Sports Medicine in the Countries of the Former
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SPORTS MEDICINE IN THE COUNTRIES OF THE FORMER
SOVIET UNION
KALINSKI M.I.2, V.A. ROGOZKIN3, D.W. MICHIELLI1, C.C. DUNBAR1,
1. Laboratory of Applied Physiology, Brooklyn College.
2. Institute of Physical Culture, Kiev, Ukraine, Institute of Biochemistry, Academy of Science of Ukraine.
3. Research Institute of Physical Culture, St. Petersburg, Russia.
In the former Soviet Union, sport science has been centralized through the state and directed from Moscow's Sport Committee. Independent sport science research or individual sponsored health related projects did not exist. Research into the medical and biological aspects of sport was an integral part of the athletic agenda and was conducted in more than 28 Institutes of Physical Education and Research Institutes of Physical Culture.
Sport institutions in the former Soviet Republics involved in sport research received assignments from the Union Research Institute of Physical Culture. This was located in Moscow and was responsible for planning and directing research efforts for all 15 republics. Institutions in Russia received preferential government support for developing Olympic scientific sport programs over the other republics. Sport research geared toward success in Olympic events took precedence over health programs and fitness for the general population (3).
Sports medicine in the former Soviet Union included the following areas:
¥ The classification, diagnosis and treatment of diseases common among athletes;
¥ Physical fitness assessment
¥ Management and rehabilitation of the athletic injuries.
The bases of these activities were supported by research done in the areas of sports training, biochemistry, molecular biology, biophysics, and physiology.
Specialists from all of the Institutes of Physical Culture and Scientific Research Institutes participated in the preparation of athletes throughout the Soviet Union for the Olympic Games. One of the most significant focal points for sports medicine in the former USSR was to create the "super athlete". Achieving this goal meant that most of the time and effort was devoted to developing the best diets for the athletes and then designing programs of sports training to optimize the athlete's performance in all events. Work capacity tests were administered to all athletes for classification purposes. This information was particularly useful to the coach who could then rank his athletes according to their fitness level. The effectiveness of training programs for the Soviet Olympic athletes were many times based upon metabolic criteria. Six different biochemical indices were used to evaluate metabolism. They were: 1. substrates of enzymatic reactions (lactic acid, glucose, creatinine, urea, etc.), 2. enzymes (aldolase, lactate dehydrogenase, creatine kinase, etc., 3. specific proteins (myoglobin, actin, tropomyosin, etc.), 4. hormones (adrenalin, noradrenalin, insulin, testosterone, etc.), 5. vitamins (A, B1, B2, C etc.) and 6. minerals (K+, Ca2+, Fe, PO4, etc.).
Although research in sports medicine covered many areas, space does not allow for a complete description of each but rather we will focus on a few which the authors are most familiar with; e.g.,. sport nutrition, and exercise biochemistry. The most published sport scientists in exercise biochemistry and sport nutrition were from three national schools. They were located in the republics of Russia, Ukraine and Estonia. A brief description of the scientists and their work follows:
RUSSIA.
Some key people from the Russian school included N. Yakovlev, V. Rogozkin, N. Volkov, V. Menchikov, A. Pshendin, V. Chaikovsky, B. Feldkoren, N. Chagovets, K. Korovnikov and V. Morosov.
Significant contributions to the understanding of exercise biochemistry were made by Professors Yakovlev and Rogozkin from the Research Institute of Physical Culture in St. Petersburg. Their work included: contributions to the theory of "super-compensation" resulting from endurance exercise training and its' effects on metabolism during exercise; cyclic patterns of biochemical markers during the post-exercise period; specificity of organ and systemic adaptations to different types of exercise training; and whether low molecular weight substances (e.g.,. amino acids) affect metabolism resulting from exercise (6,10).
The science of nutrition became a fertile area of scientific inquiry because of its' potential importance for athletes. It was recognized that the nature of the diet, particularly in terms of the volume and timing of meals were critical factors which could make the difference in who would "win the gold". Diets of athletes were individualized according to the energy requirements of their particular sport (6). Equally important was the incorporation of balance into the athlete's diet by providing all of the required nutrients during: prolonged and intensive training, the pre-game meal, the actual competitive event, and immediately after exercise when rapid recovery is important. In addition, supplementation was used in an effort to improve athletic performance.
All of the nutritional products could be divided into either macro (water, carbohydrates, fats and proteins) or micro nutrients (vitamins, minerals, metabolic intermediates). Professor Rogozkin established the formulation of the following supplements for elite Soviet athletes: protein compound mixtures, carbohydrate-mineral beverages and vitamin-mineral complexes. The form of the dry supplements were usually tablets or dry granular mixtures and seldom as a confection (6). All of the nutritional practices which were used in the former Soviet Union were to enhance athletic performance or hasten the recovery from the various competitive events (6).
