Patrick Feiereisen - Academia.edu (original) (raw)
Papers by Patrick Feiereisen
European journal of preventive cardiology, Jun 1, 2024
L’insuffisance cardiaque chronique est une maladie systemique ou des dysfonctions peripheriques v... more L’insuffisance cardiaque chronique est une maladie systemique ou des dysfonctions peripheriques viennent s’ajouter a l’incapacite du cœur a assurer un debit cardiaque adequat aux tissus metabolisants. Parmi des dysfonctions peripheriques, l’atrophie ainsi que la perte de force et d’endurance musculaire jouent un role primordial et contribuent largement a la genese des symptomes majeurs de l’insuffisance cardiaque chronique, c’est a dire la fatigue, la dyspnee et l’intolerance a l’effort.Ce n’est que depuis le debut des annees 1990 que des etudes ont montre que le reentrainement a l’effort pouvait etre benefique pour le patient insuffisant cardiaque chronique; auparavant, il etait considere comme contre-indique.La methodologie d’entrainement proposee a cette epoque aux patients etait un entrainement de l’endurance cardio-vasculaire, le renforcement musculaire n’y avait pas sa place car on craignait que l’impact hemodynamique de ce type d’entrainement risquerait de deteriorer la fonction cardiaque encore plus. Des etudes menees sur des contractions musculaires de type isometrique montraient en effet une diminution de la fonction cardiaque pendant l’entrainement. Cependant, les contraintes imposees pendant les exercices de renforcement musculaire dynamique (encore appeles « resistifs ») ne correspondent nullement a celles du renforcement isometrique. Des etudes sur des personnes saines ont montre que le renforcement musculaire est plus adapte a induire des ameliorations du volume et de la force musculaire que l’entrainement de l’endurance cardio-vasculaire.Le but de nos travaux a donc ete de verifier si l’introduction du renforcement musculaire, en complement de l’entrainement cardio-vasculaire ou bien comme entrainement a part entiere, pouvait apporter un benefice supplementaire chez l’insuffisant cardiaque chronique par son aptitude, du moins theorique, a mieux corriger certains aspects des dysfonctions musculaires.Il s’agissait, dans les differentes etudes que nous avons menees, de verifier qu’un entrainement compose de renforcement musculaire (au moins partiellement) chez le patient insuffisant cardiaque chronique:-\
European Journal of Preventive Cardiology, Feb 12, 2018
PubMed, Mar 1, 2005
Chronic (congestive) heart failure (CHF) is a disabling disease where patients suffer from dyspno... more Chronic (congestive) heart failure (CHF) is a disabling disease where patients suffer from dyspnoea and exercise intolerance. Peripheral skeletal muscle disorders play a major role in the pathogenesis of these symptoms and also in the progression of the disease. Besides cardiovascular endurance training, strength training should be an important component of cardiac rehabilitation programs in CHF because of its ability to efficiently improve muscle function and muscle mass. Safety of this type of training, while long-time questioned, has been established. Training recommendations for strength training should be based on current research. The positive training effects induced by strength training improve the patients' functional capacity and exercise tolerance and thereby also their quality of life and its widespread use should be promoted.
PubMed, 2006
Evidence based data of physical activity in primary prevention of coronary heart disease are exce... more Evidence based data of physical activity in primary prevention of coronary heart disease are excellent. For secondary prevention these data still are acceptable. Although it is an important new target group for physical therapy, there are so far no favourable data for exclusive training therapy in children or adolescents presenting a syndrome of obesity, sedentary lifestyle and bad nutrition. In nearly all the studies in this field physical activity is integrated in nutrition counselling and behavioural therapy. The following recommendations for public health can be made: Each adult should exercise at least half an hour and each child or adolescent one hour a day. Physical activity is the logical response to the sedentary lifestyle and hyper caloric food intake which are continuously spreading all over the world since 3 decades. It is an excellent therapy with nearly no side effects.
