ECSS Paris 2023: CP-MH02
INTRODUCTION: Undertaking aerobic exercise training to meet World Health Organisation guidelines is associated with positive cardiovascular benefits. There is however, evidence suggesting that very high volumes of endurance exercise training may be associated with adverse cardiac remodelling and increased prevalence of arrhythmia (including atrial fibrillation [AF]). Quantifying the burden of arrhythmia and its association with lifetime training exposure and cardiac remodelling in highly trained ultra-endurance athletes was the focus of the present study. METHODS: 20 male (age 48 ± 10 years) and 15 female (age 47 ± 12 years) asymptomatic, healthy ultrarunners who secured a place at the 2022 Western States endurance race or were attending the pre-race training camp (California, USA), were recruited. A continuous electrocardiogram (ECG) monitor was worn for one week prior to the race/training camp providing incidence of premature atrial contractions (PACs), premature ventricular contractions (PVCs) and number of episodes of AF. A questionnaire captured lifetime training volume (MET-hr) and lifetime running miles. A full transthoracic echocardiogram was undertaken 24-48 hours before the race/training run. LV structure was defined by LV mass (LVM), end diastolic volume (EDV) and mean wall thickness (MWT) whilst function was determined by ejection fraction (EF) and global longitudinal strain (GLS). Left atrial (LA) structured was defined by LA volume (LAV). Pearsons correlation determined the association between arrhythmia burden and (1) cardiac structure and function, and (2) training exposure. RESULTS: There was a 0.6 ± 0.8 (0-3.4%) and 0.7 ± 0.7 (0-2.6%) PAC and PVC burden, respectively. There were no episodes of AF. A weak but significant correlation was apparent between PVC burden and LVEDV (r= 0.376; P=0.044). There were no significant associations between arrhythmia burden and indices of cardiac structure and function. There were significant correlations for PAC burden (%) with lifetime training volume (MET-hr) (r=0.506 P=0.005), and lifetime running miles (r=0.367 P=0.046). PVC burden did not significantly correlate with measures of lifetime training exposure. CONCLUSION: In a unique cohort of asymptomatic ultra-endurance athletes with significant lifetime endurance training exposure, we observed a relatively low overall arrhythmic burden and lack of AF. We observed an association between PVC burden and LV size suggesting some level of linkage between cardiac remodelling and ventricular arrhythmia burden that requires further evaluation. The association between atrial arrhythmia burden and measures of lifetime exercise exposure maybe a pre-cursor to the development of AF that could be a focus of future clinical evaluation.
Read CV OBIPISEIBIMA PRISCILLIA AGGOKABOECSS Paris 2023: CP-MH02
INTRODUCTION: The anterior cruciate ligament (ACL) reconstruction using the Semitendinosus (ST) tendon is a common surgery. This surgery is called the ST method. It has been reported that 2 to 4 years after harvesting the ST tendon for the ACL reconstruction, the length and volume of the ST in the operated leg are shorter and smaller than those in the healthy leg 1). Previous research has shown that the ST method reduces knee flexion strength 2). Another study reported that knee flexion and extension torque correlate with sprint running velocity 3). Additionally, Sprint velocity is correlated with the volume of the ST in sprinters 4). However, there are no reports on sprint running kinematics after the ST tendon harvesting. This study aimed to investigate the ST morphology, knee flexion/extension torque, and sprint running kinematics of athletes who have undergone the ACL reconstruction using the ST methods and have returned to sports. METHODS: Nine male patients (mean age ± SD: 21.4 ± 1.4 years old, 37.3 ± 17.2 months after surgery) participated. All patients underwent isolated unilateral the ACL reconstruction, using the ST method. Length and volume of the bilateral the ST were measured using MRI. Maximal isometric knee flexion and extension torque was measured in supine positions at every 10° from 60° to 120° of knee flexion angle using a dynamometer. Step frequency, step length, and knee flexion angle were measured in the 40-50 m interval of the 50 m sprint using high-speed cameras. These variables were calculated using KINOVEA software. Paired-sample t-test was used to analyze the differences in the ST length, the ST volume, step frequency and step length between the operated and healthy leg. Two-way ANOVA was used to analyze the differences in knee flexion torque between operated and healthy legs and between every knee flexion angle. RESULTS: Length and volume of the ST muscle belly were significantly shorter and smaller in the operated leg than in the healthy leg (p < 0.05). Isometric knee flexion torque was significantly lower in the operated leg than in the healthy leg in all knee flexion angles (p < 0.05). Isometric knee extension torque was not significantly different between the healthy and operated legs at all knee flexion angles. During sprint running step frequency and step length were not significantly different between the healthy and operated legs. During sprint running the maximum knee flexion angle in the backward swing phase and minimum knee flexion angle in the forward swing phase were significantly smaller in the operated leg than in the healthy leg (p < 0.05). CONCLUSION: Even 37.3 months after the ACL reconstruction using the ST method, there was still the ST atrophy and decreased knee flexion torque. These factors may adversely affect sprint running kinematics. The ST methods should be used with caution.
