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At least 829 records · Page 46Linked to original sources
PubMed1999

Reduced resting metabolic rate in athletes with menstrual disorders.

PURPOSE: This study investigated metabolic and nutritional determinants in association with menstrual disorders in athletes. Athletes with normal menstrual function (AN; N = 21) and athletes with menstrual disorders (AD: N = 12) participated in this study. METHODS: The quality of the menstrual cycle was judged according to salivary progesterone concentrations. Resting metabolic rate (RMR) and diet-induced thermogenesis (DIT) were measured by indirect calorimetry. Body composition, energy intake and restrained eating scores were obtained. RESULTS: When adjusted for body composition by ANCOVA, RMR was significantly (approximately 460 kJ, P < 0.02) lower in athletes with menstrual disorders than in athletes without menstrual disorders. The DIT and the daily energy intake of the groups did not differ. Athletes with menstrual disturbances scored significantly higher on the Restraint Eating Scale (TFEQ). Thyroid hormones (fT3 and fT4), analyzed by a competitive chemiluminescent immunoassay, were in the normal range and not different between groups. CONCLUSIONS: The results provide evidence that restrained eating and low RMR are associated with menstrual cycle disturbances in athletes.

Adult↗
PubMed2000

Interleukins 1-beta, -8, and histamine increases in highly trained, exercising athletes.

PURPOSE: Exercise-induced hypoxemia (EIH) in highly trained athletes is associated with an increase in histamine release (%H) during exercise. Certain cytokines, known as histamine-releasing factors, are capable of interacting with basophils and/or mast cells to cause the release of histamine. The aim of this study was to determine whether the increased histamine release in highly trained athletes is related to a high plasma level in interleukin-1 beta (IL-1beta), IL-3, or IL-8 in arterial blood. METHODS: These parameters were measured in 11 endurance athletes (23.2 +/- 1.2 yr (mean +/- SEM)) known to develop exercise-induced hypoxemia and 11 control subjects (25.0 +/- 1.1 yr) at rest, during an incremental exhaustive exercise test, and at the fifth minute of recovery. RESULTS: Histamine release increased between rest and maximal exercise in the athletes (P < 0.01), showing a strong correlation with EIH (r = 0.76, P < 0.01) and was unchanged in the controls. IL-3 plasma concentration was not altered with training and/or with exercise. Circulating IL-8 levels were not different between trained and untrained subjects at any testing level and increased at maximal exercise in both groups (P < 0.01). IL-1beta plasma levels were higher in athletes than in controls (P < 0.05) at each testing level and increased during exercise only in the athletes (P < 0.05). CONCLUSION: An elevated concentration of IL-1beta in plasma and its association with increased IL-8 levels during exercise may partly explain the increase in %H associated with EIH in highly trained athletes. Histamine, IL-8, and IL-1beta releases during exercise reflect an inflammatory reaction, which is probably involved in EIH.

Adult↗
PubMed2000

Dietary fats and immune status in athletes: clinical implications.

Athletes are competitive, train at very high levels with inadequate rest, consume too few calories, avoid fats, and may be at increased risk of infections. The immune system is sensitive to both fat intake and intense exercise, suggesting that athletes may have suppressed immune function. It has been reported that many athletes consume about 25% fewer calories than the estimated expenditure, leading to low intakes of some essential micronutrients and fats. Acute exercise has been shown to increase inflammatory and decrease antiinflammatory immune factors and may increase oxidant stress. Chronic exercise appears to improve immune competence. Lipids are powerful mediators of the immune system, and they may modulate the immunosuppressive effects of strenuous exercise. Studies have shown that a low-fat high-carbohydrate diet (15% fat, 65% CHO, 20% protein of total calories), typically eaten by athletes, increases inflammatory and decreases antiinflammatory immune factors, depresses antioxidants, and negatively affects blood lipoprotein ratios. Increasing total caloric intake by 25% to match energy expenditure and the dietary fat intake to 32% in athletes appears to reverse the negative effects on immune function and lipoprotein levels reported on a low-fat diet. Increasing the dietary fat intake of athletes to 42%, while maintaining caloric intake equal to expenditure, does not negatively affect immune competency or blood lipoproteins, whereas it improves endurance exercise performance at 60-80% of VO2max in cyclists, soldiers, and runners. There is no evidence that higher fat intakes (up to 42% of total calories), in calorically balanced diets, increase the risk of cancer, but studies are needed to determine whether the beneficial effects of higher fat diets in athletes reduce their rate of infections.

