[Sports cardiology 2021 - what's new?] / Sportkardiologie 2021 ­ was gibt es Neues?

The recently published guidelines "Sports cardiology and exercise in patients with cardiovascular disease" (2020) are the first of a kind by the European Society of Cardiology (ESC). The guidelines provide comprehensive training recommendations for patients with cardiovascular diseases or risk factors, covering the entire spectrum of cardiovascular diseases with case-specific recommendations for recreational and competitive sports.The ESC recognizes exercise as an essential part of both prevention and therapy of cardiovascular diseases, that - comparable to drug therapies - requires correct prescription.The initial cardiac examination is used for individual risk stratification and is indispensable for individualized training recommendations addressing training frequency, duration and intensity, as well as type of sport.Thus, the question is not whether a patient with cardiovascular disease shall be allowed to exercise, but rather how he can safely perform it. Only in exceptional cases exercise therapy is (temporarily) contraindicated.COVID-19 can lead to cardiovascular complications even in asymptomatic and mild disease courses. Before resuming intense sporting activities, different return-to-sports protocols have been introduced. The current consensus is that the extent of these examinations should be based on symptoms, severity and duration of COVID-19 and that individual return-to-training recommendations should be given.

Is It High Time to Increase Elite Soccer Substitutions Permanently?

Rules determine how team sport matches occur. Match-induced fatigue is specific to each sport, and may be associated with injury incidence. For example, the injury rate in soccer is distinctly higher during matches than in training sessions. Understanding the differences between team sports rules might be useful for enhancing rules (e.g., safer sport). Therefore, this study aimed to evaluate the impact of the rule-induced physical demands between soccer, futsal, basketball, and handball, focusing on substitution rules. Data from the elite team sports' rules (e.g., absolute and relative court dimensions; the number of players, substitutions allowed, total game time, time-outs) were collected, including the changes due to the coronavirus disease (COVID-19) pandemic in soccer substitutions, and comparisons were performed. The data showed that soccer has higher rule-induced physical demands: e.g., substantially lower substitution rate, higher dimensions in absolute (eight to fifteen times), and relative (four to eight times) values. Simulations also showed that soccer has extremely large differences, even considering COVID-19 substitution changes (from three to up to five). We conclude that elite soccer has remarkably higher overall rule-induced physical demands than elite futsal, basketball and handball, and increasing soccer substitutions permanently (e.g., unlimited) might mitigate overall soccer demands.

[Gymnastics-sports activities: health benefits in emergency period CoViD-19. How to organize a quick shot.] / Attività ginnico-sportiva: i benefici sulla salute in periodo di emergenza CoViD-19. Come organizzare una rapida ripresa.

Regular physical activity grants significant health effects and lowers the risk of premature death for all causes, in particular cardiovascular ones in asymptomatic subjects. Physical activity is useful in the primary and secondary prevention of cardiovascular and lung diseases, metabolic diseases, musculoskeletal diseases, cancer and depression. Recent studies correlate inactivity with chronic low-grade inflammation and obesity, at the origin of chronic non-communicable diseases. The evidence must be taken seriously into consideration in this particular CoViD-19 emergency period and long-term effects of prolonged limitation of sports activity must not be overlooked. Contagion in open places is very difficult and the absolute prohibition of sports activities in open places and the closure of parks are creating discomfort and confusion. Institutions and media are generating the wrong message that active people must be looked at with disapproval. Instead, this habit should be encouraged, in order to protect citizens' and community health, lightening the welfare load for society.