Read CV Tomohiro UmedaECSS Paris 2023: CP-MH02
INTRODUCTION: Lack of physical activity is a significant risk factor for global mortality, as evidenced by Katzmarzyk et al. (2022). Studies (e.g., Heath et al. 2022) have demonstrated the effectiveness of exercise training as a preventive and treatment strategy for a wide range of at least 26 non-communicable diseases (Pedersen & Salting 2015). Consequently, an increasing number of countries are incorporating clinical exercise physiologists (CEPs), university graduates specialized in sport and exercise science, into their healthcare systems. Given the worldwide strain on healthcare systems, CEPs are seen as a cost-effective add-on therapy to hospitals, clinics and private physician practices. METHODS: Research has shown the necessity of personalized exercise prescriptions that adhere to the so called F.I.T.T. principle (i.e., frequency, intensity, time, and type of exercise) (Garrahy et al., 2020), underpinning the inadequacy of a one-size-fits-all approach (Duong, 2022). A comparative study by Carrard et al. (2022) showed the varying roles of CEPs within the healthcare systems of Australia and Switzerland, representing two different modern approaches. Already formally recognized as a health profession in Australia, the respective graduates are not implemented as healthcare providers in Switzerland yet. Looking at other countries like the UK, New Zealand, Canada or Hong Kong, CEPs are increasingly integrated into these healthcare systems. RESULTS: Locally, the CEP situation in Austria is comparable with some substantial differences. Austria is a country with one of the highest per capita health expenditures among the EU countries but persistently high preventable mortality rates and even more important less healthy life years (OECD, 2023). Recently, the Austrian government legalized exercise scientists as formally accredited health-professionals (referred to as Training Therapists) within the in-patient system. Since 2012, Training Therapists are recognized as an allied healthcare profession. However, they are limited to work salaried and are not allowed to offer training therapy services in a self-employed position, being a dissatisfying solution with respect to patient care in general. CONCLUSION: Although appropriately qualified professionals providing individually adjusted and international guideline- and evidence-based exercise interventions are available, the Austrian healthcare system is still missing this opportunity to implement Training Therapists at an individual, societal, and nation-wide level. Carrard et al. Front Sports Act Liv (2022) doi: 10.3389/fspor.2022.766641 Duong CMAJ. (2022) doi: 10.1503/cmaj.1095991 Garrahy et al. Gen Pract. (2020) doi: 10.31128/AJGP-03-20-5294 Heath et al. BMC Med (2022). https://doi.org/10.1186/s12916-022-02236-0 Katzmarzyk et al. Br J Sports Med (2022) doi: 10.1136/bjsports-2020-103640 OECD/European Observatory on Health Systems and Policies (2023) doi.org/10.1787/0f110d90-en Pedersen & Saltin, ScandJMedSciSports (2015) doi: 10.1111/sms.12581
Read CV Anita BirklbauerECSS Paris 2023: CP-MH02