Intensive Physical Training Research Articles

Structural echocardiographic parameters in male and female Asian athletes: a systematic review and meta-analysis

Abstract Introduction Following repetitive structured and intense physical training, elite athletes’ hearts undergo physiological cardiac remodelling, including increased left ventricular (LV) size and LV wall thickness. These changes may mimic those seen in pathological cardiac conditions such as dilated and hypertrophic cardiomyopathy, posing a challenge for accurate diagnosis. Reference ranges for common echocardiographic parameters in elite Caucasian and Black athletes have been reported, facilitating differentiation between physiological and pathological changes in these demographics. However, there remains a paucity of data for Asian athletes despite their increasing representation in global sport. Methods We searched MEDLINE via PubMed, Embase, and the Cochrane Database for relevant studies from inception till 20th November 2023. We included observational studies that reported relevant echocardiographic parameters in elite Asian athletes. Studies that did not report gender-specific cardiac imaging parameters were excluded. After study selection and data extraction, random-effects meta-analysis of means was performed to obtain the weighted mean and 95% confidence intervals (CI) of common echocardiographic parameters stratified by gender. Results Our final search yielded 10 studies comprising a total of 1,111 elite athletes (996 male, 115 female; 53% Japanese, 21% uncategorised, 14% South-East Asian). Athletes participating in skill and power disciplines were excluded from analysis post-hoc due to a paucity of data and extreme data ranges. In male athletes, mean LV wall thickness was 9.4 mm (95% CI 8.5-10.3, I2 = 98.9%), mean LV end diastolic diameter was 54.7 mm (95% CI 52.5-57.0, I2 = 98.6%), mean LV mass indexed to body surface area was 97.5 g/m2 (95% CI 90.5-104.5, I2 = 97.5%) and mean aortic root diameter was 31.9 mm (95% CI 29.2-34.7, I2 = 99.5%). In female athletes, mean LV wall thickness was 7.9 mm (95% CI 7.5-8.4, I2 = 85.4%), mean LV end diastolic diameter was 47.1 mm (95% CI 45.8-48.3, I2 = 77.3%), mean LV mass indexed to body surface area was 79.5 g/m2 (95% CI 69.2-89.7, I2 = 92.8%) and mean aortic root diameter was 27.5 mm (95% CI 26.9-28.1). Conclusion This meta-analysis describes commonly reported echocardiographic parameters in elite Asian athletes from endurance and mixed sport disciplines. The absolute values of all reported parameters appear to fall far below reported limits for non-Asian athletes, highlighting substantial ethnic and regional variation in cardiac remodelling in elite athletes. While our results facilitate preliminary referencing of expected normal ranges in this demographic group, further studies are necessary to fully define the cardiac characteristics of Asian athletes.

Etiology, Epidemiology And Methods Of Preventing Sudden Death Of Cardiac Origin In Sports

Introduction: Numerous epidemiological studies have consistently shown an association between moderate aerobic exercise and decreased risk of coronary heart disease (CHD) and death, and even a small amount of exercise provides a significant reduction in risk compared to a sedentary lifestyle Objective: The aim of this study was to identify the etiology, epidemiology and prevention of sudden cardiac death in sports. Methodology: The methodology used was a literature review. The research was carried out by means of an electronic search for scientific articles published on the Scielo (Scientific Electronic Library Online) and Lilacs (Latin American Health Sciences Literature) and Pubmed websites. The health terminologies consulted in the Health Sciences descriptors (DeCS/BIREME) were used; the etiology, epidemiology and ways of preventing sudden cardiac death in sports practices. Discussion: An important distinction must be made between hypertrophic cardiomyopathy and “athlete's heart syndrome”. In this syndrome, intense physical training leads to various morphological and physiological alterations, especially left ventricular hypertrophy. Conclusion: The complete health safety of athletes consists of periodic pre-participation clinical assessment as well as emergency measures, mainly in competition venues, consisting of the availability of health professionals

Changes in hormonal profiles during competition preparation in physique athletes.

