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ISBN 978-86-88449-15-1

DODATAK ISHRANIMIKROGRANULE ZA DIREKTNU PRIMENU DODATAK ISHRANIMIKROGRANULE ZA DIREKTNU PRIMENU

Magnezijum je važan za očuvanje normalne funkcije nervnog sistema

Magnezijum doprinosi normalnoj mišićnoj funkciji

B vitamini smanjuju umor i iscrpljenosti

20 kesicaukus grejpfruta

BRZA I LAKA UPOTREBA1 KESICA DNEVNO

Doziranje i način upotrebe:Magnezijum 400+B kompleks, zadovoljava povećane potrebe organizma za magnezijumom i vitaminima B kompleksa, kod odraslih.

Jednom dnevno, jednu kesicu, otopiti u ustima.

Pakovanje:20 kesica.

Magnezijum doprinosi normalnoj funkciji nervnog sistema (stres, umor, napetost)

Magnezijum doprinosi normalnoj funkciji mišića i elektrolitnom balansu (grčevi i bolovi u mišićima,

sportisti, trudnice)

B vitamin doprinose smanjenju zamora i iscrpljenosti (normalna funkcija nervnog, kardiovaskularnog i

imunološkog sistema i proizvodnja energije)

DODATAK ISHRANIMIKROGRANULE ZA DIREKTNU PRIMENU DODATAK ISHRANIMIKROGRANULE ZA DIREKTNU PRIMENU

Magnezijum je važan za očuvanje normalne funkcije nervnog sistema

Magnezijum doprinosi normalnoj mišićnoj funkciji

B vitamini smanjuju umor i iscrpljenosti

20 kesicaukus grejpfruta

BRZA I LAKA UPOTREBA1 KESICA DNEVNO

Doziranje i način upotrebe:Magnezijum 400+B kompleks, zadovoljava povećane potrebe organizma za magnezijumom i vitaminima B kompleksa, kod odraslih.

Jednom dnevno, jednu kesicu, otopiti u ustima.

Pakovanje:20 kesica.

Magnezijum doprinosi normalnoj funkciji nervnog sistema (stres, umor, napetost)

Magnezijum doprinosi normalnoj funkciji mišića i elektrolitnom balansu (grčevi i bolovi u mišićima,

sportisti, trudnice)

B vitamin doprinose smanjenju zamora i iscrpljenosti (normalna funkcija nervnog, kardiovaskularnog i

imunološkog sistema i proizvodnja energije)

nervnog sistema (stres, umor, napetost)

elektrolitnom balansu (grčevi i bolovi u mišićima,

(normalna funkcija nervnog, kardiovaskularnog i

Untitled-4 1 4/6/2016 11:39:25 AM

Udruženje za medicinu sporta Srbije / Sports medicine association of Serbiazajedno sa / with:

Antidoping agencijom Republike Srbije / Antidoping agency of SerbiaFakultetom medicinskih nauka – Univerzitet u Kragujevcu / Faculty of medical science – University of Belgrade

Katedrom za bromatologiju – Farmaceutski fakultet, Univerzitet u Beogradu / Department of Bromatology – Faculty of Pharmacy, University of Begrade

Fakultetom za �zičku kulturu i menadžment u sportu – Univerzitet Singidunum / Faculty of Physical Education and Sports Management – Singidunum Univeristy

Kliničko-bolničkim centrom Bežanijska kosa / Clinical Hospital Center Bežanijska kosaVisoka sportska i zdravstvena škola, Beograd / College of Sports and Health, BelgradeUdruženjem za sportsku kardiologiju Srbije / Sports cardiology association of Serbia

Centrom za sportsku ishranu i suplementaciju / Centar for sport nutrition and supplementation

6. kongres medicine sporta i

3. kongres prevencije dopinga u sportu

6th Congress of sports medicine and

3rd congress on prevention of doping in sport

PROMENA IGRE GAME CHANGE

Program i knjiga sažetaka Program and Abstract book

Beograd, 10-11. 05. 2018

Untitled-4 1 4/6/2016 11:39:25 AM

Izdavač i urednik: Nenad Dikić, Beograd

Pre-press: Miloš Cvjetićanin

Tiraž: 500 primeraka

Štampa: Propaganda Jovanovć, Beograd

Godina izdanja: 2018

CIP - Каталогизација у публикацији Народна библиотека Србије, Београд 61:796/799(048)796.011.5:178(048)796-05:615.035.3(048) КОНГРЕС медицине спорта (6 ; 2018 ; Београд)

Promena igre : program i knjiga sažetaka = Game Change : programme and abstract book / 6. Конгрес медицине спорта и 3. Кongres o prevenciji dopinga u sportu, Beograd, 10-11.05.2018 = 6. Congress medicine in sport and 3. Congress on prevention of doping in sport ; [organizatori] Udruženje za medicinu sporta Srbije ... [et al.] = Sports Medicine Association of Serbia ... [et al.] ; [urednik Nenad Dikić]. - Beograd : N. Dikić, 2018 (Beograd : Propaganda Jovanović). - 95 str. : ilustr. ; 25 cm Uporedo srp. tekst i engl. prevod. - Tiraž 500. ISBN 978-86-88449-15-11. Конгрес о превенцији допинга у спорту (3 ; 2018 ; Београд) 2. Удружење за медицину спорта Србије (Београд)a) Спортска медицина - Апстракти b) Допинг - Апстракти c) Спортисти - Допинг средства - Апстракти

COBISS.SR-ID 262637324

Život je kao vožnja bicikla, da bi održao ravnotežu moraš da se krećeš.

Albert Ajnštajn

Life is like riding a bicycle. To keep your balance, you must keep moving.

Albert Einstein

Drage kolege, sportisti, treneri i svi vi koji se bavite sportom,

U sportu su se mnoge stvari promenile tokom poslednjih godina i postizanje vrhunskog rezultata zahteva saradnju velikog broja stručnjaka. Sva naša istraživanja su pokazala da su naši sportisti uglavnom prepušteni sebi. Ako znamo da vrhunske sportiste iz razvi-jenih zemalja prati veliki broj stručnjaka i da su njihovi budžeti izuzetno veliki (na primer Britanske bicikliste prati preko 20 stručnjaka i imaju budžet od 26 miliona funti), onda se postavlja pitanje kako mi u našim uslovima možemo da im pomognemo. Činjenica da imamo razvijene sve oblasti sportske medicine, ali i da sportski stručnjaci nedovoljno prate trendove, zahteva okupljanje svih onih koji imaju šta da kažu u ovoj oblasti. Zbog toga pored Udruženja za medicinu sporta Srbije u organizaciji ovog kongresa učest-vuje Antidoping agencija Republike Srbije, Fakultet medicinskih nauka u Kragujevcu, Fakultet za fizičku kulturu i menadžment i sportu, Univerzitet Singidunum, Kliničko bol-nički centar Bežanijska kosa, Udruženje za sportsku kardiologiju i Centar za sportsku ishranu i suplementaciju.

