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Olaf Schulz

Publications and source records attributed to Olaf Schulz.

5 recordsLinked to original sources
PubMed2003

[Restructuring cardiovascular exercise therapy in Germany with reference to current international guidelines].

BACKGROUND: Exercise therapy has a well-established place in the primary and secondary prevention of cardiovascular disease. But its evidence-based application, or even its development, within the framework of planned disease management programs in Germany is hampered by the limitations in the structural quality of the health/fitness facilities. METHOD: Review of the literature concerning the current structure of cardiovascular exercise therapy in Germany and the USA, including current guidelines for exercise therapy in primary and secondary prevention. RESULTS: The "heart groups" represent the only organization in Germany to adhere to certain quality standards, although certain limitations in the procedural quality of their programs must be acknowledged (the evidence-based securing of the programs is relatively restricted), and their overall capacity is limited. Alternative organizations, such as fitness centers or sports clubs, do not yet offer standards of quality or safety. In the USA, in particular, there are established guidelines for exercise therapy which are edited, evidence-based, peer-reviewed and applicable to all suppliers of exercise therapy. CONCLUSION: We suggest that such standards should be brought into operation within the German context and that,as far as possible, they should be extended to include statements of mode and duration of training. The resulting guidelines, after being implemented as standards, could serve as the basis for a certification procedure applicable to all health/fitness facilities.

Adolescent↗
PubMed2003

[From bench to bicycle. Risk assessment in connection with sports activities and exercise programs in the primary and secondary prevention of cardiovascular diseases].

BACKGROUND: Due to encouraging results of studies investigating the effects of physical activity and training on cardiovascular diseases and due to the integration of preventive strategies into disease management programs by public health organizations, it is expected that a larger population, including cardiovascular patients, will increasingly participate in physical activity, fitness programs, and sports. However, a reduction in cardiovascular events and all-cause mortality by regular physical activity is accompanied by an increased mortality during exertion, as yet, there is no satisfactory definition of risk for all cardiovascular diseases and patient groups. RISK EVALUATION: A cost-effective preparticipation screening has to consider both the low incidence of events resulting from different diseases which requires subtle diagnostics and the intention of granting the larger population simple access to exercise programs and sports. There is a substantial difference in the risk profile for fatal events in athletes and young fitness program participants on the one hand and older (> 35 years) exercising people with a higher incidence of common cardiovascular diseases on the other. Additionally, a potential exercise-induced progression of chronic heart diseases should be excluded. New imaging techniques, laboratory markers, and genetic indicators will hopefully improve the quality of risk assessment. CONCLUSION: Establishing standards for diagnostics and risk assessment as well as different types of exercise and training programs, all of which need to be transformed into national guidelines, could help to reduce risks without limiting access to physical exercise and therapy. However, an element of risk will remain if rational cost-effectiveness ratios are to be applied.

Adolescent↗
PubMed2002

Cardiac troponin I: a potential marker of exercise intolerance in patients with moderate heart failure.

BACKGROUND: In severe heart failure, increased values of cardiac troponins have been detected during decompensation. In this study, we investigated whether an increase of cardiac troponin I can be observed after symptom-limited exercise and after an exercise training session in patients with moderate heart failure. METHODS: Twenty-seven patients with moderate heart failure (New York Heart Association II-III, ejection fraction 31% +/- 8%) were compared with 9 patients with mild heart failure and 10 subjects without heart failure. They underwent a symptom-limited exercise test and a bicycle exercise training session at >80% of maximal heart rate over 20 to 30 minutes. Plasma cTnI levels were measured at baseline, after symptom-limited exercise (hourly for 5 hours), and after training (4 and 10 hours). RESULTS: Patients with moderate heart failure showed an increase of cTnI from 37 +/- 49 pg/mL to 73 +/- 59 pg/mL (P <.001) after symptom-limited exercise. Four patients with moderate and 1 with mild heart failure and normal cTnI values at rest showed an increase of cTnI above 100 pg/mL after acute exercise but not after training. Subjects without heart failure had lower cTnI levels at rest and significantly lower values after symptom-limited exercise and training (P <.05 for each). CONCLUSION: Patients with symptomatic heart failure reveal an increase of cTnI after symptom-limited exercise at levels that indicate minor myocardial damage. The prognostic impact of this finding should, therefore, be further investigated.

Adult↗