Canadian Journal of Applied Physiology-revue Canadienne De Physiologie Appliquee, Nov 1, 1997
The present work was carried out to analyse the properties and behaviour of Tibialis anterior mot... more The present work was carried out to analyse the properties and behaviour of Tibialis anterior motor units (MUs) during voluntary contractions in humans. A total of 528 single MU mechanical properties was recorded in 10 subjects by means of the spike-triggered averaging (STA) technique. MU recruitment thresholds and discharge frequencies were recorded during linearly increasing maximal voluntary contraction (MVC). The results indicate a mean (±SD) MU torque of 25.5 ± 21.5 mN•m. and a mean time-to-peak of 45.6 ± 13.6 ms. A comparison of the average MU twitch torque with that of the muscle allowed an estimate of about 300 MUs in the Tibialis anterior. A positive linear relationship was recorded between the MU twitch torque and the recruitment threshold. The mean minimal and maximal discharge frequencies of MUs were 8.4 ± 3.0 Hz and 33.2 ± 14.7 Hz, respectively. The results of the present work indicate that MU behaviour during voluntary contractions is different in the tibialis anterior and in the adductor pollicis. Key words: discharge frequency, recruitment threshold, motor unit count
Experimental Brain Research, Mar 24, 1997
The recruitment order of motor units (MU) was compared during voluntary and electrically induced ... more The recruitment order of motor units (MU) was compared during voluntary and electrically induced contractions. With the use of spike-triggered averaging, a total of 302 MUs with recruitment thresholds ranging from 1% to 88% of maximal voluntary contraction were recorded in the human tibialis anterior muscle in five subjects. The mean (+/-SD) MU force was 98.3+/-93.3 mN (mean torque 16.8+/-15.9 mNm) and the mean contraction time (CT) 46.2+/-12.7 ms. The correlation coefficients (r) between MU twitch force and CT versus the recruitment threshold in voluntary contractions were +0.68 and -0.38 (P<0.001), respectively. In voluntary contractions, MUs were recruited in order of increasing size except for only 6% of the cases; whereas, during transcutaneous electrical stimulation (ES) at the muscle motor point, MU pairs showed a reversal of recruitment order in 28% and 35% of the observations, respectively, when the pulse durations were 1.0 ms or 0.1 ms. This recruitment reversal during ES was not related to the magnitude of the difference in voluntary recruitment thresholds between MUs. It is concluded that if the reversal of MU recruitment observed during ES is biophysically controlled by differences in their nerve axon input impedance, in percutaneous stimulation at the motor point, other factors such as the size and the morphological organisation of the axonal branches can also influence the order of activation.
Circulation, Feb 28, 2017
PubMed, 2016
Background: The benefits of cardiac rehabilitation are well accepted. However, there still remain... more Background: The benefits of cardiac rehabilitation are well accepted. However, there still remains a debate concerning the risk of cardiac events, especially arrhythmias, during exercise training. The goal of the study was to retrospectively analyze events, including arrhythmias, in the cardiac rehabilitation unit of the Centre Hospitalier de Luxembourg during 2014-2015 and to identify if there was a link between patients stratified as high-risk patients and events. Methods: This analysis included each patient that participated in cardiac rehabilitation at the Centre Hospitalier de Luxembourg during 2014 and 2015. Major and minor cardiac events during exercise training in this period were retraced by retrospectively looking at patient files. These events were related to the potential risk of the patients, assessed by the "Risk stratification for cardiac events", edited by the American Association of Cardiovascular and Pulmonary Rehabilitation. Results: 628 patients were recruited for cardiac rehabilitation at the Centre Hospitalier de Luxembourg during 2014 and 2015. They exercised for a combined total of 15065 training hours. There were no major cardiac events during exercise training in this period; the number of minor events was low (n=24; 1 minor event/628 training hours). About two thirds of our patients are considered as low risk patients, one third of the patients were at intermediate or high risk. We found no relationship between events and risk stratification. Conclusion: There were no major cardiac events in our patients and the rate of minor cardiac events was low and not related to risk stratification.
