Summary

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Summary

• 1) more on Sportsmedicine
• 2) Schulmedizin Medizin als Prävention bei
  Schülern

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1.)

• .sports and even elderly

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Exercise and 2 nd heart attack

• 406 patients
• 25 to 74 years old
• follow up interview for up to 5 years

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Results

• Patients who increased their activity after their
  first heart attack had a 78 lower risk of a
  second heart attack than patients who remained
  sedentary
• Circulation, 2000

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Physical activity in men and women with cardiac
disease

• Men and women did not differ in average total
  METs
• Men engaged more in repairs, yardwork and
  carrying, but these activities were performed
  sporadically and involved low METs requirements
• Women Health, 2003

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Physical activity improves gait and posture
control in the elderly

• 13 healthy aged women who regularly practised
  physical activities and in 13 healthy aged
  sedentary women
• The gait and posture control performance of the
  active group was better, the proprioceptive and
  vestibular sensitivities were higher , reaction
  time was lower
• NeuroScience Res, 2003

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Mitochondrial function...

• 45 persons (73 year)
• recovery times for Pcr and ADP longer...
• mitochondrial function declines with age in
  healthy, exercising elderly adults and the
  decline appears to be influenced by the level of
  physical activity
• Mech Ageing Dev 2003

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Low-intensity training

• Low-intensity training program  posture-balancing
  -mobility 
• Nine 74,3 /- 6 years
• for 11 weeks (2 sessions per week)
• mean power of the knee extension muscles
  increased slightly but significantly on the
  dominant and non-dominant sides
• Aging Clin Exp Res 2002

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Training and elderly

• 6-month exercise training for older adults
• 62 men and women aged 60 to 81 years
• lasted for 25 weeks, 2 hours/week
• endurance training and resistance exercises

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• Total daily energy expenditure significantly
  increased from 40,8 kcal/kg/day to 43,5 kcal/kg/j
• Calorie restriction and longevity !!!
• J Epidem 2003

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HTA et cognition

• Malmo studied at age 68 and 81 years
• 106 men (après 13 years!!)
• Change of the cognitive performance in the verbal
  spatial and speed functions
• Hypertenision, especially high DBP in late
  midlife, is associated with a decline in spatial
  performance of cognitive functions in elderly men
  J Hypert 2003

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Screening for falls.

• Floor transfer, 5-step test, 5 chair stands,
  tandem, semitandem, and side-by-side stance,
  penny pick-up, 360i turn, 50 ft walk, and 5-min
  walk
• the timed floor transfer and 50-ft walk were the
  most discriminating measures to identify
  potential fallers
• J Aging and Phys Act 2003

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PA and well-being

• SF-36, BMI, life events
• 10.063 women (70 y) Australia
• across the 3-year period
• higher levels of physical activity/higher scores
• but women who made a transition from some
  physical activity to none generally showed more
  negative changes in emotional well-being
  J Psychsom Res 2003

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PA and Parkinson

• 37 men upgo test 6 Min test
• PD patients with more severe fatigue are more
  sedentary and have poorer functional capacity
• Neurology 2003

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PA and BMD

• 129 men and women aged 72,1 years
• Higher levels of sporting activity during youth
  were associated with greater lumbar spine BMD (p
  lt.001).
• Femoral neck BMD was greatest in subjects who
  reported regularly taking part in sports over the
  previous 20 years
• Fac Sport / Nancy

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PA and Dementia

• 20 demented elderly people
• average age of 81,4
• average mini mental state score of 16,3
• two sessions a week for 16 weeks
• walking, mobility, flexibility and static balance
  were significantly improved in the training group
  (Plt0,05)

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Strength or endurance...

• To study the effects of strength or endurance
  training on cardiovascular fitness in women aged
  76-78 years
• 42 women strength (n16), endurance (n11)
• 18-week strength or endurance training programme

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..