Naravno, kongres je otvoren za sve istraživače, ali i praktičare koji imaju sopstvene rezu-ltate koje žele da prikažu, a posebno za radove studenta na akademskim i master studi-jima. Poslednji kongres medicine sporta održan je 2012. godine, a kongres prevencije dopinga u sportu 2016. godine. Razloga ima mnogo, a jedan od važnijih je interesovan-je. Činjenica je da smo mi mala zemlja i da je važno da oni koji imaju šta da kažu dobiju priliku. Pored toga ovakvi multispecijalistički događaji uvek donese nešto novo.

S druge strane verujemo da smo se uželeli jedni drugih i da je pravi trenutak da razmeni-mo misli i vidimo ko šta radi. Na kongresu će pored stručnjaka iz svih oblasti sporta biti prisutni i stipendisti, odnosno naši najbolji sportisti, tako da verujemo da će izbor tema biti takav da će maksimalno zainteresovati najširu publiku. Posebno ćemo se postarati da omogućimo studentima da predstave svoje radove, a najbolji će biti nagrađen. Po-trudićemo se da okupimo i izlagače koji u svom programu imaju ono što je neophodno sportistima za ostvarivanje vrhunskog rezultata.

Prof. dr Nenad Dikić

Predsednik Kongresa

Dear colleagues, athletes, coaches and all of you who are participating in sports,

Many things have changed in sport in recent years and the top results require coopera-tion of the large number of experts. But, all our studies have shown that our athletes are mostly left to themselves. If we know that elite athlets from developed countries are fol-lowed by a large number of experts and that their budgets are extremely large (for ex-ample, British national cycling team are followed by more than 20 experts and they have a budget of 26 million pounds), then the question is how can we help our athletes in our conditions. The fact that we have developed sports medicine in all areas of, but also that sports professionals are insufficiently following the new trends, requires the gathering of all those who have something to say. Therefore, besides the Sports Medicine Associ-ation of Serbia, Antidoping Agency of Serbia, Faculty of Medical Sciences - University of Kragujevac, Faculty of Physical Eductaion and Sports Management - University Singidu-num, Clinical Hospital Center Bežanijska kosa, Sports Cardiology Association of Serbia and Center for Sports Nutrition and Supplementation.

However, the congress is open to all researchers, but also practitioners who have their own results which they want to present, especially for the student’s of the academic and master studies. The last Congress of Sports Medicine was held in 2012. and Congress of preventing of doping in sports in 2016. The reason is many, and one of the more import-ant is the interest. The fact is that we are a small country and it is important that those who have something to say get a chance. In addition, such multispecial events always bring something new.

On the other hand, we supose that we have liked to see each other and that it is the right time to exchange thoughts and present results. The congress will be attended by experts from all fields of sports, as well as by scholars e.g. our best athletes, so we believe that the choice of topics will be such that they will be interested in the widest possible audience. We will make poossible that studnets present their work, and the best will be rewarded. We will also try to gather exhibitors who will present sport program for athletes.

Prof. dr Nenad Dikić

Congress President

NAUČNI ODBOR / Scienti c Comittee

Anđelković MarijaAntić Branislav

Blaženčić Mladenović VeraDikić Nenad

Đorđević BrižitaJakovljević VladimirMilinković Zdeslav

Mileusnić MilanMileusnić ValentinaNedeljković Ivana

Nemec VesnaNemec Predrag

Nikolić Turnić TamaraSnežana Lazarević

Srejović IvanStanišić Svetlana

Stojmenović TamaraVukašinović Vesić Milica

Zdravković MarijaŽivanić SlobodanŽivković Vladimir

ORGANIZACIONI ODBOR / Organizing Comittee

Cvjetićanin MilošJeremić NevenaJeremić Jovana

Malić TatjanaMilosević Miloš

Nikolić IvanStefanović Mirko

Izlagači / Exibitors

AlakloidATP sport

BGB ITALIANADonetEsensa

PansportProteini.si

KONGRESNA ŠEMA / CONGRESS SCHEME

10. maj 2018.

Vreme / Time Opis / Description

08:30 Registracija / Registration

09:30 Originalni radovi / Original papers

10:45 Kafe pauza / Co�ee break

11:00 Sportska kardiologija/Sports cardiology

12:15 Pauza za ručak / Lunch break

13:00 Antidoping


14:30 Sportska ishrana i suplementacija / Sports nutrition and supplementation

16:00 Kraj prvog dana/ End of the day one

11. maj 2018.


09:30 Bol u sportu / Pain in sport


11:00 Tehnologija treninga u sportu / Training technology in sport


13:00 Sportska medicina – od eksperimentalnih istraživanja do primene u praksi / Sport medicine – from

basic investigations to application in practice


14:30 Originalni radovi / Original papers

16:30 Kraj drugog dana / End of the day two

DETALJAN SADRŽAJ PO SESIJAMA / DETAILED CONTENT PER DAYS

Program Kongresa / Congress program

10. maj 2018.


08:30 Registracija / Registration

09:30 ORIGINALNI RADOVI / ORIGINAL PAPERS1. SUPLEMENTACIJA KOD ATLETIČARA / THE USE OF SUPPLEMENTS AMONG ATHLETES – Dušan Antić2. NAVIKE U ISHRANI FUDBALERA I RUKOMETAŠICA / EATING HABITS OF FOOTBALL PLAYERS AND HANDBALL PLAYERS – Jasmina Timic3. ISHRANA I SUPLEMENTACIJA VRHUNSKIH KAJAKAŠA / EVALUATION OF DIETARY AND SUPPLEMENT INTAKE OF ELITE CANOE SPRINTERS – Pavle Jovanov4. PRIMENA FORENZIČKIH METODA U ANTIDOPINGU / APPLICATION OF FORENZIC METHODS IN ANTIDOPING – Ema Radić5. NOVE PSIHOAKTIVNE SUPSTANCE – POTENCIJALNI DOPING? / NEW PSYCHOACTIVE SUBSTANCES – POTENTIAL DOPING – Snežana Đorđević


11:00 SPORTSKA KARDIOLOGIJA / SPORTS CARDIOLOGY6. OKRUGLI STO: TEREN LABORATORIJI NE VERUJE – PROBLEM IZNENADNE SRČANE SMRTI U SPORTU / ROUND TABLE: THE PITCH DOES NOT TRUST THE LABORATORY – THE PROBLEM OF SUDDEN CARDIAC DEATH IN SPORT – Nenad Dikić7. IZNENADNA SRČANA SMRT U SPORTU: RIZIK KOJI SE MORA PREPOZNATI / SUDDEN CARDIAC DEATH IN ATHLETES: RISK TO BE RECOGNIZED – Ivana Nedeljković8. PROZOR U IZNENADNU SRCANU SMRT – KARDIOMAGNETNA REZONANCA / THE NEW INSIGHT IN THE SUDDEN CARDIAC DEATH – CARDIOMAGNETIC RESONANCE – Marija Zdravković9. ISTRAŽIVANJE POTENCIJALNIH NOVIH NEINVAZIVNIH SKRINING METODA PRI PREDTAKMIČARSKOM SPORTSKO-MEDICINSKOM PREGLEDU / NEW POTENTIONAL NON-INVASIVE SCREENING METHODS IN ADDITION TO PRE-PARTICIPATION SCREENING EXAM – Ivan Nikolić