Physique athletes engage in rigorous competition preparation involving intense energy restriction and physical training to enhance muscle definition. This study investigates hormonal changes and their physiological and performance impacts during such preparation. Participants included female (10 competing (COMP) and 10 non-dieting controls (CTRL)) and male (13 COMP and 10 CTRL) physique athletes. COMP participants were tested 23weeks before (PRE), one week before (MID), and 23weeks after the competition (POST). Non-dieting CTRL participants were tested at similar intervals. Measurements included body composition (DXA), muscle cross-sectional area (ultrasound), energy availability (EA) derived by subtracting exercise energy expenditure (EEE) from energy intake (EI) and dividing by fat-free mass (FFM), muscle strength, and various serum hormone concentrations (ACTH, cortisol, estradiol, FSH, IGF-1, IGFBP-3, insulin, and free and total testosterone and SHBG). During the diet, EA (p < 0.001), IGF-1 (p < 0.001), IGFBP-3 (p < 0.01), and absolute muscle strength (p < 0.01-0.001) decreased significantly in both sexes in COMP. Decreases in IGF-1 were also associated with higher loss in FFM. In males, testosterone (p < 0.01) and free testosterone (p < 0.05) decreased, while SHBG (p < 0.001) and cortisol (p < 0.05) increased. Insulin decreased significantly only in males (p < 0.001). Mood disturbances, particularly increased fatigue in males (p < 0.05), highlighted the psychological strain of competition preparation. All these changes were restored by increased EA during the post-competition recovery period. Significant reductions in IGF-1 and IGFBP-3 during competition preparation may serve as biomarkers for monitoring physiological stress. This study offers valuable insights into hormonal changes, muscle strength, and mood state during energy-restricted intense training.

TBICoE approach to concussion rehabilitation in service members and veterans.

Concussion, also known as mild traumatic brain injury (mTBI), is a condition with unique ties to military service. Service members (SMs) are inherently at a higher risk for concussive injuries due to the intense physical training environment and combat operational tempo required to serve. The Traumatic Brain Injury Center of Excellence (TBICoE) is the US Department of Defense authority on this condition and provides a thorough approach to management of concussion and associated symptom sequela. This article seeks to review the TBICoE approach to the management and rehabilitation of military SMs with mTBI, and highlight resources available to military medical providers. The authors reviewed evidence and TBICoE resources to provide this comprehensive overview of the TBICoE approach to management and rehabilitation of concussion in military SMs. A progressive return to activity protocol in conjunction with symptom-guided management of common post-concussive sequelae, including headache, vestibular and oculomotor issues, sleep dysfunction, cognitive rehabilitation, and behavioral health comorbidities are essential for concussion management in the acute, post-acute and chronic phases of injury. The TBICoE approach to the rehabilitation of military SMs is comprehensive, and includes initial management with a stepwise return to duty protocol and an objective return to duty screening. The mainstays of treatment for SMs with post-acute and chronic post-concussion symptoms are headache management, vestibular and oculomotor rehabilitation, sleep interventions, cognitive rehabilitation, and early intervention for behavioral health comorbidities. These evidence-based strategies may be applied in the treatment of SMs in the US and internationally.

Does dry needling aid in post-training recovery? A critically appraised topic

Clinical scenarioFollowing intense physical training, it is common for athletes to develop muscle soreness, muscle tightness and a sense of fatigue. Minimizing the time spent in this state is advantageous to limit time off from sport, potential injury and lack of mental focus. Clinical questionDoes dry needling aid in post-training recovery in athletes? Summary of key findingsA search was performed for articles exploring the effect of dry needling on exercise/training recovery in athletes. Six articles were included in this critically appraised topic. Three articles were randomized controlled trials, one was a cross-over design, one was a case series, and one was a survey. Five of the six studies demonstrated that dry needling had some sort of positive effect on post-training recovery. One article found DN did not improve muscle soreness after a long distance race. Clinical bottom lineBased on six studies, DN provides mixed results on a variety of physiological and subjective measures. No adverse effects were reported with the use of DN on athletes following post-training. Strength of recommendationIn agreement with the Center of Evidence-Based Medicine, the consistent results from three Level II and two Level III intervention studies designate that there is grade D evidence that DN may aid in some post-training recovery variables.

Wielokierunkowy wpływ wysiłku fizycznego na układ immunologiczny u sportowców wyczynowych

The extreme physical effort and psychological stress are everyday challenges faced by athletes. The regular training results in adaptation to increasing physical effort. It contributes to changes in various organs and metabolic processes. Intense physical training has been shown to affect numerous body systems including the immune system. The aim of this paper is to present the influence of extreme physical activity on various aspects of immune response. The changes in the immune system of athletes include not only those related to blood leukocytes, but those in connection to respiratory and gut associated lymphoid tissue as well. Moreover, the immune cells play an important role in muscle regeneration after sustaining training injury. The mmunology of physicial activity – mainly extreme physical activity – is a new, not fully recognized yet field of research. The understanding of these interactions facilitates a proper training planning for different groups of athletes.

