El ejercicio en la salud y en la enfermedad

EL EJERCICIO EN LA SALUD Y LA ENFERMEDAD

Grado en Medicina

Código: 802620

Tipo de asignatura: Optativa

Dirigida a: Estudiantes que hayan superado las asignaturas de los tres primeros cursos de Medicina

Departamento: Medicina Física y Rehabilitación. Hidrología Médica

Créditos: 3 ECTS

Periodo de impartición: Anual.

Fechas de impartición: Octubre a Mayo de 2015-2016

Horario: Martes, de 15,30 a 16,30 h.

Lugar: Escuela de Medicina de la Educación Física y el Deporte. Facultad de Medicina. Pabellón VI, 5ª planta

Número total de estudiantes: 30

Grupos: 1 (en función del número de matriculados se establecerán grupos para las actividades prácticas y tutorizadas)

 PROFESORADO

López-Silvarrey Varela, Francisco Javier

BREVE DESCRIPCIÓN

La asignatura nace con el objetivo de proporcionar conocimientos y motivación a los estudiantes del Grado de Medicina, que les permitan utilizar el ejercicio físico y el deporte como herramienta de promoción de la salud, prevención, tratamiento y rehabilitación de enfermedades.


TEMARIO

PROGRAMA TEÓRICO (20 horas)

  1. Epidemiología de la actividad, ejercicio físico y deporte.

  2. Beneficios y riesgos del ejercicio físico.

  3. Cribado para la práctica del ejercicio físico y el deporte.

  4. Reconocimiento médico deportivo completo.

  5. El electrocardiograma en el deportista.

  6. Metodología de la prescripción del ejercicio promoción de la salud, prevención y terapéutica.

  7. Muerte súbita y ejercicio.

  8. Miocardiopatías y ejercicio.

  9. Canalopatías y ejercicio.

  10. Hipertensión arterial y ejercicio.

  11. Cardiopatía isquémica y ejercicio.

  12. Insuficiencia cardíaca y ejercicio.

  13. Asma y ejercicio físico.

  14. Enfermedad pulmonar crónica y ejercicio físico.

  15. Diabetes y ejercicio.

  16. Dislipemias y ejercicio

  17. Enfermedades reumatológicas degenerativas y ejercicio.

  18. El dolor lumbar y el ejercicio.

  19. Fibromialgia, Síndrome de Fatiga crónica y ejercicio.

  20. Enfermedades neurológicas y ejercicio.

PROGRAMA PRÁCTICO (10 horas)

10 horas de rotación por el laboratorio de valoración y prescripción de ejercicio en la Escuela Medicina de la Educación Física y el Deporte.


ACTIVIDADES TUTORIZADAS (15 horas)

Revisión bibliográfica de un tema relacionado con la prescripción de ejercicio en promoción de la salud, prevención y terapéutica de enfermedades.


CRITERIOS DE EVALUACIÓN

En la evaluación se tendrán en cuenta diferentes aspectos:

  1. Prueba final de conocimientos teóricos, con la que se obtendrá una puntuación máxima de 6 puntos sobre 10.

  2. Evaluación de las clases prácticas y las prácticas autónomas, con las que se obtendrá una puntuación máxima de 4 sobre 10.

La asignatura se superará siempre y cuando se supere la puntuación exigida para cada una de las partes evaluadas (un mínimo de 3 puntos en la prueba de conocimientos teóricos y de 2 puntos en la evaluación de clases prácticas y prácticas autónomas).

BIBLIOGRAFÍA

  • Martínez González, M.A., Prevalence of physical activity during leisure time in the European Union, MedSciSportsExerc 2000:33(7):142-1146.

  • Encuesta Europea de Salud 2009 (EES09), Ministerio Sanidad España, Instituto Nacional de Estadística, 30 noviembre 2010.

  • Esteban, S. y col., Servicio Nacional de Salud 2010, Ministerio Sanidad España, Presidencia Española Unión Europea, eu2010.es.

  • Hábitos deportivos de la población escolar española 2011, Consejo Superior de Deportes, 2011.

  • Hábitos deportivos de la población de la Comunidad de Madrid, Dirección General de Promoción Deportiva, 2005.

  • Pedersen, B.K. and Saltin, B., Evidence for prescribing exercise as therapy in chronic disease, Scan J Med Sci Sports 2006:16 (suppl.1):3-63.

  • O´Donovan, G. et al., The ABC of Physical Activity for Health: A consensus statement from the British Association of Sport and Exercise Sciences, Journal of Sports Sciences, April 2010; 28(6):573-591.

  • Janssen and LeBlanc, Sytematic review of the health benefits of physical activity and fitness in school-aged children and youth International Journal of Behavioral Nutrition and Physical Activity 2010, 7:40.