13:00 ANTIDOPING10. PRAVA SPORTISTA POSMATRANA KROZ RAD ANTDOPING AGENCIJE REPUBLIKE SRBIJE U POSLEDNJIH 12 GODINA – okrugli sto / ATHLETES RIGHTS SURVEYED THROUGH WORK OF ANTIDOPING AGENCY OF THE REPUBLIC OF SERBIA IN THE LAST 12 YEARS - round table – Milica Vukašinović Vesić


14:30 SPORTSKA ISHRANA I SUPLEMENTACIJA / SPORTNUTRITION AND SUPPLEMENTATION11. NUTRITIVNi STATUS SPORTISTA U SRBIJI / THE NUTRITIONAL STATUS OF SERBIAN ATHLETES – Marija Anđelković12. PRAVA “SNAGA” ANTIOKSIDANASA / REAL “POWER” OF ANTIOXIDANTS – Ivana Baralić13. UPOTREBA PROBIOTIKA U SPORTSKOJ POPULACIJI / USE OF PROBIOTICS IN ATHLETES – Danica Michaličkova14. IMUNSKI SISTEM I PROBIOTICI / THE IMMUNE SYSTEM AND PROBIOTICS – Rajna Minić15. BILJNI LEKOVITI PROIZVODI U SUPLEMENTACIJI SPORTISTA / HERBAL MEDICINAL PRODUCTS IN SUPPLEMENTATION OF ATHLETES - Zoran Maksimović

16:00 Kraj prvog dana / End of the day one

11. maj 2018.

Vreme / Time Opis / Description09:30 BOL U SPORTU / PAIN IN SPORT

16. BOL U KOLENU – DIJAGNOSTIKA I LEČENJE / KNEE PAIN – DIAGNOSIS AND TREATMENT – Tamara Stojmenović17. BOLOVI U LEĐIMA U SPORTU / LOW BACK PAIN IN SPORT – Branislav Antić18. ZAŠTO TETIVE BOLE – TENDINITIS, MIT ILI STVARNOST ?-PATOLOGIJA TETIVA KROZ MODEL KONTINUUMA / WHAT CAUSES A PAINFUL TENDON – TENDINITIS, MYTH OR REALITY? - CONTINUUM MODEL OF TENDON PATHOLOGY - Miloš Bojović19. OZONOTERAPIJA / OZONE THERAPY - Bojana Božović

10:45 Kafe pauza / Co�ee break11:00 TEHNOLOGIJA TRENINGA U SPORTU / TRAINING TECHNOLOGY IN SPORT

20. TRENAŽNA TEHNOLOGIJA – IZAZOVI I PRIMENA / TRAINING TECHNOLOGY - CHALLENGES AND APPLICATION – Predrag Nemec21. PRIMENA MEDIJA VIRTUALNE REALNOSTU U RAZVOJU MOTORIČKIH SPOSOBNOSTI I UNAPREĐENJU MOTORNIH PROGRAMA VRHUNSKIH SPORTISTA / APPLICATION OF VIRTUAL REALITY MEDIUM IN MOTOR CAPACITY DEVELOPMENT AND MOTOR PROGRAMS IMPROVEMENT OF ELITE ATHLETES – Predrag Nemec, Miloš Milošević, Branko Sujić22. POVEZANOST OSNOVNIH MORFOLOŠKIH KARAKTERISTIKA I RAVNOTEŽE UČENIKA V RAZREDA OSNOVNE ŠKOLE - Aleksandar Gadžić23. VAŽNOST UKLJUČIVANJA VEŽBI PILATESA I BODYART- A TEHNIKA U VRHUNSKOM, AMATERSKOM PA I REKREATIVNOM SPORTU / THE IMPORTANCE OF INCLUDING BODY & MIND TECHNIQUES (PILATES AND BODYART) IN PROFESIONAL, AMATEUR AND RECREATIONAL SPORTS - Tamara Ratković24. JAČINA STISKA ŠAKE I POSTURALNA STABILNOST KOD STARIH ŽENA / HAND GRIP STRENGTH AND POSTURAL STABILITY IN OLDER WOMEN – Ivan Ćuk25. BIOMEHANIČKE RAZLIKE KOD DVE TEHNIKE ČUČNJA - IMPLIKACIJE ZA REHABILITACIJU I TRENAŽNI PROCES / BIOMEHANICAL DIF-FERENCES BETWEEN TWO SQUAT TECHNIQUES IMPLICATIONS FOR REHABILITATION AND SPORT TRAINING – Aleksandar Dejanović

12:15 Pauza za ručak / Lunch break13:00 SPORTSKA MEDICINA – OD EKSPERIMENTALNIH ISTRAŽIVANJA DO PRIMENE U PRAKSI / SPORT MEDICINE – FROM

BASIC INVESTIGATIONS TO APPLICATION IN PRACTICE26. SPORTSKA MEDICINA – OD EKSPERIMENTALNIH ISTRAŽIVANJA DO PRIMENE U PRAKSI / SPORT MEDICINE – FROM BASIC INVESTIGATIONS TO APPLICATION IN PRACTICE – Vladimir Jakovljević27. PROMENE BAZALNOG REDOKS STATUSA MLADIH FUDBALERA NAKON ŠESTOMESEČNOG TRENAŽNOG PROGRAMA / CHANGES IN BASAL REDOX STATUS OF YOUNG MALE FOOTBALL PLAYERS AFTER A SIX-MONTH TRAINING PROGRAMME – Vladimir Živković28. AKUTNI I HRONICNI EFEKTI NANDROLON-DEKANOATA NA KARDIODINAMIKU IZOLOVANOG SRCA I REDOKS STATUS TRE-NIRANIH PACOVA / ACUTE AND CHRONIC EFFECTS OF NANDROLON DECANOATE ON CARDIODYNAMICS OF ISOLATED RAT HEART AND REDOX STATUS IN EXERCISED RATS – Tamara Nikolić Turnić 29. EFEKTI DETRENINGA PLIVANJA: RAZLIKE PREMA POLU / THE EFFECTS OF SWIMMING DETRAINING: GENDER-DEPENDENT DIF-FERENCES – Jovana Jeremić30. BENEFITI TRENINGA VISOKOG INTEZITETA NA SRČANI MIŠIĆ MIŠEVA – ULOGA MIKRORNK / BENEFICIAL EFFECTS OF HIGH INTENSITY INTERVAL TRAINING (HIIT) ON CARDIAC MUSCLE – ROLE OF MIRNA – Nevena Jeremić

