Abstract des Autors

The increasing significance of sports and exercise therapy (SET) is discussed from qualitative and quantitative point of view using the example of cardiovascular diseases (CVD), particulary coronary artery disease (CAD) which occupy the leading position not only in the mortality but in the financial costs statistics as well in the Western industrialized countries. Whereas the increasing wave of CVD after the second world war in the beginning was treated predominantly by immobilization since the sixties the old knowledge was rediscovered that the biological structures - the diseased cardiovascular system and myocardium among them - need sensible doses of exercise to develop an optimum of functional capacity and structure. The beginning of this way back to the future can be seen in the introduction of the first training group for cardiac patients in 1965. Starting carefully and slowly SET for CAD now has been generally accepted. The qualitative development can be demonstrated by the fact that none of the contraindications of the early phase is still valid today. This will be discussed by the impact of SET in extreme cardiac conditions such as heart transplantation and cardiac failure. The experience which has been made with CAD meanwhile has been transferred to nonischemic CVD as well. However, there are still a lot of major gaps which challenge sports medicine. This is discussed for deficits of SET for children with congenital respectively operated cardiac conditions. In the organisatoric area as well SET represents a major challenge, however opportunity as well, for sports medicine e.g. the sports physician. Keeping in mind the financial problems of health systems there may be developed new professional areas within cardiological prevention and rehabilitation. Last not least SET has also proceeded by itself. The classical limitation to callisthenics walking/jogging and playing is increasingly supplemented by a controlled access to sports such as tennis, golfing or downhill skiing which mean for the cardiac patient not only exercise therapy but life quality by themselves. The major task of sports medicine is to set up for the individual patients the sensible dose of physical activity between unnecessary and potentially harmful immobilisation by overprotection and conversely the risk of exceeding the therapeutic boundaries of physical activities. Verf.-Referat