Intermediary metabolism associated with the production of lactic acid; and the effects of pharmacological ergogenic aids on athletic performance were studied by Professor Volkov and his co-workers in the Central Institute of Physical Culture (Moscow) (9). Volkov studied the interrelationships of strenuous exercise on oxygen consumption and lactate production. He showed that lactic acid is one of the major metabolic factors contributing to muscular fatigue and limitations of work capacity (9).
Olympic competitors who were members of the national teams of the former USSR participated in another area of research interest to Moscow which was blood doping (9). Blood doping is the withdrawal of whole blood and reinfusion of erythrocytes 4-6 weeks later in an effort to increase hemoglobin (Hb) and therefore the oxygen carrying capacity of the blood. Increases in Hb from 135 gms Hb.l-1 of blood to 155gms.l-1 or almost 13% have been reported. The purpose of the practice is to improve performance times in endurance events. Volkov (9) has shown that runners had the best improvement in running times (3% faster) when they were tested 8-10 days after reinfusion of whole blood which had been withdrawn 20-50 days earlier. Also, in a separate experiment with swimmers, he found similar improvements in swimming times as the runners, but in these experiments, the faster swimming times were observed after 3-4 days of reinfusion of the thawed erythrocytic mass. Of course, a decrease of only a fraction of a second in competition could make the difference in setting a world record or winning "the gold". The practice of blood doping was pervasive in the former USSR. The Soviet Olympic teams used blood doping at the winter and summer Olympic Games in 1976 and 1980. Middle and long distance swimmers, cyclists, rowers, skiers, biathletes and skaters all engaged in blood doping (9).
A discussion of Soviet athletic programs would be incomplete if it did not include anabolic-androgenic steroid hormones (AAS). The discovery, study and application of AAS is of practical and theoretical significance. Similar to other hormones, AAS hormones can be used to study metabolic processes within different types of tissue. The discovery of the mechanism of AAS action is inseparably linked to the investigations of molecular-biological interactions of steroid hormones at the level of gene expression (7).
The ethical questions which have arisen internationally as a result of administering AAS hormones to athletes were of secondary importance in the Soviet Union. The primary goal was to "win at all costs". Evidence now coming to light suggests that the Soviet Union was willing to deliberately sacrifice the health of its' athletes. An antidoping laboratory, created in Moscow in the period prior to the 1980 Olympic Games, was established for the purpose of testing athletes for anabolic steroid use. If the Russian athletes were competing internationally but outside of the country, they would have a secret testing site to ensure their athletes would escape detection and avoid international sanctions against the USSR. An example of this was at the 1976 Olympic Games in Montreal and in the 1988 Games in Seoul, when the USSR kept a "hospitality ship" which was used as a center for detecting whether the Soviet athletes were "clean" from steroid use or, at best, were not detectable just prior to competition (5). Further verification of doping of Russian athletes to gain a competitive edge prior to the 1980 Olympic Games in Moscow, was recently reported by Anatole Yakimov, a professor at the Moscow Institute of Physical Culture in the March 4, 1991 issue of Soviet Sport (a Russian daily newspaper). He stated, that Soviet physicians "behind closed doors" developed doping procedures and practices for their athletes which were widespread even among the young athletes. Full-time research was conducted to determine the efficacy of anabolic steroids on human performance (1).
UKRAINE
The Ukrainian school of exercise biochemistry was established in the 1930's in the Institute of Biochemistry, Academy of Science of the Ukraine. The Institute produced some of the pioneering research in which exercise was used to better understand the fundamentals of the biochemistry of cardiac, skeletal and smooth muscle in experimental animals. In this Institute, significant contributions to one of the basic biochemical concepts, oxidative phosphorylation was made by Prof. W. Belitser. He was recognized internationally for his achievements. Other leading Ukrainian scientists included Prof. D. Ferdman for his work in processes of transamination, and Prof. A. Palladin for his work in metabolism of protein, glycogen, ATP, creatine phosphate and lactic acid during exercise training. Studies of enzymatic degradation of carbohydrates and the effects of vitamins on metabolism in athletes during exercise were performed by Prof. E. Kozhukhar.
Since the late 1960's, the Kiev Institute of Physical Culture, the Kiev Institute of Biochemistry, and the Kiev Research Institute of Endocrinology and Metabolism had established new frontiers in exercise biochemistry in areas of hormonal and intracellular regulation of metabolism. Some of the leading exercise biochemists from these institutes from 1967- 1990 were V. Lishko, M. Kurski, M. Kalinski, A. Osipenko, V. Kononenko and many of their colleagues (I. Zemtsova, V. Kotsuruba, T. Kondratiuk, V. Stefanov, W. Tiutiunnik, N. Rudnitska, O. Kamenetska) (2,3). Areas of investigations included: 1.Metabolism of catecholamine during acute exercise and exercise training; Effects of catecholamine encapsulated into liposomes on energy metabolism in cardiac, skeletal muscle, liver and blood during exercise; 2. Metabolism of intracellular second messenger systems; Effects of activators of adenylate cyclase and inhibitors of phosphodiesterase on cAMP metabolism in muscle tissues during exercise; 3. Properties of protein kinase and the role of cAMP-dependent phosphorylation in the regulation of glycolysis, transport of Ca2+ in sarcoplasmic reticulum and sarcolemma of cardiac and skeletal muscle during exercise training.