14:15 Kafe pauza / Co�ee break14:30 ORIGINALNI RADOVI / ORIGINAL PAPERS

31. FIZIČKA AKTIVNOST I ISHRANA U STARIJOJ POPULACIJI KOJA SAMA ŽIVI / PHYSICAL ACTIVITY AND NUTRITION IN AGEING AND INDEPENDENT LIVING – Vera Simovski32. ZASTUPLJENOST BENIGNIH EKG PROMENA KOD MLADIH SPORTISTA SA TERITORIJE VOJVODINE U ODNOSU NA PRIPADNOST DOMINANTNO AEROBNIM ILI ANAEROBNIM SPORTOVIMA / BENIGN ECG CHANGES IN YOUNG ATHLETES FROM VOJVODINA IN RELATION TO ENGAGEMENT IN DOMINANTLY AEROBIC OR ANAEROBIC SPORTS – Lana Andrić33. UPOTREBA DODATAKA ISHRANI MEĐU REKREATIVNIM SPORTISTIMA / USE OF FOOD SUPPLEMENTS AMONG RECREATIONAL ATHLETES – Mirjana Đermanović34. KVALITET DODATAKA ISHRANI NAMIJENJENIH SPORTISTIMA / QUALITY OF FOOD SUPPLEMENTS INTENDED FOR ATHLETES – Mirjana Đermanović35. UTICAJ GVOŽĐA NA OKSIDACIONI STRES I ANTIOKSIDANTNU AKTIVNOST VITAMINA C U AKUTNOM FIZIČKOM OPTEREĆENJU / THE INFLUENCE OF IRON ON OXIDATIVE STRESS AND THE ANTIOXIDANT ACTIVITY OF VITAMIN C IN ACUTE EXERCISE – Ljiljana Popović36. UTICAJ JEDNOKRATNOG INTENZIVNOG FIZIČKOG OPTEREĆENJA NA PROMENU ACIDOBAZNOG STATUSA I GASNIH ANALIZA / THE EFFECT OF ONE-TIME INTENSIVE PHYSICAL EXERCISE ON ACID-BASE STATUS AND BLOOD GAS ANALYSIS – Nebojša R Mitić37. POVREDE AHILOVE TETIVE KOD SPORTISTA-FIZIKALNI TRETMAN I LIJEČENJE / THE INJURIES OF THE ACHILLES TENDON AT THE ATHLETES-THE PHYSICAL TREATMENT AND CURING – Vukosav Joksimovic38. ANALIZA KORIŠĆENJA LEKOVA I SUPLEMENATA U SPORTSKOM DRUŠTVU „CRVENA ZVEZDA” / ANALYSIS OF THE USE OF MED-ICINES AND SUPPLEMENTS IN THE SPORTS SOCIETY RED STAR – N. Dikić, M. Anđelković, I. Milojevic, S. Berović, S. Stojković, A. Jakovljević, M. Bogdanović, V. Todorovic, A. Cincovic, S. Vitkovic, I. Ilić, A. Petrović, I. Popović, I. Jovanović, A. Milošević, M. Milaković, S. Bozic, M. Mitrovic, E. Nastovic, A. Nikolic, A. Arsić, M. Aranđelović, E. Prlincevic

16:30 Kraj drugog dana / End of the day two

SADRŽAJ / CONTENT

1. SUPLEMENTACIJA KOD ATLETIČARATHE USE OF SUPPLEMENTS AMONG ATHLETES

Dušan Antić . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

2. NAVIKE U ISHRANI FUDBALERA I RUKOMETAŠICAEATING HABITS OF FOOTBALL PLAYERS AND HANDBALL PLAYERS

Jasmina Timić . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

3. ISHRANA I SUPLEMENTACIJA VRHUNSKIH KAJAKAŠAEVALUATION OF DIETARY AND SUPPLEMENT INTAKE OF ELITE CANOE SPRINTERS

Pavle Jovanov, Marijana Sakač, Otto Barak, Anamarija Mandić, Olivera Đuragić, Nataša Nedeljković, Aleksandar Marić . . . . . . . . . . . . . . . . . . . . . . . . . .12

4. PRIMENA FORENZIČKIH METODA U ANTIDOPINGUAPPLICATION OF FORENSIC METHODS IN ANTI-DOPING CONTROL

Emilija Radić . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

5. NOVE PSIHOAKTIVNE SUPSTANCE – POTENCIJALNI DOPING?NEW PSYCHOACTIVE SUBSTANCES – POTENTIAL DOPING

Snežana Đorđević, Vesna Kilibarda, Slavica Vučinić . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

6. OKRUGLI STO: TEREN LABORATORIJI NE VERUJE – PROBLEM IZNENADNE SRČANE SMRTI U SPORTUROUND TABLE: THE PITCH DOES NOT TRUST THE LABORATORY – THE PROBLEM OF SUDDEN CARDIAC DEATH IN SPORT

Dikić Nenad, Nedeljković Ivana, Nikolić Ivan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

7. IZNENADNA SRČANA SMRT U SPORTU: RIZIK KOJI SE MORA PREPOZNATI SUDDEN CARDIAC DEATH IN ATHLETES: RISK TO BE RECOGNIZED

Ivana Nedeljković, Nenad Dikić, Marija Andjelković, Tamara Stojmenović, Vojislav Giga, Marija Zdravković, Ivan Nikolić, Tatjana Malić, Marija Ristić . . . . . . . . . . . . . . .19

8. PROZOR U IZNENADNU SRČANU SMRT - KARDIOMAGNETNA REZONANCATHE NEW INSIGHT IN THE SUDDEN CARDIAC DEATH – CARDIOMAGNETIC RESONANCE

Marija Zdravković, Maja Popović, Ivana Nedeljković, Nenad Dikić, Milica Vesic, Vladimir Jakovljević . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21

9. ISTRAŽIVANJE POTENCIJALNIH NOVIH NEINVAZIVNIH SKRINING METODA PRI PREDTAKMIČARSKOM SPORTSKO-MEDICINSKOM PREGLEDUNEW POTENTIONAL NON-INVASIVE SCREENING METHODS IN ADDITION TO PRE-PARTICIPATION SCREENING EXAM

Ivan Nikolić, Tamara Stojmenović, Tatjana Malić, Ivana Nedeljković, Nenad Dikić, Marija Andjelković . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

10. PRAVA SPORTISTA POSMATRANA KROZ RAD ANTDOPING AGENCIJE REPUBLIKE SRBIJE U POSLEDNJIH 12 GODINA – OKRUGLI STOATHLETES RIGHTS SURVEYED THROUGH WORK OF ANTIDOPING AGENCY OF THE REPUBLIC OF SERBIA IN THE LAST 12 YEARS - ROUND TABLE

