Systematic sports medical prophylactic evaluations in the countries of the former USSR

Abstract

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.