Esc Heart Failure, Mar 23, 2021
Medicine and Science in Sports and Exercise, Nov 4, 2019
L’insuffisance cardiaque chronique est une maladie systemique ou des dysfonctions peripheriques v... more L’insuffisance cardiaque chronique est une maladie systemique ou des dysfonctions peripheriques viennent s’ajouter a l’incapacite du cœur a assurer un debit cardiaque adequat aux tissus metabolisants. Parmi des dysfonctions peripheriques, l’atrophie ainsi que la perte de force et d’endurance musculaire jouent un role primordial et contribuent largement a la genese des symptomes majeurs de l’insuffisance cardiaque chronique, c’est a dire la fatigue, la dyspnee et l’intolerance a l’effort.Ce n’est que depuis le debut des annees 1990 que des etudes ont montre que le reentrainement a l’effort pouvait etre benefique pour le patient insuffisant cardiaque chronique; auparavant, il etait considere comme contre-indique.La methodologie d’entrainement proposee a cette epoque aux patients etait un entrainement de l’endurance cardio-vasculaire, le renforcement musculaire n’y avait pas sa place car on craignait que l’impact hemodynamique de ce type d’entrainement risquerait de deteriorer la fonct...
ESC Heart Failure, 2021
AimsWhether an exercise training intervention is associated with reduction in long‐term high‐sens... more AimsWhether an exercise training intervention is associated with reduction in long‐term high‐sensitivity cardiac troponin T (hs‐cTnT) concentration (a biomarker of subclinical myocardial injury) in patients with heart failure with reduced ejection fraction (HFrEF) is unknown. The aims were to determine (i) the effect of a 12 week endurance exercise training intervention with different training intensities on hs‐cTnT in stable patients with HFrEF (left ventricular ejection fraction ≤ 35%) and (ii) associations between hs‐cTnT and peak oxygen uptake (VO2peak).Methods and resultsIn this sub‐study of the SMARTEX‐HF trial originally including 261 patients from nine European centres, 213 eligible patients were included after withdrawals and appropriate exclusions [19% women, mean age 61.2 years (standard deviation: 11.9)], randomized to high‐intensity interval training (HIIT; n = 77), moderate continuous training (MCT; n = 63), or a recommendation of regular exercise (RRE; n = 73). Hs‐cTn...
Medicine & Science in Sports & Exercise, 2019
Purpose This study aimed to investigate baseline, exercise testing, and exercise training–mediate... more Purpose This study aimed to investigate baseline, exercise testing, and exercise training–mediated predictors of change in peak oxygen uptake (V˙O2peak) from baseline to 12-wk follow-up (ΔV˙O2peak) in a post hoc analysis from the SMARTEX Heart Failure trial. Methods We studied 215 patients with heart failure with left ventricular ejection fraction (LVEF) ≤35%, and New York Heart Association (NYHA) classes II–III who were randomized to either supervised high-intensity interval training with exercise target intensity of 90%–95% of peak heart rate (HRpeak) or supervised moderate continuous training (MCT) with target intensity of 60%–70% of HRpeak, or who received a recommendation of regular exercise on their own. Predictors of ΔV˙O2peak were assessed in two models: a logistic regression model comparing highest and lowest tertiles (baseline parameters) and a multivariate linear regression model (test/training/clinical parameters). Results The change in V˙O2peak in response to the interv...
European journal of preventive cardiology, 2018
Bulletin de la Société des sciences médicales du Grand-Duché de Luxembourg, 2011
After Second World War cardiovascular disease (CVD), especially coronary artery disease (CAD), tu... more After Second World War cardiovascular disease (CVD), especially coronary artery disease (CAD), turned out to be an epidemic in the western countries including the Grand-Duchy of Luxembourg, and accounted for nearly half of all deaths. A lot of strategies, among them treatment by physical activity, were developed to fight this challenge and, fortunately, a mortality regression of about 50 % could be achieved. Nowadays, eastern European countries and, more recently, China and India face an increasing CVD mortality. During the seventies ambulatory heart sport clubs, then labeled as, "coronary clubs" became very popular in Europe especially in West-Germany. Around 2000 there were more than 6000 heart sports groups in Germany. In 1984 a first group was founded in Luxembourg City (Centre) a, 1991 a second group started in Esch/Alzette (South) and in 2002 a third regional group in Ettelbruck (North) so that, by now, the 3 main public health districts of the Grand-Duchy of Luxembo...
