Lectures

Introduces the two goals of sports medical functional diagnostics, health assessment and performance assessment, and the procedures that serve them. Separates direct physical quantities, biological surrogate parameters and subjective ratings as the three kinds of measure on which any assessment rests. Presents the stepwise diagnostic model from history taking to training recommendation. Develops the three guiding questions that precede every ergometric test and shows how their answers differ by context. Surveys the inventory of ergometric procedures, separating measured from derived parameters.

Separates load, strain and adaptation as the three terms on which exercise physiology and sports medical functional diagnostics rest. Distinguishes positive-dynamic, negative-dynamic and static holding work and their differing metabolic cost. Quantifies the cardiovascular response to submaximal and maximal work, including cardiac output, perfusion redistribution and the pressure response to small versus large active muscle mass. Develops the ventilatory and metabolic response, the ventilatory equivalent and the three determinants of maximal oxygen uptake.

Introduces homeostasis as the control-loop logic of acute regulation and hormesis as the adaptive logic of repetition, and separates the questions each of them answers. Presents the ABA protocol — baseline, intervention, recovery — as the smallest complete demonstration of homeostatic regulation, with a maximal incremental step test as the worked case. Reads the cardiovascular, respiratory, metabolic and thermoregulatory response from that single cardiopulmonary exercise test. Develops the biphasic hormetic dose–response and the J-curve of immune function, including the dual identity of inflammatory mediators. Marks the clinical edge at which the hormetic frame breaks down, in post-acute infection syndromes and post-exertional malaise.

Establishes breathlessness as a diagnostic hinge and separates breathlessness in health from breathlessness caused by disease. States the two tasks of pulmonary respiration and the role of respiratory regulation. Gives the range of ventilation from rest to the breathing limit, with its consequence for infection transmission in enclosed rooms. Introduces the clinical vocabulary of altered breathing and its ordering along severity and time. Defines the standard lung function parameters. Explains dead space and why hypo- and hyperventilation affect O₂ uptake and CO₂ output asymmetrically. Surveys airway resistance and the causes of increased and reduced ventilation.

Makes explicit what the sports medical examination is asking, and how the question differs between apparently healthy athletes and patients. Structures the sports medical history including family, personal, medication, infection and sport history. Covers the general internal and orthopaedic parts of the physical examination and their documentation. States the measurement conditions and cuff-size rules of blood pressure measurement. Reads the resting ECG for the purpose of clearance and separates training-related adaptations from findings requiring clarification. Places laboratory diagnostics and echocardiography in a targeted, finding-driven context, including the criteria of athlete's heart hypertrophy.

States what the body mass index measures, how it is interpreted by percentile in children and adolescents, and where it systematically misclassifies. Examines bioelectrical impedance and its error sources as the worked example of a method whose precision says nothing about its usefulness in a given population. Moves from a single index to a composition profile, separating fat from adipose tissue and distribution from amount, and compares the available methods by what they actually measure.

Compares cycle and treadmill ergometry and the consequences of the choice for attainable maximal values and ECG quality. Develops the construction of a step protocol from starting load, increment, step duration and monitoring, and the reasoning behind each setting. Separates exhaustion criteria from termination criteria and states the safety requirements, indications and contraindications of the exercise ECG as a provocation test. Gives mass-related reference expectations for maximal power and treadmill speed across training states and age.

Names the established spiroergometric indicators of endurance capacity and places maximal oxygen uptake against reference expectations in athletes and patients. States the methodological quality requirements of a gas-exchange measurement, including biological quality control and the effect of protocol duration. Distinguishes the ventilatory threshold from the respiratory compensation point and makes explicit the interpretive component of threshold determination. Develops the derived variables and the nine-panel display as the instrument for the non-invasive clarification of dyspnoea.

Replaces the waste-product model of lactate with its three simultaneous functions as energy substrate, gluconeogenic precursor and signalling molecule, and draws the consequence that blood lactate is a balance rather than an output. Describes the three nested lactate shuttles, the transporters that mediate them, and the tracer and mechanistic evidence that makes lactate the principal circulating carbohydrate fuel. Connects the shuttle concept to nutrition through the enteric and systemic postprandial lactate shuttle phases.

Explains why submaximal thresholds took over from maximal values as the informative variable of endurance diagnostics, and why the anaerobic threshold is motivation-independent. Defines the aerobic and the individual anaerobic threshold, relates them to the two ventilatory thresholds, and states the limits of fixed lactate thresholds. Lists the design decisions of a lactate step test and their consequences, together with the quality criteria of the procedure as a whole. Derives training zones from the individual anaerobic threshold and interprets rightward and leftward curve shifts, including the clinical caveat in post-exertional malaise.

Describes the cohort dataset, its markers and its eight sampling time points, and identifies the ABA structure that makes the recovery curve interpretable. Specifies the six-panel figure task, from the measured variables to the two composite indices derived from absolute cell counts. Develops a reproducible figure pipeline in five steps, from a single data source to three export formats and the composed figure. Requires the indices to be defined and their magnitude classified against the published literature and against the load applied in each reference study.

Presents the clinical part of the dataset, a participant sampled on two days of an upper respiratory tract infection, and defines the comparison to be made against the exercise-induced response. Separates exercise-induced from infection-associated immune regulation by mechanism and time constant, and explains why a single blood count cannot distinguish them. Builds a structured return-to-sport plan from absolute pause criteria, re-entry criteria, graded progression and a functional retest, with explicit and falsifiable cut-offs. Sets out the requirements of the written exposé, its assessment criteria and the two recurring weaknesses it has to avoid.