International SportMed Journal - Volume 3, Issue 1, 2002
Volume 3, Issue 1, 2002
Source: International SportMed Journal 3, pp 1 –5 (2002)More Less
Endogenous fat stores provide fuel for exercise, and training enhances the muscle's capacity to oxidise these stores. Increasing fat utilisation during exercise can spare muscle glycogen use and thus enhance endurance and performance. A 1-3-day high-fat, low-carbohydrate diet impairs performance because it depletes muscle glycogen stores without significantly changing fat utilisation. Athletes who undertake such a diet for longer periods (as little as 5-6 days) adapt by increasing fat oxidation during exercise. In this fat-adapted, carbohydrate-restored condition, prolonged exercise can be undertaken with greater fat utilisation and sparing of muscle glycogen use. Despite marked changes in fuel metabolism during submaximal exercise, fat adaptation does not clearly enhance athletic performance. It appears that glycogen sparing is not important for events lasting 2-3 hours when the athlete is able to consume carbohydrate before and during the event. Ultra-endurance athletes might benefit from a combination of fat adaptation and carbohydrate intake for events lasting <4 hours, but there appears to be an individual response to this practice.
Source: International SportMed Journal 3, pp 1 –11 (2002)More Less
Myocardial contusion (MC) represents blunt cardiac injury (BCI) in which there is no gross anatomical disruption in the heart (including papillary muscles, chordae tendinae, and valves) or its covering. The cardiac damage results from the compression of the heart between the sternum and spine or from increased intrathoracic pressure from a blow to the chest. Myocardial concussion is distinguished from MC by its lack of myocardial-cell damage, both pathologically and chemically. Athletes have the potential to sustain MC, therefore adequate protective devices cannot be overemphasised. The exact prevalence of MC among athletes is not known. Diagnosis remains elusive, and no single objective test accurately predicts who will develop morbidity and mortality.
Electrocardiography, biochemical cardiac markers, echocardiography, and other imaging techniques have been used in the management of suspected MC. Both early and late complications must be sought. Monitoring in the acute phase and subsequent follow-up must be suggested for all athletes with MC.
Author James A. StoneSource: International SportMed Journal 3, pp 1 –25 (2002)More Less
Cardiac rehabilitation programmes have been proven to be effective in improving the prognosis for patients with cardiac disease. They are individually tailored and designed to enhance and maintain cardiovascular health by optimising patients' physical, psychological, social, vocational, and emotional status. This process includes facilitating and delivering secondary prevention through heart hazard identification and modification in an effort to prevent disease progression and the recurrence of cardiac events. Programmes that methodically target and treat patients to clinically validated heart hazard treatment targets are successful in reducing the likelihood of recurrent events. Cardiac rehabilitation programmes employ risk stratification protocols to identify patients at low to moderate, high, or very high risk of exercise-related events and those at risk for long-term progression of atherosclerosis. The fully integrated, holistic approach to all aspects of cardiovascular care that can affect, both positively and negatively, a patient's prognosis is what distinguishes cardiac rehabilitation programmes from the usual care model.
Author Joep PerkSource: International SportMed Journal 3, pp 1 –10 (2002)More Less
Over the past decade the scientific relevance of multi-causal management of coronary artery disease (CAD), which is the major cause of premature death in Western society, has become more evident. Modifying behaviour and lifestyle has become a key element in prevention and rehabilitation; e.g. increasing physical activity, quitting smoking, and changing one's diet favourably affect the course of the disease and might even contribute to the regression of arteriosclerosis if combined with drug treatment. Stress management and psychosocial support can improve quality of life and contribute to a timely return to work. These efforts demand a comprehensive program in which cardiologists, cardiac nurses, physiotherapists, dieticians, and psychologists cooperate. Larger groups of elderly patients need to benefit from such a program, as well as patients with mild to moderate congestive heart failure. In this review, the value of different care options is highlighted in order to contribute to a wider use of lifestyle modification in treating CAD patients.