Bulletin de la Société des sciences médicales du Grand-Duché de Luxembourg, 2007
Over the last 20 years systematic doping has become a major threat for elite sport. So far, there... more Over the last 20 years systematic doping has become a major threat for elite sport. So far, there is no clear information about the daily practice of doping. Repeated scandals and recent personal statements have added to our knowledge. Several more recent doping agents like Erythropoietin (EPO) and, probably, growth hormone (GH) enhance performance in a highly effective way and, together with the well known anabolic steroids (AAS), belong to the major doping categories. The introduction of EPO has really changed the paradigm in endurance sports allowing a good middle class athlete to become a champion. It is evident that doping practices are influenced by the possibilities of the anti-doping control system. Unethical, criminal medical doctors play a decisive role in the ongoing practice of major doping. Apart from the already mentioned substances AAS, EPO and GH several novel drugs appear on the horizon. They are highly effective and there is no doubt that they will be used in attem...
Bulletin de la Société des sciences médicales du Grand-Duché de Luxembourg, 2006
Evidence based data of physical activity in primary prevention of coronary heart disease are exce... more Evidence based data of physical activity in primary prevention of coronary heart disease are excellent. For secondary prevention these data still are acceptable. Although it is an important new target group for physical therapy, there are so far no favourable data for exclusive training therapy in children or adolescents presenting a syndrome of obesity, sedentary lifestyle and bad nutrition. In nearly all the studies in this field physical activity is integrated in nutrition counselling and behavioural therapy. The following recommendations for public health can be made: Each adult should exercise at least half an hour and each child or adolescent one hour a day. Physical activity is the logical response to the sedentary lifestyle and hyper caloric food intake which are continuously spreading all over the world since 3 decades. It is an excellent therapy with nearly no side effects.
European journal of preventive cardiology, Jun 1, 2024
L’insuffisance cardiaque chronique est une maladie systemique ou des dysfonctions peripheriques v... more L’insuffisance cardiaque chronique est une maladie systemique ou des dysfonctions peripheriques viennent s’ajouter a l’incapacite du cœur a assurer un debit cardiaque adequat aux tissus metabolisants. Parmi des dysfonctions peripheriques, l’atrophie ainsi que la perte de force et d’endurance musculaire jouent un role primordial et contribuent largement a la genese des symptomes majeurs de l’insuffisance cardiaque chronique, c’est a dire la fatigue, la dyspnee et l’intolerance a l’effort.Ce n’est que depuis le debut des annees 1990 que des etudes ont montre que le reentrainement a l’effort pouvait etre benefique pour le patient insuffisant cardiaque chronique; auparavant, il etait considere comme contre-indique.La methodologie d’entrainement proposee a cette epoque aux patients etait un entrainement de l’endurance cardio-vasculaire, le renforcement musculaire n’y avait pas sa place car on craignait que l’impact hemodynamique de ce type d’entrainement risquerait de deteriorer la fonction cardiaque encore plus. Des etudes menees sur des contractions musculaires de type isometrique montraient en effet une diminution de la fonction cardiaque pendant l’entrainement. Cependant, les contraintes imposees pendant les exercices de renforcement musculaire dynamique (encore appeles « resistifs ») ne correspondent nullement a celles du renforcement isometrique. Des etudes sur des personnes saines ont montre que le renforcement musculaire est plus adapte a induire des ameliorations du volume et de la force musculaire que l’entrainement de l’endurance cardio-vasculaire.Le but de nos travaux a donc ete de verifier si l’introduction du renforcement musculaire, en complement de l’entrainement cardio-vasculaire ou bien comme entrainement a part entiere, pouvait apporter un benefice supplementaire chez l’insuffisant cardiaque chronique par son aptitude, du moins theorique, a mieux corriger certains aspects des dysfonctions musculaires.Il s’agissait, dans les differentes etudes que nous avons menees, de verifier qu’un entrainement compose de renforcement musculaire (au moins partiellement) chez le patient insuffisant cardiaque chronique:-\
European Journal of Preventive Cardiology, Feb 12, 2018
PubMed, Mar 1, 2005
Chronic (congestive) heart failure (CHF) is a disabling disease where patients suffer from dyspno... more Chronic (congestive) heart failure (CHF) is a disabling disease where patients suffer from dyspnoea and exercise intolerance. Peripheral skeletal muscle disorders play a major role in the pathogenesis of these symptoms and also in the progression of the disease. Besides cardiovascular endurance training, strength training should be an important component of cardiac rehabilitation programs in CHF because of its ability to efficiently improve muscle function and muscle mass. Safety of this type of training, while long-time questioned, has been established. Training recommendations for strength training should be based on current research. The positive training effects induced by strength training improve the patients' functional capacity and exercise tolerance and thereby also their quality of life and its widespread use should be promoted.
