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Sports and Exercise Medicine for the Pharmacist. Eric J. Jarvi, Ph.D. Associate Dean and Professor Husson University School of Pharmacy. Physiological Effects of Exercise on Cardiac Output. Increased sympathetic stimulation Contraction of muscles around vessels - PowerPoint PPT Presentation
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Sports and Exercise Medicine for the
PharmacistEric J. Jarvi, Ph.D.
Associate Dean and ProfessorHusson University School of Pharmacy
Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)
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Increased sympathetic stimulation
Contraction of muscles around vessels
Dilation of resistant vessels in muscles
Physiological Effects of Exercise on Cardiac Output
Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)
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Flow at rest versus during exercise
Mechanisms for increased blood flow
Physiological Effects of Exercise on Muscle Blood Flow
Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)
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Oxygen uptake by pulmonary blood
Regulation of respiration
Physiological Effects of Exercise on Oxygen Demand
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Physiological Effects of Exercise on Metabolic Rate
Muscle 100 x more heat than at rest In well trained athlete body heat can • ↑50 x for a few seconds• ↑ 20 x for few minutes
Metabolic rate ↑ 2000 x Basal metabolic rate (70 kg):• Bed = 1650 calories• Eating = 1850 calories• Sitting = 2000 calories• Exercise = (170-100 calories/hour)
Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)
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Physiological Effects of Exercise on Blood Glucose
http://www.elmhurst.edu/~chm/vchembook/604glycogenesis.html
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Exercise ↑ body temperature as results of three factors: metabolic rate, environmental conditions, body temperature
Net water = [liquid/food consumed + metabolism] – [respiratoryloss + GIloss + renalloss + sweatloss]
Hypohydration versus euhydration versus hyperhydration
Physiological Effects of Exercise on Hydration
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Carbohydrate recommendationsProtein recommendationsFat recommendationsDehydrationGoals (pre-exercise, during
exercise, post-exercise)
Sports Nutrition(ADA Position Paper “Nutrition and Athletic
Performance”)
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By location• Lower extremities at greatest risk• Upper extremities – greatest risk not age but
specific skill demands• Central body
Sports Injuries
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By injury type• Overuse• Strains (1st degree, 2nd degree, 3rd degree)• Contusion/hematoma• Sprains• Fractures• Dislocations• Fractures• Concussions (grade 1, grade 2, grade 3)
Sports Injuries
RX561.05 - Soft Tissue Injuries 11
“HS Sports-Related Injury Surveillance Study” 2009-2010
RX561.05 - Soft Tissue Injuries 12
“HS Sports-Related Injury Surveillance Study” 2009-2010
RX561.05 - Soft Tissue Injuries 13
“HS Sports-Related Injury Surveillance Study” 2009-2010
RX561.05 - Soft Tissue Injuries 14
http://www.iaaf.org/mm/document/imported/42032.pdf
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Stage 1 – acute inflammatory process lasting up to 72 hours
Stage 2 – regeneration and repair lasting 48 hours to 6 weeks
Stage 3 – remodeling phase lasting 3 weeks to 12 months
Stages of Sports Injury Rehabilitation
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Rest, Ice, Compression, ElevationMovement , Ice, Compression, Elevation
Heat therapyStrapping/bracing
Non-drug Treatment of Injuries
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NSAIDOpiate analgesicsCorticosteroid injections Local anesthetics
Drug Treatment of Injuries
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Skeletal-muscle relaxantsTopical rubifacientsCapsicumDrugs for bruising
Drug Treatment of Soft Tissue Injuries
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Abrasions/cuts Stress Blisters Bruises Soft tissue injuries Cramps Pain
CAMS Treatment of Soft Tissue Injuries
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Physical activity guidelines (2008)• Avoid inactivity• Some better than none• Any activity provides some benefit
Metabolic equivalent units (MET) Cardiometabolic exercise (CME) - General
health and gradual weight loss = 150 points/day or ~1000 points/week
Exercise Guidelines
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CME TableSource: Excerpted from Tables 4.2 in Simon HB. The No Sweat Exercise Plan.
