Cardiovascular screening of Paralympic athletes reported by chief medical officers of the PyeongChang 2018 Paralympic Winter Games

Toresdahl, Brett G; Blauwet, Cheri; Chang, Cindy J.; Ling, Daphne; Asif, Irfan M.

doi:10.1136/bjsports-2018-099708

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…The use of ECG as a fundamental part of screening in most sports that responded was comparable with previous surveys of Olympic sports (in most Western countries where it was considered affordable), 17,21 but in contrast to a similar survey of sports from the United States. 22 Most sports in the United States perform regular screening but use H&P but not always ECG.…”

Section: Discussionsupporting

confidence: 74%

Cardiovascular Screening of Elite Athletes by Sporting Organizations in Australia: A Survey of Chief Medical Officers

Orchard

Toresdahl

Asif

et al. 2020

Clinical Journal of Sport Medicine

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Objective: To compare cardiovascular screening policies of Australian elite sporting organizations. Design: Online survey. Setting: Elite/professional sports in Australia. Participants: Chief medical officers (CMOs) of elite/professional sports in Australia, including rugby union and league, cricket, tennis, Australian football, and cycling. Assessment of Variables: Survey questions about each sport's cardiac screening policy: which screening components were included [eg, history and physical (H&P), resting 12-lead electrocardiogram (ECG)], whether screening was mandatory, whether the policy applied to elite junior and/or adult players, and which criteria were used to interpret ECGs. Main Outcome Measures: Which sports had a formal cardiac screening policy, which athletes the policy applied to, components of screening, ECG interpretation criteria used. Results: Chief medical officers for 22/31 (71%) sports responded, representing >5000 athletes. Of these, 19/22 (86%) perform regular screening (100% H&P; 89% included ECG) with international cyclists also having routine echocardiograms and stress testing. Thirty-three percent of CMOs used the 2017 International Criteria for athlete ECG interpretation. Screening was mandatory with enforcement (26%), mandatory without enforcement (48%), and opt-out (26%). All screened adult elite athletes, and 68% screened junior elite athletes. Forty-two percent indicated athletes were required to pay for screening tests, and 63% required athletes to pay for follow-up tests. Almost all (94%) sports with a sports physician as the CMO screened athletes. Conclusions: Most sports have a screening policy, with reasonable uniformity of components. All included H&P, and almost all included ECG. Only one sport included an echocardiogram and stress test as a standard (international players only). Promoting the latest ECG interpretation criteria may reduce false-positives and cost. Future work should explore cardiac emergency plans, screening infrastructure, cost, and long-term follow-up.

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Section: Discussionsupporting

confidence: 74%

Cardiovascular Screening of Elite Athletes by Sporting Organizations in Australia: A Survey of Chief Medical Officers

Orchard

Toresdahl

Asif

et al. 2020

Clinical Journal of Sport Medicine

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“…The higher %FM in the android and gynoid regions in SCI vs. AMP athletes is of clinical significance showing that SCI athletes are at increased risk of metabolic syndrome and cardiovascular disease ( Toresdahl et al, 2019 ), caused by an excess of central adiposity ( Goldstein et al, 2017 ; Stillman & Williams, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Body composition and bone mineral density in athletes with a physical impairment