A novel DSP zebrafish model reveals training- and drug-induced modulation of arrhythmogenic cardiomyopathy phenotypes

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Associazione Italiana per la Ricerca sul Cancro [AIRC grant IG-2017-19928], Italian Ministry of University and Research [grant PRIN 20173ZWACS] Introduction Arrhythmogenic cardiomyopathy (AC) is an inherited disorder characterized by progressive loss of the ventricular myocardium causing life-threatening ventricular arrhythmias, syncope and sudden cardiac death in young and athletes. About 40% of AC cases carry one or more mutations in genes encoding for desmosomal proteins, including Desmoplakin (Dsp). Methods We generated the first stable Dsp knock-out (KO) zebrafish line able to model cardiac alterations and cell signalling dysregulation, characteristic of the AC disease. Results Our stable Dsp knock-out (KO) zebrafish line was characterized by cardiac alterations, edema and bradycardia at larval stages. Histological analysis of mutated adult hearts showed reduced contractile structures and abnormal shape of the ventricle, with thinning of the myocardial layer, vessels dilation and presence of adipocytes within the myocardium. Moreover, TEM analysis revealed "pale", disorganized and delocalized desmosomes. Intensive physical training protocol caused a global worsening of the cardiac phenotype, accelerating the progression of the disease. Of note, we detected a decrease of Wnt/β-catenin signalling, recently associated with AC pathogenesis, as well as Hippo/YAP-TAZ and TGF-β pathway dysregulation. Pharmacological treatment of mutated larvae with SB216763, a Wnt/β-catenin agonist, rescued pathway expression and cardiac abnormalities, stabilizing the heart rhythm. Conclusion Our Dsp KO zebrafish line recapitulates many AC features observed in human patients, pointing at zebrafish as a suitable system for in vivo analysis of environmental modulators, such as the physical exercise, and the screening of pathway-targeted drugs, especially related to the Wnt/β-catenin signalling cascade.

Effect of 12-week Intensive Training on More Downward Limb Explosive Power of Adolescent Taekwondo Athletes

Objective: To explore the influence of enhanced training on the explosive force of more downward limbs of young taekwondo athletes, and to provide a reference for scientific training of young taekwondo athletes. Methods: Twenty-four young male taekwondo athletes were randomly divided into two groups:the intensive training group (12 people) and the control group (12 people). The subjects in the intensive training group received 60 minutes of intensive physical training three times a week. In contrast, the issues in the control group did not receive extra physical training except regular training. Results: Before and after intervention, it was found that the standing long jump and standing triple jump in the intensive training group were significantly higher than those before intervention (P &lt; 0.05), and the standing triple jump in the intensive training group was significantly higher than that in the control group (P &lt; 0.05). Conclusion: After 12 weeks of intensive training intervention, the more downward limb explosive force quality of athletes have been significantly improved, so 12 weeks of intensive training can be used as a training means for more downward limb explosive force quality of young Taekwondo athletes.

Differences in Troponin I and Troponin T Release in High-Performance Athletes Outside of Competition.

Troponin I and troponin T are critical biomarkers for myocardial infarction and damage and are pivotal in cardiological and laboratory diagnostics, including emergency settings. Rapid testing protocols have been developed for urgent care, particularly in emergency outpatient clinics. Studies indicate that strenuous physical activity can cause transient increases in these troponin levels, which are typically considered benign. This research focused on 219 elite athletes from national teams, evaluating their troponin I and T levels as part of routine sports medical exams, independent of competition-related physical stress. The results showed that 9.2% (18 athletes) had elevated troponin I levels above the reporting threshold, while their troponin T levels remained within the normal range. Conversely, only 0.9% (two athletes) had normal troponin I but raised troponin T levels, and 2.3% (five athletes) exhibited increases in both markers. No significant cardiovascular differences were noted between those with elevated troponin levels and those without. This study concludes that elevated troponin I is a common response to the intense physical training endured by high-performance endurance athletes, whereas troponin T elevation does not seem to be directly linked to physical exertion in this group. For cardiac assessments, particularly when ruling out cardiac damage in these athletes, troponin T might be a more reliable indicator than troponin I.