  • Centers Disease Control. U.S. Physical activity Statistics. http://apps.ncd.cdc.gov/PASurveillance/StateSumResultV.aasp, June 2007ª.

  • Kravitz, L., The 25 Most Significant Health Benefits of Physical Activity&Exercise, FitnessJournal.

  • ACSM&AHA Joint Position Statement, Exercise and Acute Cardiovascular Events: Placing the risk in prespective, MedSciSports and Exerc; 2007:886-897.

  • Maron, B.J. et al., Sudden Deaths in Young Competitive Athletes: Analysis of 1866 Deaths in US 1980-2006, Circulation 2009;119:1085-1092

  • Drezner, J.A., Contemporary approaches to the identification of athletes at risk for sudden cardiac death, CurrOpinCardiol 2008; 23:494-501.

  • Le Goff, C. et al., Intense Physical Exercise related to the Emergent generation of Cardio-vascular Risk Makers: A Review, Biology of Sport 2012, Vol. 29 Issue 1, p.11.

  • Schneider, S. et al., Sports injuries: population based representative data on incidence, diagnosis, sequelae, and high risk groups, Br J Sports Med 2006, 40:334-339.

  • Garrido Cahamorro, P.R. et al., Epidemiología de las lesiones deportivas atendidas en urgencias, Emergencias 2009; 21:5-11.

  • Hootman, M.J. et al., Epidemiology of Collegiate Injuries for 15 Sports: Summary and Recommendations for Injury Prevention Initiatives, Journal of Athletic Training 2007; 42(2):311-319.

  • Servicios Médicos F.C. Barcelona, Guía práctica de lesiones musculares. Epidemiología, diagnóstico, tratamiento y prevención, ApuntsMed Sport, 2009; 164:179-203.

  • Fredericson, M., Epidemiology and Aetiology of Marathon Running Injuries, SportsMed 2007; 37:4-6.

  • Junge, A. et al., Soccer Injuries Incidence and Prevention, Sports Med 2007; 37:4-6.

  • Randall, D. et al., Descriptive Epidemiology of Collegiate Mens´s Basketball Injuries, J Athletic Training 2007; 42(2):202-210.

  • Agel, J. et al., Descriptive Epidemiology of Collegiate Womens´s Basketball Injuries, J Athletic Training 2007; 42(2):202-210.

  • Walsh, N.P. et al., Position Statement. Pat one: Maintaining inmune health, Inmunolgy International Society, 2011.

  • Schwartz, L.B. et al., Exercise-induced hypersensitivity syndromes in recreational and competitive athletes: a PRACTALL consensus report (what the general practitioner should know about sports and allergy), Allergy 2008, 63:953-961.

  • Del Giaco, S.R. et al., Allergy and sports in children, PediatrAllergyImmunol, 2012 Feb; 23(1):11-20.

  • Al Alwane et al., Vocal cord dysfunction in athletes: clinical presentation and review of the literature, PhysSportsmed, 2012 May; 40(2):22-7.

  • Guszkowska M. Mood in the situation of imagined discontinuation of exercise,.Pol. J. Sport Tourism 2012, 19, 16-25.

  • Sistema de Reconocimientos Médicos para la Práctica del Deporte, Grupo de Trabajo de la Comisión de Control y Seguimiento de la Salud y el Dopaje, CSD, Diciembre 2011.

  • Balady, G.J. et al., ACSM and AHA Joint Position Statement: Recommendations for cardiovascular screening, staffing, and emergency policies at health/fitness facilities, Med Sci Sports Exerc 1998; 30:1009-1018.

  • Boraita, A. et al., Guías de práctica clínica de la Sociedad Española de Cardiología sobre la actividad física en el cardiópata, RevEspCardiol 2000; 53:684-726.

  • Corrado, D. et al., Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol, European Heart Journal (2005) 26, 516-524.

  • Maron, B.J. et al., Recommendations and Considerations Related to Preparticipation Screening for Cardiovascular Abnormalities in Competitive Athletes: 2007 Update A Scientific Statement From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism, Circulation, 2007; 115:1643-1655).

  • Generalitat de Catalunya. Guia de prescripció d’exercicifísic par a la salut (PEFS), Direcció General de Salut Pública, Secretaria General de l’Esport, Barcelona, 2007.

  • Rice, S.G., Medical Conditions Affecting Sports Participation, Pediatrics 2008; 121 (4):841-848.

  • IOC MC, The International Olympic Committee (IOC) Consensus Statement on Periodic Health Evaluation of Elite Athletes: March 2009, Journal of Athletic Training 2009; 44(5):538-557.

  • Borjesson, M. et al., Cardiovascular evaluation of middle-aged/senior individuals engaged in leisure-time sport activities: position stand from the sections of exercise physiology and sports cardiology of the European Association of Cardiovascular Prevention and Rehabilitation, European Journal of Cardiovascular Prevention&Rehabilitation, 2011; 18(3):446-458.