Vukašinović Vesić M., Vajagić B., Anđelković M., Cvjetićanin M., Jakovljević B., Stefanović M., Đurđević N., Mileusnić V., Dikić N. . . . . . . . . . . . . . . . . . . . . .24

11. NUTRITIVNI STATUS SPORTISTA U SRBIJINUTRITIONAL STATUS OF SERBIAN ATHLETES

Anđelković M., Dikić N., Vukašinović Vesić M., Baralić I., Đorđević B., Blaženčić Mladenović V., Bekić J., Popović M., Jovanović Z. . . . . . . . . . . . . . . . .28

12. PRAVA „SNAGA” ANTIOKSIDANASAREAL “POWER” OF ANTIOXIDANTS

Baralić Ivana. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34

13. UPOTREBA PROBIOTIKA U SPORTSKOJ POPULACIJIUSE OF PROBIOTICS IN ATHLETES

Danica Michaličková, Nevena Ivanović . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

14. IMUNSKI SISTEM I PROBIOTICITHE IMMUNE SYSTEM AND PROBIOTICS

Rajna Minić . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38

15. BILJNI LEKOVITI PROIZVODI U SUPLEMENTACIJI SPORTISTAHERBAL MEDICINAL PRODUCTS IN SUPPLEMENTATION OF ATHLETES

Zoran Maksimović . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

16. BOL U KOLENU – DIJAGNOSTIKA I LEČENJEKNEE PAIN – DIAGNOSIS AND TREATMENT

Tamara Stojmenović, Nenad Dikić, Milica Vukašinović-Vesić, Marija Anđelković, Ivan Nikolić . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41

17. BOLOVI U LEĐIMA U SPORTULOW BACK PAIN IN SPORT

Branislav Antić . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47

18. ZAŠTO TETIVE BOLE – TENDINITIS, MIT ILI STVARNOST? – PATOLOGIJA TETIVA KROZ MODEL KONTINUUMAWHAT CAUSES A PAINFUL TENDON – TENDINITIS, MYTH OR REALITY? – CONTINUUM MODEL OF TENDON PATHOLOGY

Miloš Bojović . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48

19. OZONOTERAPIJAOZONE THERAPY

Bojana Božović . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50

20. TRENAŽNA TEHNOLOGIJA – IZAZOVI I PRIMENATRAINING TECHNOLOGY - CHALLENGES AND APPLICATION

Predrag Nemec, Vesna Nemec . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51

21. PRIMENA MEDIJA VIRTUALNE REALNOSTU U RAZVOJU MOTORIČKIH SPOSOBNOSTI I UNAPREĐENJU MOTORNIH PROGRAMA VRHUNSKIH SPORTISTAAPPLICATION OF VIRTUAL REALITY MEDIUM IN MOTOR CAPACITY DEVELOPMENT AND MOTOR PROGRAMS IMPROVEMENT OF ELITE ATHLETES

Predrag Nemec, Miloš Milošević, Branko Šujić . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52

22. POVEZANOST OSNOVNIH MORFOLOŠKIH KARAKTERISTIKA I RAVNOTEŽE UČENIKA V RAZREDA OSNOVNE ŠKOLE THE CORRELATION OF BASIC MORPHOLOGICAL CHARACTERISTICS AND BALANCE IN FIFTH GRADE PUPILS

Aleksandar Gadžić, Sandra Miladinović . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53

23. VAŽNOST UKLJUČIVANJA BODY&MIND TEHNIKA VEŽBANJA (PILATESA I BODYART TEHNIKE) U VRHUN-SKOM,AMATERSKOM I REKREATIVNOM SPORTUTHE IMPORTANCE OF INCLUDING BODY & MIND TECHNIQUES (PILATES AND BODYART) IN PROFESIONAL, AMATEUR AND RECREATIONAL SPORTS

Tamara Ratković . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

24. JAČINA STISKA ŠAKE I POSTURALNA STABILNOST KOD STARIH ŽENAHAND GRIP STRENGTH AND POSTURAL STABILITY IN OLDER WOMEN

Marija Trajkov, Ivan Ćuk, Milivoj Dopsaj . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64

25. BIOMEHANIČKE RAZLIKE KOD DVE TEHNIKE ČUČNJA - IMPLIKACIJE ZA REHABILITACIJU I TRENAŽNI PROCESBIOMEHANICAL DIFFERENCES BETWEEN TWO SQUAT TECHNIQUES IMPLICATIONS FOR REHABILITATION AND SPORT TRAINING.

Aleksandar Dejanović, Bojana Petrovački - Dejanović . . . . . . . . . . . . . . . . . . . . . . . . . . .68

26. SPORTSKA MEDICINA – OD EKSPERIMENTALNIH ISTRAŽIVANJA DO PRIMENE U PRAKSISPORT MEDICINE – FROM BASIC INVESTIGATIONS TO APPLICATION IN PRACTICE

Jakovljević Vladimir, Čubrilo Dejan, Jovanović Marina, Srejović Ivan, Živković Vladimir, Jeremić Nevena, Nikolić Turnić Tamara, Milosavljević Isidora, Jeremić Jovana, Djurić Dragan . . . . . . .72

27. PROMENE BAZALNOG REDOKS STATUSA MLADIH FUDBALERA NAKON ŠESTOMESEČNOG TRENAŽNOG PROGRAMACHANGES IN BASAL REDOX STATUS OF YOUNG MALE FOOTBALL PLAYERS AFTER A SIX-MONTH TRAINING PROGRAMME

Živković Vladimir, Lazarević Predrag, Čubrilo Dejan, Macura Marija, Jeremić Nevena, Srejović Ivan, Djurić Dragan, Jakovljević Vladimir . . . . . . . . . . . . . . . . . . .74

28. AKUTNI I HRONICNI EFEKTI NANDROLON-DEKANOATA NA KARDIODINAMIKU IZOLOVANOG SRCA I RE-DOKS STATUS TRENIRANIH PACOVAACUTE AND CHRONIC EFFECTS OF NANDROLON DECANOATE ON CARDIODYNAMICS OF ISOLATED RAT HE-ART AND REDOX STATUS IN EXERCISED RATS

Nikolic Turnic Tamara, Jevdjevic Maja, Zivkovic Vladimir, Srejović Ivan, Jeremić Nevena, Milosavljević Isidora, Jeremić Jovana, Djurić Dragan i Jakovljević Vladimir. . . . . . . . . . . . . . . . .75

29. EFEKTI DETRENINGA PLIVANJA: RAZLIKE PREMA POLUTHE EFFECTS OF SWIMMING DETRAINING: GENDER-DEPENDENT DIFFERENCES

Jeremic Jovana, Dragojlovic Ruzicic Radica, Zivkovic Vladimir, Milosavljevic Isidora, Nikolic Turnic Tamara, Srejovic Ivan, Jeremic Nevena, Jakovljevic Vladimir . . . . . . . . . . . . . .76