A novel DSP zebrafish model reveals training- and drug-induced modulation of arrhythmogenic cardiomyopathy phenotypes

Arrhythmogenic cardiomyopathy (AC) is an inherited disorder characterized by progressive loss of the ventricular myocardium causing life-threatening ventricular arrhythmias, syncope and sudden cardiac death in young and athletes. About 40% of AC cases carry one or more mutations in genes encoding for desmosomal proteins, including Desmoplakin (Dsp). We present here the first stable Dsp knock-out (KO) zebrafish line able to model cardiac alterations and cell signalling dysregulation, characteristic of the AC disease, on which environmental factors and candidate drugs can be tested. Our stable Dsp knock-out (KO) zebrafish line was characterized by cardiac alterations, oedema and bradycardia at larval stages. Histological analysis of mutated adult hearts showed reduced contractile structures and abnormal shape of the ventricle, with thinning of the myocardial layer, vessels dilation and presence of adipocytes within the myocardium. Moreover, TEM analysis revealed “pale”, disorganized and delocalized desmosomes. Intensive physical training protocol caused a global worsening of the cardiac phenotype, accelerating the progression of the disease. Of note, we detected a decrease of Wnt/β-catenin signalling, recently associated with AC pathogenesis, as well as Hippo/YAP-TAZ and TGF-β pathway dysregulation. Pharmacological treatment of mutated larvae with SB216763, a Wnt/β-catenin agonist, rescued pathway expression and cardiac abnormalities, stabilizing the heart rhythm. Overall, our Dsp KO zebrafish line recapitulates many AC features observed in human patients, pointing at zebrafish as a suitable system for in vivo analysis of environmental modulators, such as the physical exercise, and the screening of pathway-targeted drugs, especially related to the Wnt/β-catenin signalling cascade.

CROSSFIT AND RECURRING JOINT INJURIES

CrossFit is an intense and multifaceted physical training modality that has gained a lot of popularity in recent years. However, it has also raised concerns about the risk of injury, especially to the joints. Recurrent joint injuries are a relevant concern for CrossFit practitioners, as the modality involves high-intensity movements, such as weight lifting, jumping, running and exercises that place significant pressure on the joints. Joint injuries in CrossFit can occur due to a variety of reasons, including lack of proper technique, overload, lack of adequate warm-up, muscle fatigue, and repetitive movements. The joints most susceptible to injury include the shoulders, knees, hips and wrist joints. Joint injuries can range from mild to severe and can include strains, sprains, cartilage injuries and even ligament tears. To prevent recurring joint injuries during CrossFit practice, it is essential that practitioners receive adequate guidance from a qualified trainer. This includes learning the correct technique for each movement, not exceeding personal load limits, warming up thoroughly, and taking appropriate recovery measures after training. Furthermore, listening to your own body and respecting signs of fatigue and pain is essential to avoid injuries. The present study aims to identify recurrent injuries in CrossFit. The methodology used to prepare the study is qualitative research, through a bibliographic review. It is concluded that CrossFit is a challenging modality that can expose practitioners to the risk of recurrent joint injuries, especially when inadequate technique and lack of safety precautions are involved. With the correct guidance, adequate training and respect for personal limits, it is possible to minimize these risks and enjoy the benefits of CrossFit in a safer and healthier way.

T-Cadherin Deficiency Is Associated with Increased Blood Pressure after Physical Activity.

T-cadherin is a regulator of blood vessel remodeling and angiogenesis, involved in adiponectin-mediated protective effects in the cardiovascular system and in skeletal muscles. GWAS study has previously demonstrated a SNP in the Cdh13 gene to be associated with hypertension. However, the role of T-cadherin in regulating blood pressure has not been experimentally elucidated. Herein, we generated Cdh13∆Exon3 mice lacking exon 3 in the Cdh13 gene and described their phenotype. Cdh13∆Exon3 mice exhibited normal gross morphology, life expectancy, and breeding capacity. Meanwhile, their body weight was considerably lower than of WT mice. When running on a treadmill, the time spent running and the distance covered by Cdh13∆Exon3 mice was similar to that of WT. The resting blood pressure in Cdh13∆Exon3 mice was slightly higher than in WT, however, upon intensive physical training their systolic blood pressure was significantly elevated. While adiponectin content in the myocardium of Cdh13∆Exon3 and WT mice was within the same range, adiponectin plasma level was 4.37-fold higher in Cdh13∆Exon3 mice. Moreover, intensive physical training augmented the AMPK phosphorylation in the skeletal muscles and myocardium of Cdh13∆Exon3 mice as compared to WT. Our data highlight a critically important role of T-cadherin in regulation of blood pressure and stamina in mice, and may shed light on the pathogenesis of hypertension.

