Contribution of epidemiology in sport practice. Health in High Performance Sport Centres (IAHPSTC)

IRMESIRMES@ @

INSEPINSEP

Role of Epidemiologyin Sport

2ème Conferència Internacional de Països EsportiusINEFC, Barcelona

November 25th 2008

CONVENTION IRMESCONVENTION IRMESCONVENTION IRMES

INSEP

INSEP

MedicalDepartment

CIMS APHPHÔTEL-DIEU

Other Partners

Paris DescartesUniversityINSERM

Scientific CommiteeBoard of

Stake Holders

Conventions

2

INSEP Missions

• (Ré)affirmation de la place centrale du sport de haut niveau

• Confirmation et adaptation permanente du « double projet » (« projet de vie »)

• Définition et mise en œuvre d’une stratégie de développement très volontariste en matière de relations internationales

• Adaptation of « Health » (nouveaux locaux, modernisation des matériels, création de l’IRMES, partenariat APHP, réflexion sur l’organisation du Département Médical)

• Rôle accordé à la Research (en interne [mise à niveau des matériels], en externe [réseau])

INSEP & HealthPreventionResearch

Cure

INSEP in BEIJING53% of French Medals

4

IRMESIRMESMissionsMissions

Physiopathology in High Level Sport

Performance Epidemiology

Public Health & Preventionby Physical Activities & Sport

5

IRMESIRMESMissionsMissions

Physiopathologies HLS20 20 FundedFunded ResearchResearch ProjetsProjets5 5 RegistriesRegistries

Performance EpidemiologyNew New IndicatorsIndicators & & NormsNorms

Sport & PreventionPNAPSPNAPS

I. Physiopathology

Perspectives 2009Perspectives 2009

Physiopathologies HLSProjects, studies & registries

- Volley Ball & Hand arteriopathy FFVB- Genetic Mutations in HLS- Growth & chondroplasts in Gym FFG- Knee ligament rupture women basket FFBB- Neck trauma FFJ- Endocrinology in football FFF- Nutrition and Weight FFSA- Traumatology women Rugby FFR- Horse accidents FFE- Psychological follow up UVSB- Inserm Sudden death registry AFLD- Hypoxia room FFS WADA

Volley ball Arteriopathy

Art médiale : 1.2 mm

High level sport is demanding

Measuring Risks

Christopher Reeve

1952-2004

per 100 millions days of exposition to risk

Motorized Sports 146Horse riding 34Rugby 16Gymnastics 4.8Football 3.8Tennis 0.7

Deadly Accidents in Sport

Fuller, Clin J Sport Med 2007

per 100 millions days of exposition to risk

Hanggliding 12 000 20 death /yMotorized Sports 146 20 000 licHorse riding 34Rugby 16Gymnastics 4.8Football 3.8Tennis 0.7

Deadly Accidents in Sport

Fuller, Clin J Sport Med 2007

Risk = deceleration

-∆V/∆t (initial speed)

Distance to ground (g= 9,8 m.s-2)

Deadly Accidents in Sport

II. Performance Epidemiology

Performance EpidemiologyProgression Norms

100m Men210 athletes, 1984-2008

Performance EpidemiologyProgression Norms

100m Men210 athletes, 1984-2008

Usain BOLTCoherent ?

Performance EpidemiologyProgression Norms

100m Women105 athletes, 1968-2008

SA FraserUncoherent ?

100m Women19 best performers 1920 - 2008

?

SWIMMING & T&F  BEIJING 2008OLYMPIC PERFORMANCES – WORLD RECORDS

‐ 20 à 30 Recordsdont les 2/3 en natation

‐ 75% des épreuves d’athlétismen’évoluent plus

‐ La natation progresse encoreen raison de sa technologie

8/8/8 Le monde

SWIMMING & T&F  BEIJING 2008OLYMPIC PERFORMANCES – WORLD RECORDS

Natation: 22 RM / 32 events+0,4%

Athlétisme: 5 RM / 47 events‐3,3%

Natation: 22 RM / 32 events+0,4%

SWIMMING & T&F  BEIJING 2008OLYMPIC PERFORMANCES – WORLD RECORDS

BEIJING 2008Performance Epidemiology

TRACK & FIELD

STAGNATION

Berthelot, PLoS ONE, Feb 2008

BEIJING 2008Performance Epidemiology

SWIMMING

PROGRESSIONTHROUGH

TECHNOLOGY

Desgorces, PLoS ONE, Nov 2008

2d GENERATION SWIMSUITS 2008

‐ Gain: 1 à 2% ‐ Short Distances‐ « Profiled » styles : FS & Back

Olympic podiumswill be Speedo

AFP, Mars 2008

2d GENERATION SWIMSUITS 2008WORLD RECORDS PROGRESSION 

Distances

2d GENERATION SWIMSUITS 2008WORLD RECORDS PROGRESSION 

Hommes

Distances

2d GENERATION SWIMSUITS 2008WORLD RECORDS PROGRESSION (100‐200m) 

Free Style BackBreast Fly

2d GENERATION SWIMSUITS 2008WORLD RECORDS PROGRESSION 

BEIJING 2008World Records during the Games

BEIJING 2008World Records during the Games

Swimsuits impact

THECITIUS

DESPERATELY NEEDS

TECHNOLOGY

33

IRMESIRMESPreventionPrevention

PNAPSProgramme National

Prévention par l’ActivitéPhysique ou Sportive

France

Heu

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d’a

ctiv

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quotidie

nne

FranceFranceMeanMean PhysicalPhysical ActivityActivity

HL Sport TRAINING VOLUME(h/Y Athlétisme, Natation, Cyclisme, Judo, Escrime, Volley-Ball, Handball)

x10

Substitution

Heu

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Sport & Sport & PhysicalPhysical ActivitiesActivitiesin in developpeddevelopped countries countries

PA/10

Spx10

37

IRMESIRMESPreventionPrevention

15 measures - 235 actions Public Health Policies

"Active" Mobility & WorkSport – CommunitiesPartnerships

New ProfessionsHealth Education

NEW RESEARCHNEW RESEARCHPARTNERSHIPSPARTNERSHIPS

Health ProfessionnalsMalakoff – Méderic

Adaptation, Performance & Climate ChangeCREAL, Barcelone

University St Joseph Beyrouth, Libanon

Risks

Intensity

Understand AthletesHealth Problems

Risks

Intensity

Facilitate Health throughPhysical Activities and Sport

Understand Athletes Health& Facilitate Health Comportments

through Physical Activities and Sport

Intensity

Risks

R. Bachelot Health & Sport Ministry

Julien Bahain Beijing Medalist

Rien n'est jamais acquis à l'homme

Louis Aragon La Diane Française, 1946