  • Steinhaus, A.H., Chronics effects of exercise, Physiol, Rev. 15:105-147 (1933).

  • Hagber et al.,The role of exercise training on treatment of hypertension, Sports Med. 2000 Sep: 30 (3):193-206.

  • Cornelissen, V.A.; Fagard, R.H., Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors, Hypertension, 2005; 46:667-75.

  • Fagard, R.H.; Bjornstad, H.H.; Borjesson, M.; Carre, F.; Deligiannis, A.; Vanhees, L., ESC Study Group of Sports Cardiology recommendations for participation in leisure-time physical activities and competitive sports for patients with hypertension, Eur J CardiovascPrevRehabil 2005; 12:326-331.

  • Guías de práctica clínica para el tratamiento de la hipertensión arterial 2007. Grupo de Trabajo para el Tratamiento de la Hipertensión Arterial de la Sociedad Europea de Hipertensión (ESH) y de la Sociedad Europea de Cardiología (ESC).

  • Torrence, B. et al., Overweight, physical activity and high blood pressure in children: a review of the literature, Vascular Health and Risk Management, 2007 Feb; 3(1):139-149.

  • Kimberly, A. et al., Exercise Prescription for the Prevention and Management of Hypertension American Journal of Lifestyle Medicine November/December 2009 3:446-449.

  • Thompson, P.D.; Balady, G.J.; Chaitman, B.R.; Clark, L.T.; Levine, B.D.; Myerburg, R.J., Task force 6: Coronary artery disease, J Am CollCardiol 2005; 45:1348-1353.

  • Pelliccia, A.; Saner, H., Participation in leisure-time physical activities and competitive sports in patients with cardiovascular disease: how to get the benefits without incurring risks, Eur J CardiovascPrevRehabil 2005; 12:315-317.

  • Borjesson, M.; Assanelli, D.; Carre, F. et al., ESC Study Group of Sports Cardiology: recommendations for participation in leisure-time physical activity and competitive sports for patients with ischaemic heart disease, European Journal of Cardiovascular Prevention and Rehabilitation 2006, 13:137-149.

  • Piepoli, M.F.; Corra, U.; Benzer, W. et al., Secondary prevention through cardiac rehabilitation: from knowledge to implementation, A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation, European Journal of Cardiovascular Prevention and Rehabilitation 2010, 17:1-17.

  • Mezzani, A.; Hamm, L.F.; Jones, A.M. et al., Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation. European Journal of Preventive Cardiology 2012, 20(3):442-467.

  • Wiase, F.M., Exercise based cardiac rehabilitation in chronic heart failure, Australian Family Physician 2007, Vol. 36, 12, 1019-1024.

  • McKelvie, R.S., Exercise training in patients with heart failure: clinical outcomes, safety, and indications, Heart Fail Rev. (2008):13:3-11.

  • Pathanasioui, G.; Tsamis, N.; Georgiadou, P. et al., Beneficial Effects of Physical Training and Methodology of Exercise Prescription in Patients with Heart Failure, Hellenic J Cardiol 2008, 49:267-277.

  • Myers, J., Principles of exercise prescription for patients with chronic heart failure, Heart Fail Rev. (2008):13:61-68.

  • Selig, SE. and Hare, D.L., Evidence-based approach to exercise prescription in chronic heart failure, Br J Sports Med 2007, 41:407-408.

  • Keteyian, S.J., Exercise Training in Congestive Heart Failure: Risks and Benefits. Progress in Cardiovascular Diseases 53 (2011):419-428.

  • IOC MC. Beta-2 Adenoceptor agonists and the Olympic Winter Games in Salt Lake City. 2001, Available from: www.olympic.org.

  • Weiler, J.M.; Bonini, S.; Coifman, R.; Craig, T.; Delgado, L.; Capao-Filipe, M. et al., American Academy of Allergy, Asthma & Immunology Work Group Report: Exercise-induced asthma. Journal of Allergy and Clinical Immunology2007, 119(6):1349-58.

  • IOC MC. IOC Consensus Statement on Asthma in Elite Athletes, 2008, Available from: www.olympic.org.

  • IOC MC. Beta 2 adrenoceptor agonists and the Olympic Games in Beijing, 2008, Available from: www.olympic.org.

  • Carlsen, K.H.; Anderson, S.D.; Bjermer, L.; Bonini, S.; Brusasco, V.; Canonica, W. et al., Exercise-induced asthma, respiratory and allergic disorders in elite athletes: epidemiology, mechanisms and diagnosis: Part I of the report from the Joint Task Force of the European Respiratory Society (ERS) and the European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA(2)LEN, Allergy2008, 63(4):387-403.