Antioxidants↗
PubMed2002

Pre- and post-synaptic control of motoneuron excitability in athletes.

PURPOSE: The purpose of this study was to examine the efficacy of two spinal mechanisms in gating motoneuron excitability in power-trained athletes (N = 9), endurance-trained athletes (N = 9), and untrained subjects (N = 9). METHODS: The dependent variable for each protocol was the peak-to-peak amplitude of the conditioned soleus Hoffmann reflex (H-reflex). Modulations of the test reflex amplitude were evaluated for each subject by using two experimental conditioning protocols: recurrent inhibition (RI) and paired-reflex depression (PRD). Also, to assess the effects of different levels of input on motoneuron excitability, two H-reflex stimulus intensities were used (10% and 30% of maximal motor response (M-max)). For each protocol, seven conditioned H-reflex trials were obtained from each subject during quiet stance. The RI protocol consisted of two reflex responses that were separated by 10 ms. The first was of the same intensity as the unconditioned trials. The second stimulus was of an intensity great enough to elicit a supramaximal motor response. The PRD protocol utilized two reflex stimuli of the same intensity separated by 80 ms. A group by intensity (3 x 2) analysis of variance was performed to determine group differences within each condition. RESULTS: For both protocols, increases in stimulus intensity resulted in significantly greater inhibition. Significant differences were observed between the trained groups for both the RI and the PRD protocols. For the RI protocol, the endurance-trained athletes demonstrated significantly less RI than either the power-trained athletes or the untrained subjects. For the PRD protocol, the endurance-trained athletes demonstrated significantly greater PRD than either the power-trained athletes or the untrained subjects. CONCLUSIONS: These observations indicate differential control of motoneuron excitability as a result of segmental reflex pathways among differently trained athletes.

Adult↗
PubMed1997

Diagnosis, prophylaxis, and treatment of headaches in the athlete.

BACKGROUND: Headaches are a common entity in the ambulatory population. Physicians involved in sports medicine must be able to accurately diagnose headaches in athletes and whether they are exacerbated by exertion. Many medications have proven or theoretical negative effects on athletic performance. Thus, we should consider all aspects of medical management and determine which therapy is least intrusive to the athlete's performance. We planned this review because of the small number of papers available on the effects of various medications on athletic performance. METHODS: We used MEDLINE to search from 1992 to current citations, using the medical subject headings of headache, prophylaxis, treatment, review, athletes, and exercise, alone or in combination. RESULTS: Fifty-two articles were identified and deemed appropriate for inclusion in this review. CONCLUSIONS: Acute therapy for tension headaches in the athletic population is best done with nonsteroidal anti-inflammatory drugs. Prophylaxis of chronic, recurrent tension headaches is best accomplished by night-time tricyclic antidepressants (especially nortriptyline) or selective serotonin reuptake inhibitors. Acute therapy for athletes with migraines is best managed with sumatriptan or DHE 45 and prophylaxis can be accomplished with verapamil, antidepressants, or valproate. Exertional, cluster, and structural/infectious headaches are also discussed briefly.

Analgesics, Non-Narcotic↗
PubMed1998

The medical demands of the special athlete.

OBJECTIVE: To identify the most common injuries and medical conditions experienced by the mentally handicapped athlete during Special Olympic competition. DESIGN: A longitudinal, observational, and prospective study. SETTING: Hawaii Special Olympic Summer Games, 1993-1996. PARTICIPANTS: A total of 2326 athletic participants were registered during a 4-year period in the Hawaii Special Olympic Summer Games. The athletes ranged in age from 8 to 76 years. INTERVENTION: Medical encounter forms were documented by physicians and nurses on participants treated at aid stations located at the athletic venues and Olympic village during competition. MAIN OUTCOME MEASURES: The number and type of injuries and medical conditions encountered during Special Olympic competition were recorded on standard medical forms supplied by the U.S. Special Olympic Committee. RESULTS: Ninety athletes (3.87%) required medical attention during four annual Special Olympic Summer Games. A total of 52 (57.8%) injuries and 38 (42.2%) medical conditions were reported during the 4 years. Of the 90 encounters, 86.7% (n = 78) were acute and 13.3% (n = 12) were nonacute medical problems. More than 61% (n = 55) of the injuries and medical conditions occurred during actual competition. The majority of injuries occurred during track and field events (n = 25, 56%), and the most commonly injured site was the knee. CONCLUSIONS: Despite preexisting medical conditions and physical limitations of the Special Olympian, most of the medical demands encountered during athletic competition are acute, minor injuries. No athlete sustained more than one injury during the period studied.

