Diagnostic Services
Services rendered to Sports Associations
Sport Medicine Outpatient Clinic
Services rendered to Sports Associations
Diagnostic services constituted a part of Olympic programs (Salt Lake, 2002 and Athens, 2004) financed and organised by the State Committee for Physical Education and Sports Administration.
Diagnostic services have been requested by sports associations, sports clubs, individual athletes, and by individuals practising non-competitive sports. Diagnostic tests take place both at the Institute and in the field, during training or competition, and include:
- Periodic control of members of national representation teams preparing for major international events (Europe and World Championships, Olympic Games) and selection-aimed examinations of athletes from the Olympic reserve teams;
- Routine examinations in course of the training periods (conducted in selected periods of the training macrocycle) adjusted to the training targets;
- Monitoring of training and competitions (in critical training periods, e.g. the peak performance phase), aimed at controlling the effectiveness of training loads;
- Doping control, run both at competitions and throughout the training period.
The diagnostic procedures involve diverse techniques and areas: medicine, anthropology, physiology, biochemistry, endocrinology, nutrition, biomechanics, kinesiology (movement technique and coordination) and psychology of sports activities and training, as presented in detail below.
- Medical examinations, resting and post-exertion ECG, continuous ECG monitoring (Holter technique), spirometry;
- Physiological evaluation of energy potential and of work capacity by measuring indices of aerobic capacity (VO2max, OBLA, PWC170), anaerobic capacity tests for arms and legs, specific laboratory exercises for selected sports by employing bicycle, kayak, and rowing ergometers and electric treadmill, assessment of adaptation to exercise and of post-exercise recovery, determination of metabolic zones of training loads (aerobic, mixed, and anaerobic work);
- Assessment of the health status of athletes from blood morphology and biochemical examinations at rest: total protein, urea, glucose, potassium, magnesium, zinc, copper, calcium, phosphorus, activities of marker enzymes (creatine kinase, aspartate and alanine aminotransferases), hormones in serum, saliva and urine (cortisol, testosterone), and the evaluation of the risk of vitamin deficiencies (B1, B2, B6, C);
- The use of plasma urea, creatine kinase activity and the "anabolic/catabolic index" determinations for the evaluation of training loads employed, the athletes' engagement in training, of the post-exercise recovery rate, and for an early detection of overtraining;
- Evaluation of the state of nutrition by estimating the dietary content and intake of basic nutrients (protein, fat, carbohydrates, minerals, vitamins), and of iron metabolism (total iron, total iron binding capacity, transferrin, ferritin, and hemoglobin). Designing nutrition programs for training camps, competitions, and recovery periods. Weight control by using a negative energy balance. Dietary counselling regarding nutritional supplements in different training periods and during competitions, and instructing physicians, coaches and athletes in optimal nutrition;
- Assessment of somatic development by anthropometry, estimation of body components (fat, lean body mass);
- Biomechanical assessment of motor apparatus, measurements of static and dynamic force/speed capacity of individual muscle groups, whole kinematic chains (leg and trunk power) and of muscle tremor;
- Evaluation of motion technique by force measurements in sports exercises, ground force measurements, forces acting on the paddle in water, video analysis and electromiography;
- Evaluation of basic coordination abilities - whole body coordination, balance maintenance, discrimination of muscle tonus and motion amplitude ("muscular sensing");
- Basic psychological characteristics - temperamental parameters, personality traits, locus of control, attitudes (hope for success, fear of failure), anxiety level, psychomotor reactions (simple and complex reaction time, audiomotor co-ordination, etc.), stress resistance capacity;
- Doping methods, detection of banned doping agents - anabolic and androgenic steroids, stimulants, diuretics, narcotics, etc.
The above-mentioned diagnostic procedures have been conducted to a different degree in the following sports: judo, wrestling, kayaking, rowing, orienteering, archery, tennis, weight lifting, boxing, taekwondo, fencing, volleyball, modern pentathlon, cycling, biathlon, figure skating, alpine skiing and lugeing.
Small teams were appointed to co-ordinate the diagnostic services and implementation of the results of applied research in individual sports. Those teams are responsible for accumulating the results of diagnostic measurements and for discussing them at special sessions with relevant staff members, coaches, physicians, or with the athletes themselves.
The results of studies on the projects, as well as those reported in the literature, important for the coaching, were popularised via lectures, seminars and courses for coaches, as well as in form of printed materials, either published in professional journals or as separate reports. The examinations performed at the Institute exceeded 10,000 and the number of male and female athletes examined - 1,000 (repeated examinations in the same subjects included). From the total number of above 100 sessions at which those examinations were conducted, near a half took place at training camps or at national and international competitions.
Sport Medicine Outpatient Clinic
Acting Head: Krystyna Burkhard-Jagodzińska, M.D.
Staff: Maria Szczypaczewska M.D., one nurse.
Research achievements: Characteristic of cardiac function in elite athletes during long-term electrocardiographic observation after endurance training (rowing, canoeing) and power training (judo, boxing). Electrocardiographic changes in 208 elite athletes at rest and after maximal exercise were observed. At rest the electrocardiographic changes were observed in 36.5% athletes (13.5% - left ventricular hypertrophy, 16.3% - conduction disordered, 6.3% - T v. changes). After maximal exercise (in compare to rest values) in 10.6% athletes atrioventricular I0 block and T v. changes were noted.
Applied research: Principal duties of the Clinic included medical examination, supervision of athletes performing laboratory tests and qualification of athletes to maximal exercise tests. In examined athletes the most frequent reasons of disqualification were: acute infections of the upper respiratory tract, digestive disorders and contusions. A routine assessment of cardiac function (ECG) was performed before and after each exercise test. The recorded disorders were reported to the Sports Medical Centre.
Medical services (examinations, treatment, first aid etc., were also rendered to the staff of the Institute and their families.
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