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Steffen K, Bahr R, Clarsen B, Fossan B, Fredriksen H, Gjelsvik H, Haugvad L, Hoksrud AF, Iversen E, Koivisto-Mørk A, Moen E, Røstad V, Reier-Nilsen T, Torgalsen T, Berge HM. Comprehensive periodic health evaluations of 454 Norwegian Paralympic and Olympic athletes over 8 years: what did we learn? Br J Sports Med 2024; 58:826-835. [PMID: 38744502 PMCID: PMC11287577 DOI: 10.1136/bjsports-2023-107942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE A periodic health evaluation (PHE) is a comprehensive and multidisciplinary investigation of athlete health widely used in elite sport, but its contents and benefits can be questioned. This study aimed to determine the prevalence of conditions identified by a PHE among Paralympic and Olympic athletes over four consecutive Games cycles from Rio de Janeiro 2016 to Beijing 2022 and to assess the benefits and potential pitfalls of a comprehensive PHE programme in detecting existing injuries, illnesses and other health issues. METHODS We collected extensive health history and clinical examination data on elite athletes: medical history, ECG, blood pressure, blood samples, spirometry, musculoskeletal health, cognitive function, mental health and compliance with public health programmes. RESULTS The final cohort included 87 Paralympic and 367 Olympic athletes, representing 565 PHE cycles. Musculoskeletal problems and unspecified pain, infections and allergies were the most frequent health issues. High blood pressure was the most prevalent cardiovascular finding, and vitamin D deficiency the most common laboratory abnormality. Most athletes complied with the public childhood vaccination programmes, but fewer with recommended cancer screening. Follow-up of health issues was variable. CONCLUSION Our PHE programme identified musculoskeletal problems, infections, allergies, elevated blood pressure and vitamin D deficiency as common health conditions. Longitudinal follow-up of health conditions identified during screening and improved compliance with public health and cancer screening programmes is needed to determine the true benefits of athlete care prompted by the PHE.
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Affiliation(s)
- Kathrin Steffen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
- Oslo Sports Trauma Research Center, Insitute of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Roald Bahr
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
- Oslo Sports Trauma Research Center, Insitute of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Benjamin Clarsen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
- Oslo Sports Trauma Research Center, Insitute of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Bjørn Fossan
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | - Hilde Fredriksen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | - Hilde Gjelsvik
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | - Lars Haugvad
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | | | - Erik Iversen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | | | - Ellen Moen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | - Vibeke Røstad
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | | | - Thomas Torgalsen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | - Hilde Moseby Berge
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
- Oslo Sports Trauma Research Center, Insitute of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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Pentikäinen H, Toivo K, Kokko S, Alanko L, Heinonen OJ, Nylander T, Selänne H, Vasankari T, Kujala UM, Villberg J, Parkkari J, Savonen K. Resting Electrocardiogram and Blood Pressure in Young Athletes and Non-Athletes: A 4-year follow-up. Clin Physiol Funct Imaging 2022; 42:200-207. [PMID: 35180329 DOI: 10.1111/cpf.12747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
A follow-up data on electrocardiogram (ECG) and blood pressure (BP) changes in adolescent athletes are scarce. We compared ECG and BP between adolescent athletes and non-athletes in a 4-year follow-up. A total of 154 youth sports clubs (SC) in Finland and 100 secondary schools for comparison data participated in this observational follow-up study. Those who maintained or adopted SC participation are referred to as "Always athletes" (n=137), those who never participated in SC as "Never athletes" (n=108) and those who dropped out of SC during the follow-up as "Changers" (n=116). The mean age of the participants was 15.5 (0.6) years in all study groups at baseline. Resting ECG including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis and QT interval and BP were measured from all participants at baseline and after follow-up. "Always athletes" had lower resting heart rate, more negative T-wave axis and higher QRS amplitude than "Never athletes" at baseline and at 4-years (P < 0.05). "Changers" had lower resting heart rate, more negative T-wave axis and higher QRS amplitude, systolic BP and pulse pressure than "Never athletes" at baseline (P < 0.05). None of the observed differences at baseline, were visible at 4-years (P > 0.05) except the difference in T-wave axis (P = 0.028). The significant group x time interaction between "Changers" and "Never athletes" was found for QRS amplitude (P = 0.017). Adolescent athletes have several training-induced cardiovascular adaptations, which return towards the levels of non-athletes after cessation of regular training. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Heikki Pentikäinen
