BackgroundPeriodic health evaluations for athletes are widely discussed in the sports medical literature, and are intended to screen for underlying cardiovascular disease, identify sports injury risk factors and posture disturbances, as well as exercise induced physiological conditions.ObjectiveTo review the systematic the athletes' periodic health evaluations in the territories of the former USSR.ParticipantsSelected sports medicine outpatient centres (SMC) and sports medicine physicians in Russia and Estonia.MethodsWe reviewed the structure and outcome of the yearly visits at the participating SMCs, and the sports medicine educational curriculum at the University of Tartu in Estonia.ResultsPeriodic health evaluations for athletes have been conducted since 1949. The system integrates the facilities (sports medical centers) and the education of the sports physicians. Outpatient check ups of the athletes coming from all the levels of sport were conducted at the SMC. At one time over 500 SMCs existed, involving sports physicians, surgeons, neurologists, otolaryngologists, ophthalmologists, dentists and gynaecologists. Anthropometric data were collected, in addition to EKG, physical work capacity testing, and laboratory measurements – depending on the athletes' level and on a kind of sport. As a current sample, an annual amount of visits to the physicians per single regional SMC was 99 601 (Yekaterinburg Sports medical centre (Russia), prophylactic check ups and treatments, year 2009). The specific program of sports physician education at the University of Tartu in Estonia began in 1959. The program comprised the standard MD curriculum plus additional courses on sports theory, sports physiology, sports cardiology, exercise stress testing, sports injury, and rehabilitation. A total of 818 physicians were trained through 1995 – when the program was closed after the breakup of the USSR. Although still in existence in Russia, in many other countries the system has been downscaled or phased out.ConclusionsTo our knowledge, the system described was the largest state-sponsored sports medical prophylactic approach in the world. Although in many instances there was no proof of the cost effectiveness of this approach, many elements of the athletes' periodic health evaluations and education of the sports physicians we describe should be considered as precursors of today's modern sports medicine programs.

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One of the most important criteria used to characterise the level of integration of a person with a disability in the society is life quality criteria. The quality of life is determined by the individual’s ability to engage in social activities, including in regular physical activities and sports events. Engagement in different kinds of sports might be difficult or even impossible for people with limited functions, therefore alternative kinds of sports are being developed in the world, uniting them in the Paralympic sports movement. As the Paralympic sports developed, a necessity arouse for a special medical and functional classification system that allows to divide the athletes into groups that correspond their functioning disorders and ensures equal competition for all athletes. For people with limited functions, while integrating into the society and increasing the quality of life, regular engagement in sports activities may cause additional load and traumas, including cumulative traumas, limitations on physical abilities. The aim of the study is to discover how regular sitting volleyball trainings influence health condition, the quality of life and functional abilities of people with disabilities. The study was conducted from 1995 until 2008, was prospective and consists of five sections: 1) analysis of the quality of life of sitting volleyball players, assessing their level of integration in leisure activities; 2) assessment of cardiorespiratory work capacity of sitting volleyball players; 3) assessment of cardiorespiratory work capacity of people who have had amputations at different levels but who are not engaged in sports activities; 4) assessment of the specific sports skills of sitting volleyball players, depending on their sports medical and functional class; 5) Determination of secondary health disorders of sitting volleyball players related with sports activities, including locomotor system traumas. During the present study, it was discovered that: • the physical health aspect of the quality of life for sitting volleyball players is statistically significantly higher than for people who have limb functioning limitations, but who are not engaged into any sports; • sitting volleyball players have better physical functioning and mental health data compared to people who have limb functioning limitations, but who are not engaged into any sports; • sitting volleyball players have higher relative cardiorespiratory work capacity and higher absolute physical work capacity (PWC170) compared with people who have functioning limitations, but who are not engaged into sports. Predisposed risk factors for sitting volleyball players related with functioning limitations and cumulative sports traumas related with sports activities were discovered. The data obtained in the study can be used for safe exercise and competition planning and prophylaxis of secondary health disorders. The five sections of the study include several hundreds of Paralympic volleyball players, representing both genders, from 25 countries of the all the world continents. The study was conducted for a period of 24 years, several dozens of sports medicine specialists volunteered in collection of data, and professors from several universities participated in academic cooperation, representing Rīga Stradiņš University, the University of Tartu (Estonia), Karolinska Institute (Sweden), Jozef Pilsudski University of Physical Education in Warsaw (Poland). The fifth section of the study (Determination of the most frequent subjective complaints about the locomotor system and sports-related traumas) is the first prospective long-term study in the world about sports traumatism in a Paralympic sports.