In Prof. Kalinski's laboratory in Kiev it has been shown that changes in catecholamine concentration in cardiac and skeletal muscles are dependent on the intensity and duration of exercise; and are less responsive to exercise after training. Along with changes in the catecholamines, the effects of acute exercise on cAMP metabolism in cardiac and skeletal muscle varies according to the intensity and duration of exercise. Experimental evidence shows a time dependence for cAMP concentration, adenylate cyclase and phosphodiesterase activity during the post-exercise period. The activity of adenylate cyclase and cAMP-dependent protein kinase of cardiac and skeletal muscle were increased as a result of exercise training (2). These changes depended on the length of exercise training. Furthermore, it has been shown, that changes in protein phosphorylation may have adaptive significance leading to increased glycolysis, increases in Ca2+ transport in the sarcoplasmic reticulum and sarcolemma, and in turn may enhance contractile and relaxation properties in cardiac and skeletal muscle. This work has given us great insight into the intracellular regulation of cardiac and skeletal muscle during exercise (2).
Other investigations by Professor Kalinski and his colleagues sought to determine the optimal chemical composition of vesicle membranes in liposomes needed to prolong the action of epinephrine. The liposomes, with encapsulated epinephrine, increased the time to fatigue during treadmill exercise, and increased the level of blood free fatty acids and cAMP concentration in cardiac, skeletal muscle and liver, when compared to epinephrine alone. Also a liposome preparation has been shown to attenuate lactic acid accumulation and spare blood glucose.
ESTONIA.
Leading Estonian exercise biochemists included Professors A. Viru, P. Korge, T. Seene and many of their colleagues (E. Seppet, A. Paju, J. Parnat, O. Imelik, T. Matsin, K. Tomson, T. Savi, A. Eller, R. Masso) of the Tartu University. There was a keen interest in studying the humoral-hormonal interaction, in particular, the pituitary-adrenocortical system during exercise and its' adaptation during training. They have shown that activation of the pituitary-adrenocortical system takes place if the intensity of exercise exceeds the level of 60-70% of maximal oxygen uptake. In prolonged exercise, the blood cortisol concentration increased up to 40 min and can decrease after the second hour of prolonged exercise in humans (8). A more detailed description of this work has been included in the bibliography (8).
Professor P. Korge, contributed to our understanding about the molecular mechanisms of hormone activity in muscle cells. Specifically, he studied the glucocorticoid-receptor complex activation and translocation into nuclei of muscle cells. He has shown the critical importance of maintaining a homeostatic microenvironment for balancing the contraction and relaxation of muscle. Korge demonstrated the close functional relationship and coupling between the sarcoplasmic reticulum (SR), Ca2+-ATPase and creatine kinase (CK) (4). Factors which overload and disturb enzyme coupling such as oxidative stress which occurs in severe exercise, can affect the functional capacity of the SR, which in turn, will compromise the contractile and relaxation capabilities within muscle (4).
REFERENCES
1. Annonymous. Anabolic Steroid And Sport Capacity. (Scientific and methodic information), Moscow: Central Institute of Physical Culture Publisher , "for limited use", 1972, pp. 39.
2. Kalinski, M.I., M.D. Kurski and A.A. Osipenko. Biochemical Mechanisms of the Adaptation to Exercise. Kiev, Ukraine: Higher Education Publishers, 1986, pp. 184.
3. Kalinski, M.I. Nutrition, Health, Exercise. Kiev, Ukraine: Science Publishers, 1990, pp. 176.
4. Korge, P., S.K. Byrd and K.B. Campbell. Functional coupling between sarcoplasmic-reticulum-bound creatine kinase and Ca 2+-ATPase. Europ. J. Biochem. 213;973-980, 1993.
5. Riordan, J. Sport, Politics and Communism, New York: University Press, 1991, pp. 169.
6. Rogozkin, V., A. Pshendin and N. Shishina. Athletes Nutrition. Moscow: FIS Publishers, 1989, pp. 160.
7. Rogozkin, V. Metabolism of Anabolic Androgenic Steroids. Boca Raton, FL: CRC. Press Inc., 1991, pp. 190.
8. Viru, A. Hormones in Muscular Activity. Boca Raton, FL: CRC. Press Inc., v.1, pp.195, v.2,1985, pp. 190.
9. Volkov, N. Bioenergetics of Human Strenuous Exercise and the Ways of Enhancing of Athletes' Work Capacity. Doctoral dissertation, Moscow: P.K. Anochin's Research Institute of Normal Physiology Publishers, Medicine's Academy of Science, 1990, pp. 101.
10. Yakovlev, N. Biochemistry of Sport. Moscow: FIS Publishers, 1974, pp. 184.
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