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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