Adolescent↗
PubMed2004

Screening of athletes for exercise-induced bronchoconstriction.

Exercise-induced bronchoconstriction (EIB) has a high prevalence in elite athletes, particularly endurance athletes, winter athletes and swimmers. Recent studies have shown that a clinical diagnosis of EIB has only a moderate sensitivity and specificity for EIB. This finding in conjunction with a recent ruling by the IOC-medical commission that all athletes competing in initially the 2003 Winter Olympic Games in Salt Lake City, and now the 2004 Summer Olympic Games in Athens require objective evidence of EIB, support the need for bronchial provocation challenge tests in the diagnosis of EIB. The recommended bronchial provocation challenge test is the eucapnic voluntary hyperpnea (EVH) challenge; this challenge test has been shown to have both a high sensitivity and specificity for EIB. Pharmacological challenge tests, such as the methacholine challenge test, have been shown to have only a low sensitivity but high specificity for EIB in elite athletes, and are thus not recommended in the athlete with pure EIB. Exercise challenge tests performed both in the laboratory and field have a high specificity for EIB; however those in the laboratory have only a moderate sensitivity for EIB in elite athletes, whilst those in the field are limited by problems with standardization. The osmotic challenge tests, such as the hypertonic saline and newer inhaled dry powder mannitol challenge have both a high sensitivity and specificity for EIB, and may be used as an alternative to the EVH challenge.

Asthma, Exercise-Induced↗
PubMed2006

Complementary and alternative medicine usage by intercollegiate athletes.

OBJECTIVE: The purpose of this study is to determine the prevalence and types of provider-delivered complementary and alternative medicine (CAM) used by intercollegiate student athletes attending a Division I NCAA University. DESIGN AND SETTING: Survey methodology within a group of intercollegiate student athletes at a Division I NCAA university during the fall semester of 2004. PARTICIPANTS: All incoming and returning intercollegiate student athletes were invited to participate. Surveys were completed by 309 (122 women, 187 men) of 482 (64.1%) student athletes representing 20 sports (11 women's, 9 men's teams). MAIN OUTCOME MEASUREMENTS: A 28-item reliable and valid survey instrument that measured the use of provider delivered CAM and allopathic medical care was administered. Data were analyzed using descriptive statistics, chi2 tests, and logistic regressions. RESULTS: Fifty-six percent of subjects reported using CAM within the past 12 months, including a significantly higher percentage of women (67%) than men (49%) (P < 0.01). Massage was the most commonly used type (38%), followed by chiropractic (29%), Lomilomi (14%), and acupuncture (12%). CAM usage overall did not differ significantly by sport, year in college, nor ethnicity. Hawaiian, Samoan, and Tongan subjects were more likely to use the Hawaiian-originated forms of CAM. Sixty percent of respondents have a regular medical doctor, eighty percent of which are family practitioners. Forty-two percent of subjects were referred to a medical specialist within the previous three years. CONCLUSIONS: CAM usage is common among collegiate student athletes and rates are higher than in adults nationwide and within the state of Hawai'i. This study and future investigations will increase the awareness of CAM use patterns by collegiate athletes, and hopefully improve allopathic physicians' abilities to provide optimal athletic health care.

Adult↗
PubMedDate not supplied

Cardiac arrhythmias in the athlete.

Cardiac arrhythmias in the athlete are a frequent cause for concern. Some arrhythmias may be benign and asymptomatic, but others may be life threatening and a sign that serious cardiovascular disease is present. Physicians often are consulted with regard to arrhythmias, or symptoms consistent with arrhythmias, in athletes. Sinus bradyarrhythmias are common and even expected in athletes. These bradyarrhythmias are rarely a cause for concern. Heart block is unusual and merits a thorough workup. Atrial fibrillation may be more common in the athlete. Supraventricular tachycardias other than atrial fibrillation generally warrant consideration of radiofrequency ablation for cure of the tachyarrhythmia. Ventricular arrhythmias in the athlete generally occur in the setting of structural heart disease that is genetically determined (hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, anomalous coronary arteries) or acquired (coronary artery disease, myocarditis, idiopathic dilated cardiomyopathies). In these conditions, the arrhythmia generally is life threatening. Ventricular arrhythmias that occur in the athlete without structural heart disease are not thought to be life threatening. Athletes with structural heart disease and syncope and those with exertional syncope merit a complete evaluation.