PubMed, 2006
Evidence based data of physical activity in primary prevention of coronary heart disease are exce... more Evidence based data of physical activity in primary prevention of coronary heart disease are excellent. For secondary prevention these data still are acceptable. Although it is an important new target group for physical therapy, there are so far no favourable data for exclusive training therapy in children or adolescents presenting a syndrome of obesity, sedentary lifestyle and bad nutrition. In nearly all the studies in this field physical activity is integrated in nutrition counselling and behavioural therapy. The following recommendations for public health can be made: Each adult should exercise at least half an hour and each child or adolescent one hour a day. Physical activity is the logical response to the sedentary lifestyle and hyper caloric food intake which are continuously spreading all over the world since 3 decades. It is an excellent therapy with nearly no side effects.
Canadian Journal of Applied Physiology-revue Canadienne De Physiologie Appliquee, Nov 1, 1997
The present work was carried out to analyse the properties and behaviour of Tibialis anterior mot... more The present work was carried out to analyse the properties and behaviour of Tibialis anterior motor units (MUs) during voluntary contractions in humans. A total of 528 single MU mechanical properties was recorded in 10 subjects by means of the spike-triggered averaging (STA) technique. MU recruitment thresholds and discharge frequencies were recorded during linearly increasing maximal voluntary contraction (MVC). The results indicate a mean (±SD) MU torque of 25.5 ± 21.5 mN•m. and a mean time-to-peak of 45.6 ± 13.6 ms. A comparison of the average MU twitch torque with that of the muscle allowed an estimate of about 300 MUs in the Tibialis anterior. A positive linear relationship was recorded between the MU twitch torque and the recruitment threshold. The mean minimal and maximal discharge frequencies of MUs were 8.4 ± 3.0 Hz and 33.2 ± 14.7 Hz, respectively. The results of the present work indicate that MU behaviour during voluntary contractions is different in the tibialis anterior and in the adductor pollicis. Key words: discharge frequency, recruitment threshold, motor unit count
Experimental Brain Research, Mar 24, 1997
The recruitment order of motor units (MU) was compared during voluntary and electrically induced ... more The recruitment order of motor units (MU) was compared during voluntary and electrically induced contractions. With the use of spike-triggered averaging, a total of 302 MUs with recruitment thresholds ranging from 1% to 88% of maximal voluntary contraction were recorded in the human tibialis anterior muscle in five subjects. The mean (+/-SD) MU force was 98.3+/-93.3 mN (mean torque 16.8+/-15.9 mNm) and the mean contraction time (CT) 46.2+/-12.7 ms. The correlation coefficients (r) between MU twitch force and CT versus the recruitment threshold in voluntary contractions were +0.68 and -0.38 (P<0.001), respectively. In voluntary contractions, MUs were recruited in order of increasing size except for only 6% of the cases; whereas, during transcutaneous electrical stimulation (ES) at the muscle motor point, MU pairs showed a reversal of recruitment order in 28% and 35% of the observations, respectively, when the pulse durations were 1.0 ms or 0.1 ms. This recruitment reversal during ES was not related to the magnitude of the difference in voluntary recruitment thresholds between MUs. It is concluded that if the reversal of MU recruitment observed during ES is biophysically controlled by differences in their nerve axon input impedance, in percutaneous stimulation at the motor point, other factors such as the size and the morphological organisation of the axonal branches can also influence the order of activation.
