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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:
medicine
5-10%
ekology
15%
Incident 5%
modus vitae
55-60%
genetic 15%
Types of motor activity of the human
INSUFFICIENT
hypokinesia
(hypodynamia)
MINIMAL
Don’t increase the
healthy status
(1 time a week)
OPTIMAL
(4-6 times a week for
30-45 min.)
EXCESSIVE
Increase the man’s
reserve abilities
All systems overfatigue
and overexertion
decrease vital processes,
early aging of the body.
The range of the man’s
adaptation reactions
and risk factors
tolerant increase.
Prepathological changes
and pathological states
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 and
sports.
Cardiovascular Response to Acute Exercise
w Heart
rate (HR), stroke volume (SV), and cardiac output
.
(Q) increase.
w Blood flow and blood pressure change.
w All result in allowing the body to meet the increased
demands placed on it efficiently.
HEART RATE AND INTENSITY
Steady-State Heart Rate
w Heart rate plateau reached during constant rate of
submaximal work
w Optimal heart rate for meeting circulatory demands at that
rate of work
w The lower the steady-state heart rate, the more efficient
the heart
Stroke Volume
w Determinant of cardiorespiratory endurance capacity at
maximal rates of work
w May increase with increasing rates of work up to
intensities of 40% to 60% of max
w May continue to increase up through maximal exercise
intensity, generally in highly trained athletes
w Depends on position of body during exercise
STROKE VOLUME
Stroke Volume Increases During Exercise
w Frank Starling mechanism—more blood in the ventricle
causes it to stretch more and contract with more force.
w Increased ventricular contractility (without end-diastolic
volume increases).
w Decreased total peripheral resistance due to increased
vasodilation of blood vessels to active muscles.
Cardiac Output
w Resting value is approximately 5.0 L/min.
w Increases directly with increasing exercise intensity to
between 20 to 40 L/min.
wThe magnitude of increase varies with body size and
endurance conditioning.
w 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
Activity
Heart rate Stroke volume
(beats/min)
(ml/beat)
Cardiac output
(L/min)
Resting (supine)
55
95
5.2
Resting (standing
and sitting)
60
70
4.2
Running
190
130
24.7
Cycling
185
120
22.2
Swimming
170
135
22.9
Blood Pressure
Cardiovascular Endurance Exercise
w Systolic BP increases in direct proportion to increased
exercise intensity
w Diastolic BP changes little if any during endurance
exercise, regardless of intensity
Resistance Exercise
w Exaggerates BP responses to as high as 280/150 mmHg
w 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
1. Personal history
2. Family history
Exertional chest pain/discomfort
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.
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
3. Physical
examination
Heart murmur
Femoral pulses to exclude aortic
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:
1. Inqury
(somatoscopy)
2. Anthropometry
(somatometry)
PD INDEXES:
The fat development
The muscles development
The chest shape
The back shape
The legs and feet shapes
The constitution type.
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