30. BENEFITI TRENINGA VISOKOG INTEZITETA NA SRČANI MIŠIĆ MIŠEVA – ULOGA MIKRORNKBENEFICIAL EFFECTS OF HIGH INTENSITY INTERVAL TRAINING (HIIT) ON CARDIAC MUSCLE – ROLE OF MIRNA

Nevena Jeremic, Gregory Weber, Nicholas Thelien, Vladimir Jakovljevic, Suesh Tyagi. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78

31. FIZIČKA AKTIVNOST I ISHRANA KOD STARIJIH OSOBA KOJE ŽIVE SAMOSTALNO PHYSICAL ACTIVITY AND NUTRITION IN AGEING AND INDEPENDENT LIVING

Simovska Vera, Vidin Mila . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79

32 . ZASTUPLJENOST BENIGNIH EKG PROMENA KOD MLADIH SPORTISTA SA TERITORIJE VOJVODINE U OD-NOSU NA PRIPADNOST DOMINANTNO AEROBNIM ILI ANAEROBNIM SPORTOVIMABENIGN ECG CHANGES IN YOUNG ATHLETES FROM VOJVODINA IN RELATION TO ENGAGEMENT IN DOMI-NANTLY AEROBIC OR ANAEROBIC SPORTS

Andrić Lana, Karan Vedrana, Bogdan Maja, Slavić Danijel, Rakovac Aleksandra, Radulović Nikola, Klašnja Aleksandar . . . . . . . . . . . . . . . . . . . . . . . .32

33. UPOTREBA DODATAKA ISHRANI MEĐU REKREATIVNIM SPORTISTIMAUSE OF FOOD SUPPLEMENTS AMONG RECREATIONAL ATHLETES

Mirjana Đermanović, Lj.Bojanić. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86

34. KVALITET DODATAKA ISHRANI NAMIJENJENIH SPORTISTIMA QUALITY OF FOOD SUPPLEMENTS INTENDED FOR ATHLETES

Mirjana Đermanović, Lj. Bojanić . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87

35. UTICAJ GVOŽĐA NA OKSIDACIONI STRES I ANTIOKSIDANTNU AKTIVNOST VITAMINA C U AKUTNOM FIZIČKOM OPTEREĆENJUTHE INFLUENCE OF IRON ON OXIDATIVE STRESS AND THE ANTIOXIDANT ACTIVITY OF VITAMIN C IN ACUTE EXERCISE

Ljiljana M. Popović, Nebojša R Mitić . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89

36. UTICAJ JEDNOKRATNOG INTENZIVNOG FIZIČKOG OPTEREĆENJA NA PROMENU ACIDOBAZNOG STATUSA I GASNIH ANALIZA THE EFFECT OF ONE-TIME INTENSIVE PHYSICAL EXERCISE ON ACID-BASE STATUS AND BLOOD GAS ANALYSIS

Nebojša R Mitić, Ljiljana M. Popović . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91

37. POVREDE AHILOVE TETIVE KOD SPORTISTA-FIZIKALNI TRETMAN I LIJEČENJETHE INJURIES OF THE ACHILLES TENDON AT THE ATHLETES - THE PHYSICAL TREATMENT AND CURING

Vukosav Joksimović, Marija Joksimović, Slavko Tomić . . . . . . . . . . . . . . . . . . . . . . . . . . .93

38. ANALIZA KORIŠĆENJA LEKOVA I SUPLEMENATA U SPORTSKOM DRUŠTVU „CRVENA ZVEZDA”ANALYSIS OF THE USE OF MEDICINES AND SUPPLEMENTS IN THE SPORTS SOCIETY RED STAR

Nenad Dikić, Marija Anđelković, Igor Milojevic, Stefan Berović, Suzana Stojković, Aleksandar Jakovljević, Marija Bogdanović, Vanja Todorovic, Aleksandar Cincovic, Stefan Vitkovic, Isidora Ilić, Aleksandar Petrović, Ivana Popović, Irena Jovanović, Ana Milošević, Marija Milaković, Bozic Saska, Marko Mitrovic, Emilija Nastovic, Andreja Nikolic, Anđela Arsić, Milica Aranđelović, Emilija Prlincevic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95

PREGLED APSTRAKTA PREMA REDOSLEDU POJAVLJIVANJAREVIEW OF ABSTRACTS BY THE ORDER OF PRESENTATION

9PROGRAM I KNJIGA SAŽETAKA / PROGRAM AND ABSTRACT BOOK

1. SUPLEMENTACIJA KOD ATLETIČARADušan AntićAtletski klub „Vožd“ Jagodina

UVOD - Suplementacija u sportu se u da-našnje vreme nalazi u širokoj upotrebi, bilo opravdano ili neopravdano. Suple-mente upotrebljavaju sportisti svih staro-snih dobi, i aktivni sportisti i rekreativci. Suplementi imaju svoje mesto u očuvanju i unapređenju zdravlja, kao i poboljšanju sportskih performansi, ali samo ako se uz-imaju na način na koji je to propisano. Cilj ovog istraživanja je bio da se ispita upo-treba suplemenata kod atletičara, a da se rezultati uporede u odnosu na starosnu dob atletičara (seniori i veterani).

METODOLOGIJA - Istraživanje je obuhvati-lo 206 ispitanika (122 muškarca i 84 žene; srednje godine starosti 32,56±12,93) koji su činili 2 subuzorka: atletičari seniori (62 muškarca i 52 žene; raspon godina 18 do 35, srednje godine starosti 24,43±3,79) i

atletičari veterani (60 muškaraca i 32 žene; stariji od 35 godina, srednje godine staro-sti 46,04±6,11). Potreban uslov je bio da je atletičar u poslednjih 12 meseci učestvo-vao na atletskim takmičenjima. Za priku-pljanje podataka je korišćena nestandar-dizovana istraživačka tehnika anketiranja.

REZULTATI - Suplemente u ovom trenutku koristi ukupno 66,5% seniora i 62,5% ve-terana, dok je u poslednjih godinu dana koristilo 81,5% seniora i 70,8% veterana.

Kao najčešći izvor informacija o suplemen-tima ispitanici iz grupe seniora navode tre-nera (27%), internet (22,9%) i kolege spor-tiste (8,3%), dok su za ispitanike iz grupe veterana to internet (36,6%), prijatelji (9,8%) i kolege sportisti (7,3%), p<0,05.