P09.05.A IMPACT OF A 16-WEEK SUPERVISED EXERCISE INTERVENTION ON CANCER-RELATED FATIGUE IN PATIENTS WITH NEWLY DIAGNOSED GLIOBLASTOMA UNDERGOING ADJUVANT CHEMOTHERAPY

Abstract BACKGROUND Cancer-related fatigue (CRF) is considered one of the most prevalent symptoms in brain tumor patients undergoing concurrent chemoradiation (approx. 80 % of those affected). Several studies have identified beneficial effects of physical activity on reducing CRF. However, few studies have examined the reduction of CRF by exercise in glioma patients. Here we present prospective data showing the effect of an intensive 16-week supervised exercise intervention on CRF in neuro-oncological patients. MATERIAL AND METHODS Between July 2020 and April 2023, patients with newly diagnosed glioblastoma and after surgery and concomitant radiochemotherapy have been recruited for this single-arm trial in progress. Participants have received a 16-week supervised training intervention on a 1:1-basis consisting of two intensive 50-minute sessions per week (bicycle ergometry at an average of 75 % of maximum heart rate and progressive whole-body resistance training). CRF has been assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C30). We calculated change scores (scores: 0-100; 100=max. fatigue) from baseline, after 8 weeks, and post-intervention (week 16). RESULTS So far, 26 glioblastoma patients (13 women) aged 35-84 years (mean 59 years) participated in the exercise intervention. All patients received adjuvant chemotherapy (50 % Stupp, 42 % CeTeG, 8 % other). Paired t-test indicated a statistically significant reduction in CRF from baseline to post-intervention (p=.030; 95 % CI: -0.5 - 24.2). Mean scores reduced from 40.4 to 36.2 (week 8) to 26.9 (week 16). However, the decrease between week 0 and week 8 was not yet significant (p=.281; 95 % CI: -7.6 - 13.6). CONCLUSION The present trial shows that a 16-week supervised exercise program can reduce CRF in glioblastoma patients despite adjuvant chemotherapy. Thus, and consistent with studies of exercise interventions in patients of other tumor types, glioblastoma patients have the opportunity to actively contribute to the reduction of tumor- and therapy-induced side effects through intensive physical training.

Longitudinal cardiac remodeling in collegiate American football players as assessed by echocardiography during their collegiate career.

Studies on the longitudinal effects of intense physical training on cardiac remodeling are limited, especially in American collegiate football players. College-level American football training will result in remodeling in a pattern consistent of a sport with moderate static and dynamic demands with increases in both wall and chamber sizes. We studied 85 American collegiate football players who underwent transthoracic echocardiogram (TTE) for asymptomatic or mild COVID-19-related illness and compared the changes in echo dimensions to their preparticipation screening TTE. Pre- and posttraining variables were compared using a paired t-test for normally distributed variables. Mean age was 19 years ± 1 and 61% of athletes were Black. Mean follow-up between TTEs was 21 ± 13 months. There was an increase in left atrial volume index (26.4 ± 5.5 to 32.8 ± 8.4 mL/m2 , p < .001), LV end diastolic diameter (5.13 ± 0.4 to 5.27 ± 0.4 cm, p = .003), basal RV diameter (3.28 ± 0.7 to 3.83 ± 0.5 cm, p = <.001), LV mass index (86.7 ± 15.3 to 90.1 ± 15.3, p = .015), and aortic root diameter (3.1 ± 0.4 to 3.2 ± 0.3 cm, p = .03) from pre- to posttraining, with a slightly greater magnitude in athletes with >2 years of training. Presence of left atrial enlargement (≥35 mL/m2 ) increased from 2.9% to 29% pre- to postparticipation in athletes with >2 years training. No significant changes in wall thickness, diastolic function, or right ventricular systolic function were observed. American football players college-level training was associated with increases in left and right ventricular chamber sizes, left atrial size, and aortic root diameter.

Heat Intolerance, Body Size, and Return to Duty.