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FI-70100, Kuopio, Finland
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lauri Alanko
- Clinic for Sports and Exercise Medicine, University of Helsinki, Helsinki, Finland.,Department of Sports and Exercise Medicine, Central Finland Central Hospital, Jyvaskyla, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Tiina Nylander
- Department of Sports and Exercise Clinic, Oulu Deaconess Institute Foundation, Oulu, Finland
| | | | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FI-70100, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
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Miroshnikov AB, Sergeeva KV, Formenov AD, Smolensky AV. [The role of interval training in the physical rehabilitation of strength sports athletes with hypertension: a randomized controlled study]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2020; 97:5-10. [PMID: 33307657 DOI: 10.17116/kurort2020970615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate the effect of high-intensity interval aerobic work on blood pressure and body composition in strength sports athletes of heavy weight categories. MATERIAL AND METHODS The examination and physical rehabilitation of 55 strength sports athletes of heavy weight categories with arterial hypertension were performed. Athletes were randomized into two groups: the main group (n=35) and the control group (n=20). The main group athletes trained 120 days (3 times a week) on a bicycle ergometer according to the high-intensity interval protocol, and the control group participants trained 120 days (3 times a week) according to their traditional strenght protocol. All athletes underwent a complex examination, including: a survey, examination, three-time measurement of blood pressure, bioelectrical impedance analysis and calculations of body composition indices, Before and after the physical rehabilitation. RESULTS After 120 days of physical rehabilitation, there was an improvement in body composition and a significant decrease in blood pressure: systolic blood pressure by 4.7%, diastolic blood pressure by 5.6%. CONCLUSIONS High-intensity aerobic interval work, regardless of the athlete's body composition, has a therapeutic and prophylactic effect on the cardiovascular system. The aerobic workout training protocol taking into account metabolic variables, that we developed, will allow athletes to effectively and safely influence the prevention and treatment of hypertension.
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Affiliation(s)
- A B Miroshnikov
- Russian state university of physical education, sport, youth and tourism, Moscow, Russia
| | - K V Sergeeva
- Russian state university of physical education, sport, youth and tourism, Moscow, Russia
| | - A D Formenov
- Russian state university of physical education, sport, youth and tourism, Moscow, Russia
| | - A V Smolensky
- Russian state university of physical education, sport, youth and tourism, Moscow, Russia
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Description and Comparison of Preseason and Postseason Blood Pressure Measures Among Collegiate Athletes: A Prospective Observational Study. Cardiopulm Phys Ther J 2019. [DOI: 10.1097/cpt.0000000000000085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Berge HM, Andersen TE, Bahr R. Cardiovascular incidents in male professional football players with negative preparticipation cardiac screening results: an 8-year follow-up. Br J Sports Med 2018; 53:1279-1284. [PMID: 30442719 DOI: 10.1136/bjsports-2018-099845] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Preparticipation cardiac screening of athletes aims to detect cardiovascular disease at an early stage to prevent sudden cardiac arrests and deaths. Few studies have described the cardiovascular outcomes in athletes classified as negative on screening. OBJECTIVE To identify cardiovascular incidents in a cohort of male professional football players who were cleared to play after a negative screening result. METHODS This is a retrospective 8-year follow-up study of 595 professional male football players in Norway who underwent preparticipation cardiac screening by experienced cardiologists, including electrocardiography (ECG) and echocardiography, in 2008. We performed a media search to identify sudden cardiovascular incidents between January 2008 and February 2016. Incidents were cross-checked with medical records. RESULTS Six of the 595 players (1%), all classified as negative on cardiac screening, experienced severe cardiovascular incidents during follow-up. Retrospective review revealed abnormal ECG findings in one case, not recognised at the time of screening. Three players suffered a sudden cardiac arrest (all resuscitated successfully), one a myocardial infarction, one a transient ischaemic attack and one atrial flutter. Three of the players ignored chest pain, paresis, dyspnoea or near-syncope, two completed a match with symptoms before seeking medical assistance, one player's symptoms were misinterpreted and received inappropriate treatment initially, and two players were discharged from hospital without proper follow-up, despite having serious cardiovascular symptoms. CONCLUSIONS A comprehensive preparticipation cardiac screening did not identify a subset of 6 of 595 players who experienced subsequent cardiovascular incidents as being at risk. It is important to remind athletes that a normal cardiac screening exam does not protect against all cardiac diseases. Timely reporting of symptoms is essential.