Ispitanici uzimaju različite suplemente. Ukupno su prijavili da su upotrebljavali 48 različitih suplemenata. Najčešće upotre-bljavani suplementi u poslednjih godinu su prikazani u tabeli.

seniori veterani

broj suplemenata 5,24±2,73 (opseg 1-11) 4,35±3,52 (opseg 1-13) p<0,05

whey protein 64,5% 25% p<0,05

kreatin 38,7% 20,8% p<0,05

multivitamini i minerali 29% 25% ns

glutamin 35,5% 8,3% p<0,05

bcaa 16% 4,2% p<0,05

amino kiseline 12,9% 0 p<0,05

zma 9,7% 0 p<0,05

glukozamin 9,7% 16,7% p<0,05

beta alanin 6,5% 4,2% ns

omega-3 0 12,5% p<0,05

ZAKLJUČAK - Rezultati istraživanja ukazu-ju da postoje razlike između atletičara se-niora i veterana kada je u pitanju uzimanje različitih sportskih suplemenata i način in-formisanja o njima. Ono što bi svi trebalo da imaju na umu je da se suplementi uvek

koriste kada i koliko treba, uz strogu kon-trolu. Konstantna edukacija iz ove oblasti može pomoći da se bolje razume i shvati uloga i potreba za suplementima.

Ključne reči: suplementi, anketiranje, atletika

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6. KONGRES MEDICINE SPORTA i 3. KONGRES O PREVENCIJI DOPINGA U SPORTU 6th CONGRESS OF SPORTS MEDICINE and 3rd CONGRESS ON PREVENTION OF DOPING IN SPORT

THE USE OF SUPPLEMENTS AMONG ATHLETESDušan AnticAthletic club „Vozd“ Jagodina

INTRODUCTION – Nowadays supplements in sports are widely used. They are used by athletes of all ages and di�erent level of physical activity. Supplements play a great role in maintaining and promoting health and improving athletic performance, but only taken in the way it is de ned. The aim of this study was to establish the use of supplements among athletes, and to compare the results with respect to age of respondents (seniors and veterans).

METHODS – The survey included 206 participants (122 men and 84 women; the mean age was 32,56±12,93) who were divided in two sub-samples: athletes (62 men and 52 women; ranged 18-35 years, the mean age was 24,43±3,79) and veteran athletes

(60 men and 32 women; older than 35, the mean age was 46,04±6,11). Participation in any athletic competition in last 12 months was important factor for all athletes who took part in this survey. The data collection was done through a questionnaire, a non-standard research technique.

RESULTS – Supplements currently use 66,5% of seniors and 62,5% of veterans, whereas in last year supplements have been used more - 81,5% of seniors and 70,8% of veterans. The most common source of information on supplementation for seniors is the coach (27%), followed by the internet (22,9%) and other athletes (8,3%). On the other hand, for veterans it is the internet (36,6%), friends (9,8%) and other athletes (7,3%), p<0,05. The participants use many supplements. They reported using of 48 di�erent supplements. The most commonly used supplements in last year are shown in the table.

senior athletes veteran athletes

number of supplements 5,24±2,73 (range 1-11) 4,35±3,52 (range 1-13) p<0,05

whey protein 64,5% 25% p<0,05

creatine 38,7% 20,8% p<0,05

multivitamins plus minerals 29% 25% ns

glutamine 35,5% 8,3% p<0,05

bcaa 16% 4,2% p<0,05

amino acids 12,9% 0 p<0,05

zma 9,7% 0 p<0,05

glucosamine 9,7% 16,7% p<0,05

beta alanine 6,5% 4,2% ns

omega-3 0 12,5% p<0,05

CONCLUSION - The results of this study indicate di�erences among the groups when it comes to taking various supplements, but also the way of information about them. What all athletes should have in their minds is that sport supplements are supposed to use

only when it is necessary, with strict control. These results could be a good direction for planning di�erent kinds of education of athletes about proper use of supplements.

Key words: supplements, athletes, questionnaire, athletics


2. NAVIKE U ISHRANI FUDBALERA I RUKOMETAŠICAJasmina TimićKatedra za Bromatologiju, Farmaceutski fakultet Univerziteta u Beogradu

Dvadeset šest fudbalera poznatog grad-skog fudbalskog kluba, kao i četiri ruko-metašice istoimenog gradskog kluba, intervjuisani su o navikama vezanim za ishrani. Sprovedeno Istraživanje odnosilo se na učestalost i vrstu hrane koju najče-šće koriste u svojoj dnevnoj ishrani, način pripreme jela, broj glavnih obroka i užina u toku dana, sveukupnu ocenu ishrane, omiljenu vrstu namirnice, regularnost u glavnim obrocima, unos određenih suple-menata. Takođe je procenjeno i koju hra-nu najčešće konzumiraju tokom doručka, ručka i večere. Prosečna starost ispitanika iznosila je 22 godine, prosečna visina 181 cm i težina 75 kg. BMI bio je u granicama normale (BMI = 23 kg / m2). Na pitanje da li imaju redovan doručak, 43% ispitanika je odgovorilo “da”. Za redovni ručak, svi uče-snici su odgovorili potvrdno, a na pitanje da li je večera sastavni deo njihove dijete, polovina ispitanika je odgovorila sa “da”. Na pitanje da li sami pripremaju obroke, najveći procenat je negativno odgovorio i konzumirao hranu pretežno u restoranu (12 ispitanika), kod kuće (9), prodavnica-ma brze hrane, kao i lokalnim pekarama. Samo je njih četvoro prijavilo da sami učestvuju u pripremi obroka. Kao najza-stupljenija namirnica za doručak navede-na su jaja i to u kombinaciji sa drugim prehrambenim proizvodima - mlečnim proizvodima, pecivom, voćem, povrćem, salatom i tunjevinom ili sardinom. Samo jaja konzumira 5 ispitanika dok se osmoro njih opredelilo za peciva. Ručak je bio re-zervisan uglavnom za kombinaciju supe, mesa, salata i kuvanog jela. Meso je hrana koju je trećina ispitanika navela kao glav-

nu namirnicu za večeru. Posle toga, tu su i kombinacije mesa sa salatom, supom i testeninom, ali u mnogo manjem procen-tu. Sledeće vrste namirnica navedene su kao omiljene : prvenstveno meso i naj-češće u kombinaciji sa ostalom hranom (kuvana jela, testenina, slatkiši i mliečni proizvodi). Različite vrste grickalica kon-zumira 16 učesnika ankete i to ponekad, a čak osamnaestoro ispitanika prijavilo je orašaste plodove i semenke kao obavezni deo njihove ishrane. Činjenica je da čak 17 sportista ne koristi dodatke u ishrani, a oni koji su odgovorili potvrdno koriste uglav-nom: vitamin C, Magnezijum, Whey prote-in, sportska i energetska pića, vitaminsko--mineralni kompleks. Jedan od ispitanika prijavio je Glukozamin a jedan preparat “Herbalife”kao jedan od čestih korišćenih suplemenata. Na pitanje kako su zadovolj-ni svojom sveukupnom ishranom oprede-lili su se za odgovor “ishrana je dobra”, a u svojoj ishrani na skali od 1 do 10, većina odgovora ocenom 8. Trećina ispitanika ima tri obroka u toku dana, broj glavnih obroka 2 (više od polovine ispitanika), a dve trećine njih imala je samo jednu užinu tokom dana.