Arrhythmias, Cardiac↗
PubMed2006

Patterns of allergic reactivity and disease in Olympic athletes.

OBJECTIVE: Because the Sydney Olympic Games were being held in the spring, we wished to examine the prevalence of allergic disorders in the Australian Olympic and Paralympic athletes and to examine patterns of allergic reactivity and medication use for the treatment of allergic symptoms. DESIGN: A survey case series of Australian Olympic and Paralympic athletes. SETTING: Screening was conducted on team processing days. PARTICIPANTS: Prospective members of the Australian Olympic and Paralympic teams. INTERVENTION: A questionnaire seeking information on the presence of allergic disorders, symptoms, family history, and medication use was administered. Skin-prick tests (SPT) for sensitivity to common aeroallergens was performed. OUTCOME MEASURES: Athletes were classified as atopic or non-atopic, and patterns of reactivity were examined according to sporting category. RESULTS: Of the athletes, 56% had a positive SPT to at least 1 allergen, with 34% reacting to at least 1 seasonal allergen. There was no significant association between skin test reactivity and sporting category. Of the athletes, 37% had allergic rhinoconjunctivitis (AR/C), whereas 24% had seasonal allergic rhinoconjunctivitis (SAR/C). Approximately one-third of all those with AR/C had a history of asthma, whereas approximately one-fifth had a history of atopic dermatitis. Swimmers were most likely to have asthma, AR/C, and positive skin tests to any allergen. Very few athletes with self-reported AR/C took any medication to relieve their symptoms. CONCLUSIONS: Allergic disorders are common among athletes from all sports. The known impact of AR/C on quality of life necessitates that it be screened for and managed appropriately.

Adult↗
PubMed2006

Parental and coach support or pressure on psychosocial outcomes of pediatric athletes in soccer.

OBJECTIVE: The purpose of this article was to examine supportive and/or pressuring influences of parents and coaches on young athletes' maladaptive perfectionist tendencies, relationships to friends, and competency perceptions in soccer. Previous research has revealed that parents and coaches may give rise to both enjoyable and stressful sport experiences for the pediatric athlete and that parents and coaches are thus able to influence whether young people decide to quit sport or continue participating. Less is known about the relation of supportive versus pressuring parental and coach behaviors on the quality of athletes' achievement striving, relationships to friends in sport, and their competence perceptions. Such knowledge may help create a better psychological sport experience for pediatric athletes. DATA SOURCES/SYNTHESIS: A questionnaire-based cross-sectional field study was carried out among 677 young Norwegian soccer players (aged 10 to 14 years; 504 boys, 173 girls; mean age: boys = 11.9 years, SD = 2.9; girls = 11.2 years, SD = 2.1) taking part in the Norway Cup international youth soccer tournament in 2001. Multivariate analysis of variance (MANOVA) with follow-up canonical correlation was used to examine multivariate relationships between supportive and pressuring behavior and athletes' psychosocial experiences. RESULTS: Joint pressuring behaviors from parents and coaches related positively to maladaptive achievement striving, as indicated by overconcern for mistakes, doubt about one's soccer actions, and lowered perceptions of soccer competence. Mirroring these findings, predominantly supportive coach-created psychological climates were related to a linear pattern of psychological outcomes comprising high-quality friendships, positive competency perceptions, and the absence of specific worries related to achievement striving. CONCLUSIONS: Supportive, mastery-oriented coach influence seems beneficial for constructive psychosocial outcomes in pediatric athletes, and athletes experiencing a joint social pressure to excel from coaches and parents may benefit less psychosocially through sport.

Achievement↗
PubMed2005

Dynamics of saccadic adaptation: differences between athletes and nonathletes.