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Affiliation(s)
- Hilde Moseby Berge
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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von Lueder TG, Hodt A, Gjerdalen GF, Steine K. Left ventricular biomechanics in professional football players. Scand J Med Sci Sports 2017; 28:187-195. [PMID: 28378431 DOI: 10.1111/sms.12893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2017] [Indexed: 10/19/2022]
Abstract
Chronic exercise induces adaptive changes of left ventricular (LV) ejection and filling capacities which may be detected by novel speckle-tracking echocardiography (STE) and tissue Doppler imaging (TDI)-based techniques. A total of 103 consecutive male elite Norwegian soccer players and 46 age-matched healthy controls underwent echocardiography at rest. STE was used to assess LV torsional mechanics and LV systolic longitudinal strain (LS). Diastolic function was evaluated by trans-mitral blood flow, mitral annular velocities by TDI, and LV inflow propagation velocity by color M-mode. Despite similar global LS, players displayed lower basal wall and higher apical wall LS values vs controls, resulting in an incremental base-to-apex gradient of LS. Color M-mode and TDI-derived data were similar in both groups. Peak systolic twist rate (TWR) was significantly lower in players (86.4±2.8 vs controls 101.9±5.2 deg/s, P<.01). Diastolic untwisting rate (UTWR) was higher in players (-124.5±4.2 vs -106.9±6.7 deg/s) and peaked earlier during the cardiac cycle (112.7±0.8 vs 117.4±2.4% of systole duration, both P<.05). Untwisting/twisting ratio (-1.48±0.05 vs -1.11±0.08; P<.001) and untwisting performance (=UTR/TW; -9.25±0.34 vs -7.38±0.40 s-1 , P<.01) were increased in players. Augmented diastolic wall strain (DWS), a novel measure of LV compliance in players, was associated with improved myocardial mechanical efficiency. The described myocardial biomechanics may underlie augmented exertional cardiac function in athletes and may have a potential role to characterize athlete's heart by itself or to distinguish it from hypertensive or hypertrophic cardiomyopathy.
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Affiliation(s)
- T G von Lueder
- Department of Cardiology, Akershus University Hospital, Lørenskog/Oslo, Norway.,Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - A Hodt
- Center for Heart Failure Research, University of Oslo, Oslo, Norway.,Section of Vascular Investigations, Oslo University Hospital Aker, Oslo, Norway
| | - G F Gjerdalen
- Section of Vascular Investigations, Oslo University Hospital Aker, Oslo, Norway
| | - K Steine
- Department of Cardiology, Akershus University Hospital, Lørenskog/Oslo, Norway.,Center for Heart Failure Research, University of Oslo, Oslo, Norway
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Abstract
Hypertension continues to be the most common cardiovascular disorder in the USA and worldwide. While generally considered a disorder of aging individuals, hypertension is more prevalent in athletes and the active population than is generally appreciated. The timely detection, diagnosis, and appropriate treatment of hypertension in athletes must focus on both adequately managing the disorder and ensuring safe participation in sport while not compromising exercise capacity. This publication focuses on appropriately diagnosing hypertension, treating hypertension in the athletic population, and suggesting follow-up and participation guidelines for athletes.
