Sports medical aspects of fitness and wellness

Both the development of diagnosis of performance capacity and of sports medicine over the last 60 years as well as the consequences of action of the individual nowadays (e.g. enough physical activity) and the perspectives for the future are described. In two additional contributions, one from the Department of Physical Medicine and Rehabilitation of the Charité Berlin, methods and effects of classic and Asian massage and holistic Asian health approaches and motion arts, such as acupuncture, Tai chi chuan, Qi gong, Yoga, Ayurveda, Taekwondo and Aikido, are described.

Sports in fitness centers – history, development, tasks

In the 1950s Hollmann detected – as did other researchers – relevant health risks induced by bed rest. On the other hand it was shown that even minimal training programs oppose the effects of performance reduction. In 1966 an ad-hoc commission of the world organisation for sports medicine approached the World Health Organisation WHO in Geneva and requested the evaluation of the – at that time – internationally usual treatment after myocardial infarction in the form of bed rest for several weeks. Since 1977 it has been possible – due to the Luxemburg resolution of the WHO – to change the therapeutic approach to involve early mobilisation, movement therapy and rehabilitation, which are nowadays internationally established.
Avoiding risk factors such as lack of physical activity, smoking, arterial hypertension and adipositas can preventively counteract cardiovascular and metabolic diseases. Sufficient physical activity, especially endurance training, reveals a variety of health-related advantages such as protection of the heart based on reduced oxygen need combined with increased oxygen supply, prevention of arteriosclerotic vascular disorders, beneficial influence on fat and carbohydrate metabolism, reduction of blood pressure and body weight and improvement of cognitive abilities. Strength training may have favourable effects on musculature and bone stability.
By using the imaging methods available today, it has become possible to greatly expand our knowledge about structure and biochemistry of the brain in relation to physical activity. Appropriate physical activity improves angiogenesis, brain plasticity and neurogenesis. Especially in the elderly, this coincides with improved cognitive function.
As general physicians can not usually carry out the desired physical training, or supervise it, institutions such as qualified fitness centers or health-related sports clubs are medically appropriate. A medical examination including performance diagnosis should be carried out before the start of the training program, which can be developed in consultation with the physician, and the further procedure should be chosen regarding the training results and the assessment of the physician.

Methods and effects of classic and Asian massage

Massage is one of the oldest forms of medical treatment known to mankind and is used in most cultures of the world. Massage is defined as a manual technique directly related to the diagnostic findings.
Many studies have demonstrated proven beneficial effects of classic massage such as pain reduction, improvement of psychological well-being, and improved function.
Much of the literature on Asian massage merely describes the different forms of massage, while controlled studies are only available for acupressure. Based on the conception of diseases, their causes and treatment, Asian forms of massage have a spiritual background. In addition, palpation findings are treated which are comparable to the trigger points of the classic massage.

Holistic Asian health approaches and motion arts

Asian methods of medical treatment and methods to support health are becoming increasingly common in Europe. Some of them are used by physicians, others are being offered to improve wellness and wellbeing. Examples are acupuncture, Tai chi chuan, Qi gong, Yoga and Ayurveda.
Furthermore, many sports disciplines originating in the Far East have found supporters throughout the world. This mainly concerns martial arts which require a certain physical condition and which may result in injuries during competitions. Aikido from Japan and Taekwondo from Korea are virtually two poles in the field of Asian martial arts.
Besides the aspects of fighting and competitions, the Asian disciplines also involve elements found in health-orientated sports: upright posture, coordination, sufficient musculature, stamina and stress tolerance. The German Olympic Sports Federation has created the certificate “Sports for Health” which can be awarded to sports associations offering programmes especially designed for health purposes. The granting of such an award may offer benefits to customers since some health insurances are willing to at least partly contribute to the costs. The German Aikido Federation is one of the few sports associations allowed to award this certificate.

Hoffmann G, Siegfried I. Sportmedizinische Aspekte zu Fitness und Wellness . Seminar des Arbeitskreises Sportmedizin der Akademie für ärztliche Fortbildung und Weiterbildung der Landesärztekammer Hessen, Bad Nauheim. Düsseldorf, Köln: German Medical Science; 2010. Doc06sportmed1.
DOI: 10.3205/06sportmed1, URN: urn:nbn:de:0183-06sportmed11
Online available from: (PDF, 26 pages with 32 figures, 4 tables, and 73 references) and (shtml).

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