BACKGROUND: Exertional heatstroke affects athletes and soldiers and can lead to temporary heat intolerance. The heat tolerance test (HTT) was developed to assist in the return-to-duty decisions of military personnel. Although there are several possible causes for heat intolerance, a soldier who fails the test is prevented from returning to serve in a front-line combat unit, regardless of the underlying reason.CASE REPORT: A 19-yr-old special infantry male soldier with unremarkable medical history collapsed during an afternoon hand-to-hand combat training session in the gym. The medic on site promptly initiated inefficient tap water cooling and measured a rectal temperature of 38.7 °C; he returned to duty the same evening. A few weeks later, after intensive physical training, he experienced exhaustion during a stretcher-carrying foot march. He was referred by the unit's physician, who suspected a condition of heat intolerance, to an HTT. The soldier underwent two HTTs, which were found to be positive. Consequently, he was discharged from serving in his infantry unit. No congenital or functional underlying causes could explain the diagnosis of heat intolerance.DISCUSSION: We discuss the possibility that the only explaining cause for the two positive HTTs was the soldier's anthropometric measures, particularly the low body surface area to body weight ratio. We raise the question of whether this soldier could have been returned safely to duty.Rabotin A, Epstein Y, Ketko I. Heat intolerance, body size, and return to duty. Aerosp Med Hum Perform. 2023; 94(7):546-549.

P11 RISK STRATIFICATION IN ATHLETES: AN "IRREDUCIBLE" MASTER ATHLETE

Abstract We describe the clinical case of a 48–year–old master athlete, runner (marathon runner), always asymptomatic at rest and during effort, with a family history of ischemic heart disease and no other known cardiovascular risk factors. On the occasion of the pre–partecipation screening visit, he presented an altered baseline electrocardiogram with low peripheral voltages and T wave inversion in V1–V5 leads and inferior leads. The echocardiogram documented morphofunctional alterations in the right ventricle and raises the suspicion of arrhythmogenic cardiomyopathy, later confirmed by cardiac magnetic resonance with Gadolinium. During effort, even repetitive premature ventricular beats LBBB with superior axis morphology appeared. Also, torsade de pointes episode with presyncopal sensation. He was hospitalized with a diagnosis of threatening arrhythmias in right ventricular arrhythmogenic heart disease. Coronary angiography was negative. We recommend beta–blocker therapy, genetic analysis, screening of family members. A subcutaneus defibrillator has been placed. The patient, against the advice of the Physicians, continued to train even at high intensity until he has a syncopal episode with correct intervention of the device on ventricular fibrillation. Since the patient has requested specific indications to continue training independently, an exercise test in beta–blocker therapy is repeated and the training thresholds are calculated. The case of this master athlete highlights the issue of the difficulty of screening the master athlete with frequent omission of symptoms (the patient already had syncopal/presyncopal episodes at home which he had omitted), poor adherence to therapeutic indications, possible negative effects of high intensity physical training on the evolution of arrhythmogenic cardiomyopathy.

C80 GENETIC AND NON–GENETIC DETERMINANTS OF CLINICAL VARIABILITY IN A FAMILIAL CASE OF HYPERTROPHIC CARDIOMYOPATHY WITH HETEROZYGOUS PATHOGENIC MYPBC3 MUTATION

Abstract Mutations in the MYBPC3 gene, which encodes myosin C–binding protein C (cMyBP–C) are among the main causes of hypertrophic cardiomyopathy (HCM). Truncating mutations are recognized as causative in many HCM patients and recently, even missense mutations (e.g E258K mutation) appear to be clinically related to the disease. E258K is one of the most common MYBPC3 mutations, with a prevalence of 15% in Italians. We report a family case, with father and son affected by HCM in which where this mutation was identified thanks to the NGS. HCM in the father was diagnosed at the age of 70 after several episodes of atrial fibrillation and after a myocardial infarction. The son, a sportsman, had a very early and severe presentation of HCM in the absence of manifest clinical signs. The same E258K mutation was also found in the proband son, in the absence of clinical signs of HCM. Given the diversity of the carrier phenotypes, the molecular analysis of the proband was extended beyond rare variants and we found a common substitution in the DES gene, (encoding desmin) which, acting as an unfavourable modifier, could partly explain the different clinical presentation of HCM. Probably also the intense physical activity carried out by the proband contributed to the phenotype severity. The father, asymptomatic for a much longer period and with a lower hypertrophy grade compared to the proband, may have benefited from a less intense physical activity and from the absence of the DES polymorphism. To date, the role of physical exercise is widely debated: on the one hand, a regular intense physical training could worsen hypertrophy, fibrosis and trigger arrhythmias, on the other hand however, a sedentary lifestyle predisposes to obesity and other cardiovascular risk factors which induce diseases with a worse prognosis than HCM itself. Nowadays 70% of patients with HCM are overweight, and more than 50% are below the minimum recommended exercise threshold. In addition, there is growing evidence that competitive sports are safe and could have beneficial effects in asymptomatic low–risk HCM patients. This case study suggests that the decision–making process must include both genotypic and phenotypic characterization of patients, as well as the evaluation of the causative mutation pathogenicity and of co–existing genetic modifiers.

