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I58 A65 G Muscle anatomy and physiology are briefly recapped in order to enhance reader comprehension. The Muscle Testing Handbook describes testing procedures for almost individual muscles in a unique, quick reference, template approach. O94 J46 Covering many subdisciplines that include biochemistry, biomechanics, functional anatomy, epidemiology, kinanthropometry, motor behavior, nutrition, psychology, physiology, and sociology, and with references to key books and journal articles, these volumes help to gain a clear overview of sports science. Some eBook databases Cambridge Core.

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Medical Physiology: Principles for Clinical Medicine 5E

Full text eBooks, including selections by UCF faculty, students, and staff. CAUTION: Although some books provide for unlimited simultaneous users, some have restrictions which make them unsuitable for assigning as course readings. By contrast, their practical importance and also their adequate experimental as well as clinical implementation depend in many ways on the framework conditions in the specific field of application. To begin with this concerns the performance characteristics of standard care: the effect size of common interventions or the inter- and intra-individual variability of diagnostic markers defines the frame within which individual optimization is possible.

On the other side are optimization pressure and resource availability in the particular field of application health, performance, elite sports and finally — with a view to the methodical requirements — realizable sample sizes and acceptance of experimental manipulation, repeated examinations and possibly invasive sample collection.

Figure 3 illustrates this field of tension which is the decisive interface for practical implementation of personalized sports medicine from 9.

The necessity of compromises becomes exemplary in the conflict between highest optimization demands and the smallest number of available cases in elite sports. Their complexity may extend from informal consideration of the possibility of relevant individual deviations from the mean 12 through easy-to-determine 10 , 11 , molecular-biological 14 and genomic 3 , 31 predictors and on up to personalized regression models 7 and deduction of individualized reference ranges based on bayesian procedures 15 9.

In light of the multidimensional gradualist development of practical individualization approaches, a single procedure which is superior in every respect will exist only in very rare cases. Two applications are given as examples below to demonstrate the diversity in form of possible implementations of a personalized sports medicine.

From Physiologic Principles to Clinical Applications

Prediction of Health-Related Training Effectiveness in Preventive SportTask: The effectiveness of preventive training to improve physical performance capacity and state of health is beyond doubt. However, the extent of training-induced changes varies considerably. In addition, estimation of the individual training effect would be helpful the coordination of exercise with therapeutic drug measures. A frequent example in clinical practice is the question whether a pure life-style intervention has a good chance of success in hypertension, or whether concurrent medication should be directly recommended for the particular patient in the case that only little training effectiveness is anticipated.


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However, reliable and practice-relevant predictors are needed for this. Procedure: For several cardiovascular risk factors e. If a relationship exists between the two phenomena, the acute changes e. Results: A relationship between acute and chronic changes could be shown in two independent pilot studies for blood pressure and insulin sensitivity but not for the blood lipid values 10 , 11 , Figure 4 with permission from 10 illustrates the relationship for resting systolic blood pressure.

This finding was recently reproduced in a broad randomized controlled training study Perspective: Acute changes in blood pressure and insulin sensitivity appear to be suitable for the prediction of corresponding training effects in the practice of sports and preventive medicine.

Medical Physiology: Principles for Clinical Medicine 5E - Rodney A. Rhoades, David R. Bell | Znanje

Determination of reference values and predictive precision in relevant groups of people is still lacking. Individualization of the Reference Range of Fatigue Markers Task: The assessment of the fatigue status of athletes is the basis for the daily fine-tuning of training. The goal is a maximization of training effects while avoiding longer-lasting regeneration deficits. Numerous fatigue markers are known, some have been used for decades, but they all bring the problem of broad variability.

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Procedure: Differences between individual athletes explain a considerable part of the overall variability Fig. Accordingly, the meaning of a measured value differs between athletes; it may be above the personal normal range of one athlete, below that of another athlete and at the same time lie within the broader group-based reference range. For this reason, it makes sense to individualize the reference range to increase the certainty of assessment in the individual case.


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In principle, the mean and standard deviation of the measured individual values could be used. But since the width of the reference range depends largely on the number of measured values, it makes sense to begin with a group-based reference range and individualize this step-by-step with an increasing number of individual measurements. Since unlike in the anti-doping campaign, two physiological situations are to be delineated recovered and fatigued , two reference ranges are formed Fig.

A detailed presentation of the method and an Excel spreadsheet for further use are found in Results: The error rates in the assessment of fatigue status in 14 elite athletes in swimming and triathlon based on the parameters urea and CK were significantly lower using individualized reference ranges compared to an optimal groupbased threshold value Perspective: A better diagnostic validity of fatigue markers using individualized reference ranges has meanwhile be confirmed in other types of sports Fred MacDonald.

Fred Bergsten. Dewayne Ashmead. You Decide. Gerard Guillory M. Vonnie Colvin.

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