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Affiliation(s)
- Kevin T Schleich
- Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.,Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
| | - M Kyle Smoot
- Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, KY, USA
| | - Michael E Ernst
- Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA. .,Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa City, IA, USA.
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The impact of elevated blood pressure on exercise capacity in elite athletes. Int J Cardiol 2015; 180:171-7. [DOI: 10.1016/j.ijcard.2014.11.125] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 11/18/2014] [Accepted: 11/22/2014] [Indexed: 11/22/2022]
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9
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Berge HM, Isern CB, Berge E. Blood pressure and hypertension in athletes: a systematic review. Br J Sports Med 2015; 49:716-23. [DOI: 10.1136/bjsports-2014-093976] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2014] [Indexed: 12/18/2022]
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10
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Berge HM, Gjesdal K, Andersen TE, Solberg EE, Steine K. Prevalence of abnormal ECGs in male soccer players decreases with the Seattle criteria, but is still high. Scand J Med Sci Sports 2014; 25:501-8. [DOI: 10.1111/sms.12274] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2014] [Indexed: 01/21/2023]
Affiliation(s)
- H. M. Berge
- Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - K. Gjesdal
- Cardiology Department; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - T. E. Andersen
- Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - E. E. Solberg
- Department of Internal Medicine; Diakonhjemmet Hospital; Oslo Norway
| | - K. Steine
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
- Cardiology Department; Akershus University Hospital; Lørenskog Norway
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Heron N, Cupples M. The health profile of football/soccer players in Northern Ireland - a review of the uefa pre-participation medical screening procedure. BMC Sports Sci Med Rehabil 2014; 6:5. [PMID: 24521343 PMCID: PMC4021641 DOI: 10.1186/2052-1847-6-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 02/10/2014] [Indexed: 01/16/2023]
Abstract
Background It is compulsory that domestic football/soccer teams in UEFA competitions organise players’ pre-participation medicals. Although screening guidelines have been established, these remain controversial. The findings of medical examinations can have lasting consequences for athletes and doctors. No previous studies have reported UEFA pre-participation screening results in semi-professional footballers. This study aims to further knowledge regarding ‘normal’ data in this population. Method Retrospective audit and analysis of records of pre-season medicals for all male first-team players at one semi-professional Northern Ireland Premiership team between 2009-2012. Medicals were conducted by the club doctor following the UEFA proforma. Height, weight, blood pressure (BP), full blood count (FBC), dipstick urinalysis and resting electrocardiogram (ECG) were conducted by an independent nurse. Only one ECG must be documented during a player’s career; other tests are repeated yearly. Results 89 medicals from 47 players (6 goalkeepers, 11 defenders, 22 midfielders and 8 attackers; mean age 25.0 years (SD 4.86)) were reviewed. Mean height of the players was 179.3 cm (SD 5.90) with a mean weight of 77.6 kg (SD 10.5). Of 89 urine dipsticks, 7 were positive for protein; all 7 were normal on repeat testing following 48 hours of rest. Of 40 ECGs (mean ventricular rate 61.2 bpm (SD 11.6)), one was referred to cardiology (right bundle branch block; prolonged Q-T interval). No players were excluded from participation. Conclusions This study provides important information about ‘normal’ values in a population of semi-professional footballers. Urinalysis showing protein is not uncommon but is likely to be normal on repeat testing.
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Affiliation(s)
- Neil Heron
- Department of General Practice and Primary Care, Queen's University, Belfast, Irelan.
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