DBP < 60 mmHg. It’s caused by
parasympathicotonia and is not accompanied by any
complaints and pathological changes in the organism.
3. Moderate (physiological) - hypertrophy of the
myocardium with tonogenic dilatation his chambers
and adequate the capillary net development.

4. The auscultative findings:

-the systolic functional murmurs;
-reduplication the first heart sound is caused by
asynchronous work of right and left chambers of the
heart;
-decrease intensity of the heart sounds is caused by
deep development of the chest muscles in athletes.
 PHYSICAL DEVELOPMENT – the complex of morphological and
functional properties of body, which depend on ontogenetic and
genetics factors of human

METHODS OF PD INVESTIGATION:
PD INDEXES:
The fat development
The muscles development
The chest shape
1. Inqury The back shape
(somatoscopy) The legs and feet shapes
The constitution type.
2. Anthropometry
(somatometry) Height, weight, circumference of the chest,
VC, dynamometry and other.

Methods of PD evaluation:
1. The standard's method
2. The anthropometric profile
3. The indexes method
4. Correlation method and others.
 «Non progredi est regredi»

Thank you for attention