Comprehensive periodic health evaluations of 454 Norwegian Paralympic and Olympic athletes over 8 years: what did we learn?

OBJECTIVE: A periodic health evaluation (PHE) is a comprehensive and multidisciplinary investigation of athlete health widely used in elite sport, but its contents and benefits can be questioned. This study aimed to determine the prevalence of conditions identified by a PHE among Paralympic and Olympic athletes over four consecutive Games cycles from Rio de Janeiro 2016 to Beijing 2022 and to assess the benefits and potential pitfalls of a comprehensive PHE programme in detecting existing injuries, illnesses and other health issues. METHODS: We collected extensive health history and clinical examination data on elite athletes: medical history, ECG, blood pressure, blood samples, spirometry, musculoskeletal health, cognitive function, mental health and compliance with public health programmes. RESULTS: The final cohort included 87 Paralympic and 367 Olympic athletes, representing 565 PHE cycles. Musculoskeletal problems and unspecified pain, infections and allergies were the most frequent health issues. High blood pressure was the most prevalent cardiovascular finding, and vitamin D deficiency the most common laboratory abnormality. Most athletes complied with the public childhood vaccination programmes, but fewer with recommended cancer screening. Follow-up of health issues was variable. CONCLUSION: Our PHE programme identified musculoskeletal problems, infections, allergies, elevated blood pressure and vitamin D deficiency as common health conditions. Longitudinal follow-up of health conditions identified during screening and improved compliance with public health and cancer screening programmes is needed to determine the true benefits of athlete care prompted by the PHE.

Intermittent blood flow restriction does not reduce atrophy following anterior cruciate ligament reconstruction.

BACKGROUND: A previous study has reported a 50% reduction in disuse atrophy of the quadriceps during the first 14 days after anterior cruciate ligament (ACL) reconstruction. A follow-up trial is needed to confirm these promising results. The present study aims to investigate the effect of an occlusion stimulus on quadriceps atrophy after ACL reconstruction. METHODS: A total of 24 subjects participated in the study. They were randomized into two groups. Starting the 2nd day after surgery, the occlusion group received an occlusion stimulus for 5 min, followed by removal of the occlusive pressure for 3 min. This was repeated five times in one training session, twice daily. During the period of occlusive stimulus, the subjects performed 20 low load exercises for the quadriceps. The control group followed the same exercise protocol, but without the occlusion stimulus. Changes in quadriceps anatomical cross section area (ACSA) were measured using axial magnetic resonance (MR) images at 40% and 50% of the length of the femur. RESULTS: Both groups had a significant reduction of quadriceps ACSA from 2 days before surgery to 16 days after surgery. During the intervention period, the occlusion group lost 13.8% ± 1.1% (mean ± SEM) and the control group lost 13.1% ± 1.0% of their quadriceps ACSA, respectively. There was no significant difference between the occlusion and control groups with regards to atrophy of the quadriceps muscles. CONCLUSION: In conflict with other studies using a similar protocol, application of blood flow restriction the first 14 days after ACL reconstruction did not reduce quadriceps ACSA muscle atrophy measured by MR in a population of athletes.