  • Carlsen, K.H.; Anderson, S.D.; Bjermer, L.; Bonini, S.; Brusasco, V.; Canonica, W. et al., Treatment of exercise-induced asthma, respiratory and allergic disorders in sports and the relationship to doping: Part II of the report from the Joint Task Force of European Respiratory Society (ERS) and European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA(2)LEN. Allergy2008 May, 63(5):492-505.

  • Fitch, K.D.; Sue-Chu, M.; Anderson, S.D.; Boulet, L.P.; Hancox, R.J.; McKenzie, D.C. et al., Asthma and the elite athlete: Summary of the International Olympic Committee"s Consensus Conference, Lausanne, Switzerland, January 22-24, 2008, Journal of Allergy and Clinical Immunology2008, 122(2):254-60.

  • Rundell, K.W.; Slee, J.B., Exercise and other indirect challenges to demonstrate asthma or exercise-induced bronchoconstriction in athletes, J Allergy Clin Immunol2008 Aug, 122(2):238-46, quiz 47-8.

  • Schwartz, L.B.; Delgado, L.; Craig, T.; Bonini, S.; Carlsen, K.H.; Casale, T.B. et al., Exercise-induced hypersensitivity syndromes in recreational and competitive athletes: a PRACTALL consensus report (what the general practitioner should know about sports and allergy), Allergy2008 Aug, 63(8):953-61.

  • López-Silvarrey Varela, F.J., Tesis Doctoral 2010, Universidad Complutense. http://eprints.ucm.es/11595/1/T32310.pdf.

  • Boule, N.G.; Haddad, E.; Kenny, G.P.; Wells, G.A.; Sigal, R.J., Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials, JAMA, 2001, 286(10):1218-1227.

  • Boule, N.G.; Kenny, G.P.; Haddad, E.; Wells, G.A.; Sigal, R.J., Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in type 2 diabetes mellitus, Diabetologia, 2003, 46(8):1071-1081.

  • Snowling, N.J.; Hopkins, W.G., Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis, Diabetes Care, 2006, 29(11):2518-2527.

  • Thomas, D.E.; Elliott, E.J.; Naughton, G.A., Exercise for type 2 diabetes mellitus, Cochrane Database Syst Rev., 2006, 3:CD002968.

  • Sigal, R.J.; Kenny, G.P.; Boule, N.G. et al., Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial, Ann Intern Med, 2007, 147(6):357-369.

  • Church, T.S.; Blair, S.N.; Cocreham, S., et al., Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial, JAMA, 2010, 304(20):2253-2262.

  • Gillies, C.L.; Abrams, K.R.; Lambert, P.C. et al. (2007), Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis, BMJ 334:299-307.

  • Pi-Sunyer, X.; Blackburn, G.; Brancati, F.L.; Bray, G.A.; Bright, R.; Clark, J.M.; Curtis, J.M.; Espeland, M.A.; Foreyt, J.P.; Graves, K. et al., Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial, Diabetes Care 2007, 30(6):4-1383.

  • Absetz, P.; Valve, R.; Oldenburg, B.; Heinonen, H.; Nissinen, A.; Fogelholm, M.; Ilvesmäki, V.; Talja, M.; Uutela, A., Type 2 diabetes prevention in the “real world": one-year results of the GOAL Implementation Trial, Diabetes Care 2007, 30(10):5-2470.

  • Ackermann, R.T.; Finch, E.A.; Brizendine, E.; Zhou, H.; Marrero, D.G., Translating the Diabetes Prevention Program into the community. The DEPLOY Pilot Study, Am J Prev Med 2008, 35(4):7-363.

  • Amundson, H.A.; Butcher, M.K.; Gohdes, D.; Hall, T.O.; Harwell, T.S.; Helgerson, S.D.; Vanderwood, K.K., Translating the diabetes prevention program into practice in the general community: findings from the Montana Cardiovascular Disease and Diabetes Prevention Program, Diabetes Educ 2009, 35(2):9-210, 213-204, 216-220 passim.

  • Cardona-Morrell, M.; Rychetnik, L.; Morrell, S.L.; Espinel, P.T.; Bauman, A., Reduction of diabetes risk in routine clinical practice: Are Physical Activity and Nutrition Interventions feasible and are the outcomes from reference trials replicable? A Systematic Review and meta-analysis, BMC public health 2010, 10:653.

  • Laatikainen, T.; Dunbar, J.A.; Chapman, A.; Kilkkinen, A.; Vartiainen, E.; Heistaro, S.; Philpot, B.; Absetz, P.; Bunker, S.; O’Neil, A. et al., Prevention of type 2 diabetes by lifestyle intervention in an Australian primary health care setting: Greater Green Triangle (GGT) Diabetes Prevention Project, BMC public health 2007, 7:249.