Cavedon

Sandri

Peluso

et al. 2021

PeerJ

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Background The impact of the type and the severity of disability on whole-body and regional body composition (BC), and bone mineral density (BMD) must be considered for dietary advice in athletes with a physical impairment (PI). This study aimed to investigate the impact of the type and the severity of disability on BC, the pattern of distribution of fat mass at the regional level, and BMD in athletes with a PI. Methods Forty-two male athletes with spinal cord injury (SCI, n = 24; age = 40.04 ± 9.95 years, Body Mass Index [BMI] = 23.07 ± 4.01 kg/m2) or unilateral lower limb amputation (AMP, n = 18; age = 34.39 ± 9.19 years, BMI = 22.81 ± 2.63 kg/m2) underwent a Dual-Energy X-Ray Absorptiometry scan. Each athlete with a PI was matched by age with an able-bodied athlete (AB, n = 42; age = 37.81 ± 10.31 years, BMI = 23.94 ± 1.8 kg/m2). Results One-Way Analysis of Variance showed significant differences between the SCI, AMP and AB groups for percentage fat mass (%FM) (P < 0.001, eta squared = 0.440). Post-hoc analysis with Bonferroni’s correction showed that athletes with SCI had significantly higher %FM vs. the AMP and AB groups (25.45 ± 5.99%, 21.45 ± 4.21% and 16.69 ± 2.56%, respectively; P = 0.008 vs. AMP and P < 0.001 vs. AB). The %FM was also significantly higher in the AMP vs. the AB group (P < 0.001). Whole-body BMD was negatively affected in SCI athletes, with about half of them showing osteopenia or osteoporosis. In fact, the mean BMD and T-score values in the SCI group (1.07 ± 0.09 g/cm2 and −1.25 ± 0.85, respectively) were significantly lower in comparison with the AB group (P = 0.001 for both) as well as the AMP group (P = 0.008 for both). The type of disability affected BC and BMD in the trunk, android, gynoid and leg regions in SCI athletes and the impaired leg only in AMP athletes. Conclusions In conclusion, the type of disability and, partly, the severity of PI impact on BC and BMD in athletes with a PI. Nutritionists, sports medicine doctors, clinicians, coaches and physical conditioners should consider athletes with SCI or AMP separately. Athletes with a PI would benefit from specific nutrition and training programs taking into account the type of their disability.

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“…One study showed that approximately 34% of patients with spinal cord injuries suffer from hypertension, ischemic heart disease or diabetes mellitus compared to 18.6% of the control group [ 5 ]. The increased risk of cardiovascular diseases is probably attributable to a higher prevalence of structural cardiac changes due to haemodynamic alternations in those with spinal cord injuries and in amputees [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Prevalence of Cardiovascular Diseases in Paralympic Athletes

et al. 2023

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Paralympic participants represent a special subset of athletes. Although sudden cardiac death in this group is a rare event, it should be underlined that, in particular, Paralympians with movement restrictions have a higher prevalence of coronary heart disease. Numerous reports have focused on comparing athletes with spinal cord injury (SCI) and the ones with non-spinal cord injury—NSCI. The first group is more prone to develop arrhythmias, arterial hypertension, hyperlipidaemia including atrial fibrillation and atrial flutter, and this group potentially may have a higher risk of cardiovascular mortality. In ECGs of the disabled athletes with SCI, we more often find changes typically established as consequences of exercise training, such as T-wave inversions. The potential differences in the cardiovascular status of disabled athletes may depend not only on the class of impairment, but also on the discipline of sport and environmental conditions, which makes the analysis relatively complex. The paper analyses up-to-date articles discussing the cardiovascular problems in disabled athletes, pointing to scarce data in several fields of interest. Previous studies on the frequency of abnormalities of the cardiovascular system in Paralympic athletes highlighted the need to intensify preventive cardiology care for this group of athletes, and some activities could be proposed for sportsmen and sportswomen in this group, including more frequent screening ECG, application of 24 h ECG Holter monitoring, echocardiography and cardiological care. Due to the relatively few data available and existing discrepancies in this area, further research is necessary.

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Cardiovascular screening of Paralympic athletes reported by chief medical officers of the PyeongChang 2018 Paralympic Winter Games

Cited by 3 publications

References 7 publications

Cardiovascular Screening of Elite Athletes by Sporting Organizations in Australia: A Survey of Chief Medical Officers

Cardiovascular Screening of Elite Athletes by Sporting Organizations in Australia: A Survey of Chief Medical Officers

Body composition and bone mineral density in athletes with a physical impairment

The Prevalence of Cardiovascular Diseases in Paralympic Athletes

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