Circulation, Feb 28, 2017
PubMed, 2016
Background: The benefits of cardiac rehabilitation are well accepted. However, there still remain... more Background: The benefits of cardiac rehabilitation are well accepted. However, there still remains a debate concerning the risk of cardiac events, especially arrhythmias, during exercise training. The goal of the study was to retrospectively analyze events, including arrhythmias, in the cardiac rehabilitation unit of the Centre Hospitalier de Luxembourg during 2014-2015 and to identify if there was a link between patients stratified as high-risk patients and events. Methods: This analysis included each patient that participated in cardiac rehabilitation at the Centre Hospitalier de Luxembourg during 2014 and 2015. Major and minor cardiac events during exercise training in this period were retraced by retrospectively looking at patient files. These events were related to the potential risk of the patients, assessed by the "Risk stratification for cardiac events", edited by the American Association of Cardiovascular and Pulmonary Rehabilitation. Results: 628 patients were recruited for cardiac rehabilitation at the Centre Hospitalier de Luxembourg during 2014 and 2015. They exercised for a combined total of 15065 training hours. There were no major cardiac events during exercise training in this period; the number of minor events was low (n=24; 1 minor event/628 training hours). About two thirds of our patients are considered as low risk patients, one third of the patients were at intermediate or high risk. We found no relationship between events and risk stratification. Conclusion: There were no major cardiac events in our patients and the rate of minor cardiac events was low and not related to risk stratification.
Esc Heart Failure, Mar 23, 2021
Medicine and Science in Sports and Exercise, Nov 4, 2019
L’insuffisance cardiaque chronique est une maladie systemique ou des dysfonctions peripheriques v... more L’insuffisance cardiaque chronique est une maladie systemique ou des dysfonctions peripheriques viennent s’ajouter a l’incapacite du cœur a assurer un debit cardiaque adequat aux tissus metabolisants. Parmi des dysfonctions peripheriques, l’atrophie ainsi que la perte de force et d’endurance musculaire jouent un role primordial et contribuent largement a la genese des symptomes majeurs de l’insuffisance cardiaque chronique, c’est a dire la fatigue, la dyspnee et l’intolerance a l’effort.Ce n’est que depuis le debut des annees 1990 que des etudes ont montre que le reentrainement a l’effort pouvait etre benefique pour le patient insuffisant cardiaque chronique; auparavant, il etait considere comme contre-indique.La methodologie d’entrainement proposee a cette epoque aux patients etait un entrainement de l’endurance cardio-vasculaire, le renforcement musculaire n’y avait pas sa place car on craignait que l’impact hemodynamique de ce type d’entrainement risquerait de deteriorer la fonct...
ESC Heart Failure, 2021
AimsWhether an exercise training intervention is associated with reduction in long‐term high‐sens... more AimsWhether an exercise training intervention is associated with reduction in long‐term high‐sensitivity cardiac troponin T (hs‐cTnT) concentration (a biomarker of subclinical myocardial injury) in patients with heart failure with reduced ejection fraction (HFrEF) is unknown. The aims were to determine (i) the effect of a 12 week endurance exercise training intervention with different training intensities on hs‐cTnT in stable patients with HFrEF (left ventricular ejection fraction ≤ 35%) and (ii) associations between hs‐cTnT and peak oxygen uptake (VO2peak).Methods and resultsIn this sub‐study of the SMARTEX‐HF trial originally including 261 patients from nine European centres, 213 eligible patients were included after withdrawals and appropriate exclusions [19% women, mean age 61.2 years (standard deviation: 11.9)], randomized to high‐intensity interval training (HIIT; n = 77), moderate continuous training (MCT; n = 63), or a recommendation of regular exercise (RRE; n = 73). Hs‐cTn...