• Strength training increase in cycle ergometer
  peak power from 68,1 to 70,3 W
• Peak oxygen uptake increased from 18.1 to 19.7 ml
  x kg(-1) x min(-1) Strength group
• from 17.1 to 18.2 Endurance group
• Kallinen,Spila,Suominen Fl

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Dance-based aerobic exercise

• 32 healthy women aged 72-87
• twenty women performed dance-based aerobic
  exercise for 60 minutes, 3 days a week, for 12
  weeks
• The exercise group showed significantly greater
  single-leg balance with eyes closed, functional
  reach and walking time
  Higashiura Jp

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Diet and walking

• 76 obèses /- 60 ans
• 6 mois diète et walking
• perte de poids 4-5 kg
• perte de graisse sous-cutanée
• sang ?TG ?HDL2 cholestérol ? LDL cholestérol
• J Geront A Biol Sci Med Sci 2003

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Strength Training for the Over 50 Crowd

• ACSM
• perform exercises 2-3 times a week
• arms, legs, shoulders, trunk
• achieve 10-15 repetitions per session
• get stronger by exercising in water

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• To reduce the risk of falls and injury, people
  over 60 should begin by strenghtening their legs,
  arms and trunk muscles with 3-4 weeks of weight
  training 2-3 times a week before walking long
  distances or engaging in other aerobic exercise.

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• ACSM
• 20-60 minutes aerobic activity is advised 3-5
  days a week
• weight training should be done for 20-30 minutes
  2-3 times a week
• stretching exercises minimum of 2-3 times a week

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...

• Weight-bearing endurance activities such
• as brisk walking,
• stair climbing, and
• aerobics.

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Conclusions

• Capacity for exercise can predict life span!
• 2 MET 2 miles/h
• 8 MET 6 miles/h
• Each 1 MET improve 12 survival !!
• 6000 / 6 years
• Risk of death X 100 if MET inf 5 p.r. sup 8 !!!
• NEJM 2002

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2.)

• Schulmedizin

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Ziele der medizinischen Untersuchung

• Gesundheit
• Fitness
• Belastbarkeit

Dr Jean-Claude Leners - CHNP
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Schulmedizin in den Primär- undSekundärklassen
Dr Jean-Claude Leners CHNP
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Luxemburg-Stadt fest angestellte Schulmediziner
ansonsten frei arbeitende Allgemeinmediziner
Pädiater
Dr Jean-Claude Leners CHNP
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Systematische Untersuchungen finden jedes 2.
Jahr statt
Dr Jean-Claude Leners CHNP
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F
B ESC R ESTP G ESTG
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Untersuchung der Sehstärke in einer
Vorschulklasse ergab bei 9962 Kinder

• 87 normal
• 9,6 Untersuchung unvollständig
• 2,0 Untersuchung zweifelhaft
• 9,0 pathologische Untersuchung
• gt 6,5 Sehkraft ungenügend
• gt 1,2 Amblyopie
• gt 0,9 Schielen
• gt andere

Dr Jean-Claude Leners - CHNP
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Logopädische Untersuchung bei 162 Kindern ergab

• 83
• keine Besonderheiten
• bzgl. der Sehstärke
• 15
• pathologische Bilanz

Dr Jean-Claude Leners - CHNP
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Differenzierte Erziehung im Jahr 2000
Festgestellte Erkrankungen (214 Untersuchte)

• Erkrankungen
• der Haut 24
• der Augen 13
• der Ohren 29
• des kardio-vaskulären Systems /
  Kardiopathie 9
• Bluthochdruck 14
• Ectopie testiculaire / Phimosis 7
• Deformation der Wirbelsäule 32
• Deformation der Füsse 42
• In 111 Fällen wurden die Eltern benachrichtigt

Dr Leners
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Schulmedizin Statistische Daten Schuljahr
2003/2004

• Gemischte Schule
• Ettelbruck

Dr Jean-Claude Leners / CHNP
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Dr Jean-Claude Leners / CHNP