Lose Weight, Get Healthy, and Live Longer. New York: McGraw-Hill; 2006. Activity Pace Duration CME Points
Daily Activities Carpentry Moderate 30 minutes 100Cleaning Heavy 30 minutes 150Digging in yard Moderate 30 minutes 190Mowing lawn Pushing hand mower 30 minutes 200
Pushing power mower 30 minutes 145Raking lawn Moderate 30 minutes 130Stair climbing Moderate, upstairs 10 minutes 100
Moderate, downstairs 10 minutes 30Washing car by hand Moderate 30 minutes 100
Recreational Activities Aerobic dance Moderate 30 minutes 200Biking Moderate 30 minutes 250Golfing Pulling clubs 30 minutes 145Jogging 12 minutes/mile 30 minutes 200Rope jumping Moderate 15 minutes 200Skiing Downhill or water 30 minutes 200
Cross-country 30 minutes 315Swimming Moderate 30 minutes 230Tennis Doubles 30 minutes 160
Singles 30 minutes 200Walking Moderate 30 minutes 125
Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)
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Aerobic Exercise versus Resistance Exercise
AET RET
Improves CV reserve Increased muscle/bone mass/strength
Increased skeletal muscle adaptation
Improved psychological well being
Decrease age-related accumulate of central body fat
Decreased cognitive decline
Trained older individuals sustain maximum exercise load with less CV stress and muscle fatigueImproved glycemic control and clearance of post-prandial lipids
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History goes back to ancient Egypt First laws governing doping in 1963 Prohibited substances
Prohibited methods
Doping
Stimulants b2 agonistsNarcotic analgesics Anti-estrogenic agentsCannabinoids Masking agentsAnabolic agents GlucocorticosteroidsPeptide hormones/analogs
Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)
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Caffeine is on the watch list of doping of International Olympic Committee (IOC)
Maximum permissible urinary concentration by World Anti-Doping Agency (WADA) is 12 µg/ml.
31 (17 male and 14 female) healthy university students with sedentary lifestyle (mean weight 63.0±2.9 kg, height 166.80±9.84 and age 24±2.25) reporting caffeine intake of ≤200 mg/week participated in the study
the dosage of caffeine tested was 5 mg/kg BW
Performance Enhancement“Effects of caffeine ingestion on strength and endurance performance of normal
young adults” Sharma Archna, Sandhu S Jaspal, Doping Journal (2012): 7(2)
Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)
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Caffeine is on the watch list of doping of International Olympic Committee (IOC)
Maximum permissible urinary concentration by World Anti-Doping Agency (WADA) is 12 µg/ml.
31 (17 male and 14 female) healthy university students with sedentary lifestyle (mean weight 63.0±2.9 kg, height 166.80±9.84 and age 24±2.25) reporting caffeine intake of ≤200 mg/week participated in the study
the dosage of caffeine tested was 5 mg/kg BW
Performance Enhancement“Effects of caffeine ingestion on strength and endurance performance of normal
young adults” Sharma Archna, Sandhu S Jaspal, Doping Journal (2012): 7(2)
Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)
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Performance Enhancement“Effects of caffeine ingestion on strength and endurance performance of normal
young adults” Sharma Archna, Sandhu S Jaspal, Doping Journal (2012): 7(2)
Distribution of Mean values of Peak Force with 5 mg/kg BW Caffeine
Distribution of Mean values of Average Force with 5 mg/kg BW Caffeine*
Distribution of Mean values of Fatigue index with 5 mg/kg BW Caffeine*
Distribution of Mean values of Time to Exhaustion with 5 mg/kg BW Caffeine
Distribution of Mean values of Urinary Caffeine concentration following 5 mg/kg BW Caffeine ingestion
Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)
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Study: n = 40,795 walkers The ant-idiabetic, antihypertensive and LDL
cholesterol-lower medication use may be reduced by walking, function of• Walking distance• Longest walk• Walking intensity
Exercise Effects in Chronic Drug Use“Reduced Diabetic, Hypertensive and Cholesterol Medication Use With Walking” Paul. T.
Williams, Medicine and Science in Sports Exercise (2008): 40(3): 433-443
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Injury types and patterns differ from adult because of skill level, conditioning and musculoskeletal differences
Common causes of injury Chronic injuries
Special Case #1 – Adolescent Athlete
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First described at the 1993 meeting of the American College of Sports Medicine (ACSM)
Components: eating disordered, menstrual disorder, and osteoporosis
Pathophysiology: Reduced energy availability Menstrual dysfunction Impaired bone health Endothelial dysfunction
Special Case #2 – Female Athlete(Female Athlete Triad)
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Injury as barrier to exercise Age associated muscle atrophy and loss of
strength Bone loss Connective tissue changes Intrinsic factors contributing to injury Extrinsic factors contributing to injury
Special Case #3 – Older Athlete
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“Sports and Exercise Medicine for Pharmacists” Steven B. Kayne, Pharmaceutical Press (2006)
Simon HB. The No Sweat Exercise Plan. Lose Weight, Get Healthy, and Live Longer. New York: McGraw-Hill; (2006)
“Effects of caffeine ingestion on strength and endurance performance of normal young adults” Sharma Archna, Sandhu S Jaspal, Doping Journal (2012): 7(2)
“Reduced Diabetic, Hypertensive and Cholesterol Medication Use With Walking” Paul. T. Williams, Medicine and Science in Sports Exercise (2008): 40(3): 433-443
References
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