ИСТОРИЧЕСКАЯ ТРАНСФОРМАЦИЯ СИСТЕМЫ ПСИХОЛОГИЧЕСКОГО СОПРОВОЖДЕНИЯ СПОРТСМЕНОВ И ПЕРСПЕКТИВЫ ЕЕ ДАЛЬНЕЙШЕГО РАЗВИТИЯ

The high level of training of athletes is the result of intense long-term physical training, however, in modern conditions the development of psychological qualities of an athlete is no less important. In the process of historical transformation the system of psychological support for athletes has repeatedly confirmed its effectiveness. Specialists who continued to work in the system of sports psychology in the Republic of Belarus after obtaining the status of an independent status managed with great difficulty to retain a significant part of their accumulated experience and continue the development of this area. Unfortunately, at present, the activities of the sports psychology service are mainly concentrated in the Minsk region and work with athletes from the regions is not of a permanent qualitative nature. However, there is a perspective of forming a unified republican service of sports psychological support through the involvement of the teaching staff and graduates of the psychological profile of regional higher educational institutions in cooperation with specialists in the field of physical culture and sports. Based on the results of a pilot research project conducted by employees of the Mental Health Medicine Faculty of the Grodno State Medical University it was possible to determine the areas of research work that will contribute to the development of a system of psychological support for athletes in the Grodno region.

ВИКОРИСТАННЯ МЕТОДИКИ CROSSFIT В ОСВІТНЬОМУ ПРОЦЕСІ ЗАКЛАДІВ ВИЩОЇ ОСВІТИ

Modern society requires the expansion of the fitness industry and the improvement of fitness technologies. Based on this, the search for effective forms and content of physical education in secondary schools, which would contribute to increasing motor activity, physical fitness and interest of students in classes, is the leading direction of improving the system of physical education. The goal: increasing the effectiveness of the selection of CrossFit methods and tools to increase the level of physical fitness, in the conditions of the educational process. Methods of work: theoretical research methods were used in the work: analysis, induction, deduction, systematization and generalization of scientific and methodical literature, documents and information resources of the Internet network on the investigated problem. Results: classes using the method give positive results and contribute to the successful development of physical fitness. The positive features of the system can be considered its versatility, which consists in the use of a wide range of training tools, as well as in the ability to choose the necessary training modes to solve specific tasks. The article examines the approaches of scientists to considering the effectiveness of CrossFit as a system of intensive physical training, as well as possible negative consequences.

MONITORAMENTO FISIOLÓGICO NO TREINO FÍSICO DE INTENSIDADE EM LUTADORAS FEMININAS

ABSTRACT Introduction Currently, female wrestling has become one of the potential advantages in the Olympic Games, which has also allowed the sport to receive more attention. Physiological monitoring in intense physical training in female wrestlers is still little explored despite its importance in training conduction. Objective Explore special intensity physical training effects on female wrestlers through physiological monitoring. Methods Literature search, expert interview, and an experimental method conducted a situation analysis on 2-month training for 8 female wrestling team athletes, specific contents also included: analysis of female wrestlers’ body composition, changes in serum testosterone levels, and variations in cortisol levels. Results During the two-month training period, the various athletes’ physiological indicators underwent noticeable changes, remaining at the top of the normal range. Most of the athletes could adapt to the training load and intensity in this phase. Serum testosterone, cortisol, and hemoglobin levels in early athletes increased significantly. However, as training progresses, all indicators decrease, showing that the adaptability of the athlete’s body is consolidated. The hemoglobin content increased in most of the athletes, showing that the athlete’s own intensity of physical training was high. Conclusion The above physiological indicators can reflect the physical function of the athletes, providing a theoretical basis for coaches to develop evidence-based training plans. Evidence Level II; Therapeutic Studies - Investigating the result.