Physical activity was measured with an accelerometer for one week. A comprehensive health examination was carried out at one of the Centers of Excellence in Sports Medicine by a physician on 399 sports club participants and 177 non-participants. The examination included a medical history questionnaire, general clinical examination, musculoskeletal examination, electrocardiogram, spirometry, blood pressure measurement and blood tests. Acute and overuse injuries within the past year were surveyed from 1,077 adolescents participating in sports clubs and 812 non-participants. The data was collected during 2013–2014.
In this study, the current World Health Organization and Finnish physical activity guidelines of an average of 60 minutes of moderate to vigorous physical activity daily, was reached by 85% of sports club participants and 45% of non-participants. While daily physical activity is recognized as being beneficial for health and developing basic endurance, athletes are recommended at least one day per week without programmed training to allow for sufficient recovery.
The downside of sports participation is the increased risk of injury. At least one acute injury within the past year was reported by 44% and at least one overuse injury by 35% of sports club participants. The corresponding percentages for non- participants were 20% and 17%, respectively. A higher training volume and greater number of competitions were associated with a higher acute injury risk in sports club participants. Injury prevention can be effective and deserves more attention, as injuries cause significant time loss from sports.
In the musculoskeletal examination, we found that sports club participation was associated with better shoulder and ankle mobility, better knee control in the vertical drop jump test, and better core muscle control in the plank test. However, both groups had postural asymmetries and shortcomings in mobility and movement control, which may be associated with prolonged sedentary behavior and/or monotonous training. The interrater repeatability varied between different parts of the musculoskeletal examination, as a whole we found that it was adequate between two physicians.
The significance of iron deficiency and untreated asthma is underlined in endurance sports and the risk of asthma is increased especially among cross-country skiers. In this dissertation, iron deficiency was found in 23–60% of females and 5– 30% of males, depending on the threshold value of ferritin used (15–30 µg/l). Less than 4% of adolescent males and females reported taking supplementary iron. A result diagnostic for asthma in the lung function test was found in 7% of sports club participants who were not using asthma medication.
The goal of the cardiovascular examination is to detect underlying cardiac disease that may endanger the health of the athlete. It is important to differentiate between physiological adaptations associated with training and pathologic changes which may be a sign of cardiac disease. We found that young athletes exhibit similar physiological adaptations to regular physical exertion as adults as adults, such as sinus bradycardia, higher QRS amplitude, and lower diastolic blood pressure, regardless of the type of sport. Systolic blood pressure was more frequently elevated in adolescents participating in non-endurance sports than in endurance sport participants and non- participants.
This dissertation showed that sports club participation is associated with health benefits, such as a greater amount of physical activity and better musculoskeletal control. Due to the factors found in the study that may compromise the health of the athlete and reduce the amount of healthy training days, we recommend carrying out periodic health examinations for adolescents participating in competitive sports. Daily physical activity, as well as frequent vigorous physical activity, is recommended for all adolescents. Therefore, more effort should be made to encourage sufficient amounts of physical activity, to prevent injuries, and systematically assess symptoms associated with physical activity in all adolescents in their regular medical checkups.
The doctoral dissertation of M.D. Kerttu Toivo in the field of Sports and Exercise Medicine titled Periodic Health Examinations in Young Athletes: The Finnish Health Promoting Sports Club (FHPSC) Study will be publicly examined at the Faculty of Medicine and Health Technology of Tampere University at 12 o'clock on Friday 8 October, 2021. The venue is Arvo building auditorium F114, address: Arvo Ylpön katu 34. Professor Heikki Tikkanen from University of Eastern Finland will be the opponent while Professor Tero Järvinen will act as the custos.
The event can be followed via remote connection.
The dissertation is available online at
http://urn.fi/URN:ISBN:978-952-03-2115-4
Photo: Studio Torkkeli