PURPOSE: The aim of the study was to delineate differences in saccadic adaptation characteristics between a population of racquet sports athletes and nonathletes. METHODS: Eye movements were recorded at 120 Hz using a video-based eye tracker (ELMAR 2020) in a sample of 27 athletes (varsity badminton and squash players) and 14 nonathletes (<3 hours/week participation in recreational sports). Responses to negative positional error and positive positional error were studied in two sessions on separate days. Negative positional errors were induced by displacing the stimuli backwards by 3 degrees from the initial target step (12 degrees). Likewise, positive positional errors were induced by displacing the stimuli forward by 3 degrees . Amplitude gains were calculated for trials before, during, and after the adaptation phase. The magnitude and the rate of change of saccadic adaptation were determined from the amplitude gains. Differences between the groups were compared using regression analysis. RESULTS: No significant differences were found between the two groups in the magnitude of saccadic adaptation, both for negative (athletes -60%, nonathletes -57%) and positive (athletes +26%, and nonathletes +27%) positional error. Racquet sports athletes showed a significantly faster rate of adaptation for the positive positional error. A significant difference was not observed in the rate of adaptation for the negative positional error. CONCLUSIONS: Racquet sports athletes and nonathletes adapt to positional error signals by similar amounts. However, racquet sports athletes respond to positive positional errors at a faster rate, suggesting that a strategic component or environmental influences (such as practice) may play a role in saccadic adaptation.

Adaptation, Ocular↗
PubMed2004

Supplements and athletes.

Supplements have become a staple with athletes. Athletes take supplements to enhance their performance through replenishment of real and perceived deficiencies, anabolic action of stimulants, increased energy and alertness, and for weight control. Physicians who deal with athletes should be aware of the supplements being utilized by athletes, the athletes' desired effects and the efficacy of the supplement, the adverse effects, and whether the supplement is banned by leagues or organizations in which the athletes are competing. For those athletes who are regularly drug tested for performance enhancers, it is important to remember that one cannot be 100% sure that any supplement will not result in a positive drug test, because there is no independent agency certifying purity.

Anabolic Agents↗
PubMed2004

Vision in athletes with intellectual disabilities: the need for improved eyecare.

BACKGROUND: Special Olympics provides sporting opportunities for people with intellectual disabilities (ID), and Lions Clubs International Opening Eyes GB offers vision screening for athletes at Special Olympics Games. METHODS: Opening Eyes GB screened the vision of 505 UK athletes at its inaugural event in 2001. The results were analysed and are presented here. RESULTS: Results showed that athletes do not differ from other people with ID in being at high risk of ocular and visual defects and many are not accessing eyecare. 15% reported never having an optometric eye examination, and yet 19% of these athletes had a significant refractive error, 32% had ocular anomalies and 6% were visually impaired. Overall, findings confirmed the high prevalence of refractive errors and strabismus amongst people with ID. 40% of athletes had ocular abnormalities, including 15.6% with blepharitis, a readily treatable condition that causes discomfort. 9% had lens opacities, of which half were probably impairing sight. An important finding was that many athletes have reduced vision and 14% could be classified as visually impaired (WHO definition) even when refractive errors were fully corrected. CONCLUSIONS: Special Olympics athletes should be encouraged to have regular eye examinations (as indeed, should all people with ID), and educators, carers and coaches need appropriate information about the visual status of their charges.

Adolescent↗
PubMed1997

Pregnancy in endurance athletes.

The purpose of the present study was to examine pregnancy and delivery among Finnish endurance athletes at the national top level. A questionnaire concerning first pregnancy was sent to 30 Finnish endurance athletes who had been at national top level in cross-country skiing, running, speed-skating or orienteering. Data on labour were collected retrospectively through a questionnaire and from the diaries in the hospital concerned. The next primipara in the diaries formed a member of the control group. Twenty-three athletes (77%) had regular menstrual cycles, seven (23%) had irregularities, and four of them had received hormonal treatment for this. Seven athletes (23%) had experienced spontaneous abortion during the first trimester in previous pregnancy. Sixteen (53%) did not notice any change in their exercise performance, three (10%) subjectively felt themselves to be in a better physical condition, and seven (23%) felt themselves to be in a worse condition than before the pregnancy. Four did not respond on the question. After delivery, 18 athletes continued to compete, the median interval being 8.2 months (range 2-24 months). Two of them (11%) achieved a better condition than before the pregnancy, 11 (61%) reached the same level and five (28%) did not achieve the same performance level. There were no significant differences in labour parameters between the athletes and controls. Endurance training had no harmful side-effects on the pregnancies or deliveries of the athletes. The effect of pregnancy on exercise performance is individual.

