The Impact of Exercise Consultation on Athlete Health and Exercise Tolerance. Summary of the Doctoral Thesis

Abstract

Sport is developing and becoming increasingly popular in Latvia as well as worldwide. The number of sporting competitions and individuals taking part is on the rise. Participants of sports competitions will include individuals with varied levels of physical working capacity and underlying health conditions, undergoing different training programmes. In order to maintain the health and quality of life of the exercising population, as well as to provide safe participation and prevent the increased risks to human health caused by physical exercise, it is necessary to provide a periodical pre-participation evaluation of the athletes and physically active people in accordance with the latest recommendations. The aim of this study was to determine the impact of the sports physician’s exercise consultation on the parameters of health and exercise tolerance in physically active individuals who participate in sports competitions–athletes. The study was done at the certified medical center “Sports Laboratory”–FIMS Collaborating Centre of Sports Medicine. This study involved 1.600 self-perceived as healthy individuals aged 12 to 70 years (1.050 males, 550 females) who regularly engaged in sports consisting of high intensity dynamic and medium-high intensity static exercise and participated in sports competitions. The study participants' body composition, complaints, illness, injury, training programme and sporting history were assessed, repeated cardiopulmonary exercise testing and the data statistical analysis were done. The exercise consultation with a sports physician, as well as gender, age and the nature of the training programme were the main factors that impacted the parameters of health, physical working capacity and exercise tolerance of the amateur athlete population. Athletes of both genders undergoing training programme more than 300 exercise minutes per week had significantly 0.5–0.57 W/kg higher cardiorespiratory fitness, higher cardiac chronotropic and inotropic capacity, respiratory system functionality and 0.67–0.69 W/kg higher physical working capacity compared to amateur athletes undergoing training programme less than 300 exercise minutes per week. With advancing age, individuals reduced their training regularity and training duration as well as their association with a formal sports organization or the guidance of a sports coach. For most of the participants, the training programme was suitable for their health status but not for exercise tolerance. The results of the study provided good evidence that general physical activity recommendations, while beneficial, are not optimal and can be enhanced further with individualized prescription via an exercise consultation. A sports physician’s exercise consultation improved an individual's health status and exercise tolerance: 0.32–0.46 W/kg higher physical working capacity, 4–21 ml higher stroke volume and 1.6–3.6 l/min higher cardiac output, 8.8 l/min higher expired volume, 4.0 ml/min/kg higher oxygen uptake and volume of carbon dioxide during exercise, 1.14 MET higher metabolic units and 0.7–3.1 ml/min/rpm higher oxygen pulse. Higher aerobic capacity, anaerobic capacity and faster recovery which significantly affected exercise tolerance and performance benefits, were observed in amateur athletes undergoing training programme more than 300 exercise minutes per week depending on gender, age and training programme. An important outcome of this study was establishing age-, gender- and training specific physical working capacity index and heart functional index evaluation scales for general use.