Medicine & Science in Sports & Exercise, 2019
Purpose This study aimed to investigate baseline, exercise testing, and exercise training–mediate... more Purpose This study aimed to investigate baseline, exercise testing, and exercise training–mediated predictors of change in peak oxygen uptake (V˙O2peak) from baseline to 12-wk follow-up (ΔV˙O2peak) in a post hoc analysis from the SMARTEX Heart Failure trial. Methods We studied 215 patients with heart failure with left ventricular ejection fraction (LVEF) ≤35%, and New York Heart Association (NYHA) classes II–III who were randomized to either supervised high-intensity interval training with exercise target intensity of 90%–95% of peak heart rate (HRpeak) or supervised moderate continuous training (MCT) with target intensity of 60%–70% of HRpeak, or who received a recommendation of regular exercise on their own. Predictors of ΔV˙O2peak were assessed in two models: a logistic regression model comparing highest and lowest tertiles (baseline parameters) and a multivariate linear regression model (test/training/clinical parameters). Results The change in V˙O2peak in response to the interv...
European journal of preventive cardiology, 2018
Bulletin de la Société des sciences médicales du Grand-Duché de Luxembourg, 2011
After Second World War cardiovascular disease (CVD), especially coronary artery disease (CAD), tu... more After Second World War cardiovascular disease (CVD), especially coronary artery disease (CAD), turned out to be an epidemic in the western countries including the Grand-Duchy of Luxembourg, and accounted for nearly half of all deaths. A lot of strategies, among them treatment by physical activity, were developed to fight this challenge and, fortunately, a mortality regression of about 50 % could be achieved. Nowadays, eastern European countries and, more recently, China and India face an increasing CVD mortality. During the seventies ambulatory heart sport clubs, then labeled as, "coronary clubs" became very popular in Europe especially in West-Germany. Around 2000 there were more than 6000 heart sports groups in Germany. In 1984 a first group was founded in Luxembourg City (Centre) a, 1991 a second group started in Esch/Alzette (South) and in 2002 a third regional group in Ettelbruck (North) so that, by now, the 3 main public health districts of the Grand-Duchy of Luxembo...
Bulletin de la Société des sciences médicales du Grand-Duché de Luxembourg, 2007
Over the last 20 years systematic doping has become a major threat for elite sport. So far, there... more Over the last 20 years systematic doping has become a major threat for elite sport. So far, there is no clear information about the daily practice of doping. Repeated scandals and recent personal statements have added to our knowledge. Several more recent doping agents like Erythropoietin (EPO) and, probably, growth hormone (GH) enhance performance in a highly effective way and, together with the well known anabolic steroids (AAS), belong to the major doping categories. The introduction of EPO has really changed the paradigm in endurance sports allowing a good middle class athlete to become a champion. It is evident that doping practices are influenced by the possibilities of the anti-doping control system. Unethical, criminal medical doctors play a decisive role in the ongoing practice of major doping. Apart from the already mentioned substances AAS, EPO and GH several novel drugs appear on the horizon. They are highly effective and there is no doubt that they will be used in attem...
Bulletin de la Société des sciences médicales du Grand-Duché de Luxembourg, 2006
Evidence based data of physical activity in primary prevention of coronary heart disease are exce... more Evidence based data of physical activity in primary prevention of coronary heart disease are excellent. For secondary prevention these data still are acceptable. Although it is an important new target group for physical therapy, there are so far no favourable data for exclusive training therapy in children or adolescents presenting a syndrome of obesity, sedentary lifestyle and bad nutrition. In nearly all the studies in this field physical activity is integrated in nutrition counselling and behavioural therapy. The following recommendations for public health can be made: Each adult should exercise at least half an hour and each child or adolescent one hour a day. Physical activity is the logical response to the sedentary lifestyle and hyper caloric food intake which are continuously spreading all over the world since 3 decades. It is an excellent therapy with nearly no side effects.