Adult↗
PubMed1999

Preserved vascular reactivity in elderly male athletes.

The objective was to characterise function and morphology of the arterial wall in 9 elderly men (mean age 75 +/- 3.4 years) with a history of lifelong regular strenuous exercise. A control group of 11 healthy sedentary or moderately physically active men (74.5 +/- 2.7 years) was also studied. With increasing age atherosclerosis becomes more common and endothelium-dependent vasodilation reduced. The effects of training on endothelial function and atherosclerosis have not been studied previously in elderly subjects. High-frequency ultrasound was used to estimate vasodilatory function in the brachial artery. The endothelium-dependent (flow-mediated) and non-endothelium-dependent (nitroglycerine-induced) dilation of the brachial artery were measured. Stasis was used to induce reactive hyperaemia. The carotid arteries were scanned for plaques, intima-media thickness was measured in the common carotid arteries and arterial wall stiffness was calculated from pulsatile diameter changes in the right carotid artery in relation to blood pressure. The athletes' maximal oxygen uptake during treadmill exercise was 2.90 +/- 0.50 l or 41 +/- 7 ml.kg-1. The athletes' and the controls' maximal exercise capacity on a bicycle was 254 +/- 38 W and 148 +/- 19 W respectively (P < 0.001). The athletes' body mass index was 22.6 +/- 2.6 kg.m-2 and the controls' body mass index was 25.8 +/- 3.5 kg.m-2 (P = 0.037). Three of 9 athletes had plaques in either or both carotid bifurcations compared with 6 of 11 controls. The athletes had less stiff arteries and better vasodilatory capacity in the brachial artery during increased flow, and borderline significantly greater vasodilation after nitroglycerine. So, elderly athletes with a lifelong training history appear to have better vasodilatory capacity and less stiff arteries than healthy controls. Plaques in the carotid bifurcation were common in both athletes and controls.

Aged↗
PubMed1996

Patterns of tobacco and alcohol use among sedentary, exercising, nonathletic, and athletic youth.

Through a statewide random design, 7,846 9th to 12th grade students in 81 South Carolina public schools were selected to complete the Youth Risk Behavior Survey. Mantel-Haenszel Chi-Square, general linear models, and logistic regression were used to examine the relation between the independent variables of race, gender, and physical activity status with the dependent variables of tobacco and alcohol use while controlling for race, gender, and participation in physical education classes. The six physical activity levels ranged from sedentary nonathletes to athletes participating on two or more sports teams. Highly active athletes drank more frequently than did low-activity nonathletes (p = .002) and sedentary nonathletes (p = .006), and they were more likely to binge drink (p = .004). Athletic groups were less likely to smoke than were the nonathletic groups (p < .0001) with "sedentary nonathletes" the heaviest smokers of all groups. Athletes were more likely to use smokeless tobacco (p < .0001) than nonathletes although this difference disappeared when controlling for gender and race. This research supports other findings about prevalence of smokeless tobacco use among athletic youth. In addition, it reveals that athletic youth are at an increased risk of alcohol use and binge drinking. Possible factors such as the risk-taking tendencies of team sport athletes should be investigated.

Adolescent↗
PubMed1977

The athlete's heart syndrome: a new perspective.

Although earlier electrocardiographic and roentgenographic studies suggested that the heart of trained athletes differed from that of nonathletes, little was known of the cardiac dimensions of the athlete's heart until the advent of echocardiography. Echocardiographic studies have demonstrated that trained athletes may have increased left ventricular mass and that the structural change accounting for this increase is related to the type of physical conditioning. Athletes participating primarily in isotonic exercise have an increase in left ventricular end-diastolic volume with little or no increase in left ventricular wall thickness whereas those athletes participating primarily in isometric exercise have an increase in left ventricular wall thickness associated with normal left ventricular end-diastolic volume. Comparisons between echocardiographically determined cardiac changes in college and world class athletes were made, and the electrocardiographic and chest roentgenographic changes present in the athlete's heart syndrome were reviewed.

Adaptation, Physiological↗