EATING HABITS OF FOOTBALL PLAYERS AND HANDBALL PLAYERSJasmina TimicDepartment of Bromatology, Faculty of Pharmacy, University of Belgrade

Twenty-Six Football players of the famous city football club, as well as 4 handball player teams of the same city club, were interviewed about eating habits. The research was conducted regarding the frequency and type of foods most often entered the place and way for preparing meals, the number of main meals and refreshments, the overall food rating, the

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favorite food type, regularity in the main meals, the intake of certain supplements. It was also assessed and which foods are most often consumed among the respondents for breakfast, lunch, and dinner. There were 26 men and 4 girls. The average age year of respondents was 22, average height 181 cm, and weight 75 kg. BMI was within the normal range (BMI = 23 kg / m2). When asked if they have a regular breakfast 43% of respondents answered “yes”. For regular lunch, all of participants answered positive and when asked whether the dinner is an integral part of their diet half of respondents answered “yes”. When asked if they were preparing meals themselves, the largest percentage answered negatively and consumed food mainly in a restaurant (12 respondents), at home (9), fast food stores as well as in local bakery. Only four of them prepared meals themselves. As the most prevalent foods for breakfast, the eggs are combined with other foods-dairy products, pastry, fruit, vegetables, salad and tuna or sardine. Only eggs consume 5 examinees while 8 de ne them for pastries. The lunch was reserved mostly for a combination of soups, meat, salads, and cooked meal. Meat is a food that a third of the respondents stated as the main for dinner. After that, there are also combinations of meat with salad, soup and pasta, but in much less percentage. The following foods were listed as favorites: primarily meat and most often in combination with other foods (cooked meals, pasta, sweets, and dairy products. Snacks consumed 16 of all participants sometimes, and even 18 have nuts and seeds as mandatory part of their nutrition. Srprising is fact that even 17 of them do not use any supplements, and those who respond positively use mostly vitamin C, Magnesium, Whey Protein, sport and energy drinks, vitamin

and mineral complex. One of them reported Glucosamine and one reported the Herbalife supplement as one of the frequent used. Whether how are they satis ed with the overall diet, they responded as “the diet is good” and in their diet on the scale from 1 to 10 most of the answers was rated by eights (a third of respondents). The number of meals they had during the day was 3, the number of main meals 2 (more than half of the respondents) and two thirds of them had only have one refreshment during the day.

3. ISHRANA I SUPLEMENTACIJA VRHUNSKIH KAJAKAŠAPavle Jovanov1, Marijana Sakač1, Otto Barak2, Anamarija Man-dić1, Olivera Đuragić1, Nataša Nedeljković1, Aleksandar Marić1

1Naučni institut za prehrambene tehnologije u Novom Sadu, Univer-zitet u Novom Sadu, 2Medicinski fakultet Univerzitet u Novom Sadu

Boravak u inostranim trening kampovima postao je uobičajna praksa tokom priprem-ne sezone kajakaša. Međutim, promene na-vika u ishrani koje mogu nastati tokom bo-ravka u kampu potencijalno se odražavaju i na perforrmanse kajakaša na vodi. Iako postoje preporuke o neophodnom unosu ukupne energije (TE), izražene u kalorija-ma na osnovu trenažnog opterećenja, koji omogućava da se unosom ugljenih hidrata obnovile rezerve glikogena, unosom prote-ina omogući rast i obnova mišićnih tkiva, a dovoljnim unosom tečnosti obezbedi ade-kvatna hidratacija, postoji malo podataka koji govore o tome da li se kajakaši pridr-žavaju ovih preporuka. Takođe, upotreba raznih sportskih suplemenata bez stručnog nadzora je ukazala na potrebu za evaluaci-jom njihove upotrebe tokom boravka u tre-ning kampu.

Tokom ove studije, 8 vrhunskih kajakaša je beležilo unos namirnica i sportskih suple-menata u periodu od 72 h tokom boravka


u inostranom trening kampu kako bi se kvanti kovao dijetetski unos preko ma-kro i mikro nutrijenata. Svi sportisti u ovoj studiji su imali minimum 5 obroka dnevno unoseći raznovrsne namirnice. Svi kajakaši su koristili slične sportske suplemente kao dodatke ishrani, prevashodno proteine surutke, vitamine i minerale, keratin, beta alanine I druge. Analiza unosa makro i mi-kro nutrijenata je pokazala da su kajakaši prosečno unosili 374 g ugljenih hidrata (39% TE), 240 g proteina (30% TE) i 122 g masti (31% TE) dnevno. Prekomerna upo-treba proteinskih suplemenata dovela je do porasta udela energije iz proteina, koji je praćen nedovoljnim unosom ugljenih hidrata. Preporučene dnevne količine vi-tamina i minerala su bile višestruko preko-račene (B6, B12, C, E, K, Ca, Fe, Mg, P, K, Na), što je moglo da prouzrokuje zdravstve probleme, naročito u slučaju liposolubil-nih vitamina.

Stoga je neophodno vršiti stručni nadzor ishrane i i korišćenja suplemenata vrhun-skih kajakaša tokom pripremne i sezone takmičenja.

Ključne reči: dijetetski suplementi, kajak, ishrana sportista

Zahvalnica: Autori se zahvaljulju Ministar-stvu Prosvete, nauke I tehnološkog razvo-ja (projekti broj TR31029 i ON172012) na obezbeđenim sredstvima za realizaciju ove studije.

EVALUATION OF DIETARY AND SUPPLEMENT INTAKE OF ELITE CANOE SPRINTERSPavle Jovanov1, Marijana Sakač1, Otto Barak2, Anamarija Mandić1, Olivera Đuragić1, Nataša Nedeljković1, Aleksandar Marić1

1Institute of Food Technology, University of Novi Sad, 2Faculty of Medicine, University of Novi Sad

International training camp is now a common feature of an elite canoe sprint athlete’s competition schedule; however, di�ering eating arrangements when away from home may in�uence an athlete’s food choice, and potentially their performance. Athletes need to consume suitable food and �uid prior to, during, and after trainings or competitions in order to maximise performance. Although total calorie recommendations exist for athletes based on training loads to ensure that they consume su�cient total energy (TE) to meet requirements, carbohydrate to replenish glycogen stores, protein to aid in muscle repair and growth, as well as �uid to stay adequately hydrated, little data is available to ascertain if elite canoe sprinters meet these recommendations. Furthermore, unsupervised use of various dietary supplements showed the necessity for evaluation of their intake during preparation canoe sprint training camp.

In this study 8 elite canoe sprint athletes recorded their dietary and supplements intake during 72 h at the international training camp in order to quantify dietary intake in regards to energy and macronutrient content. All of the athletes had at least 5 meals per day, with the variety of foods consumed. Similar dietary supplements were consumed by all the athletes, among which whey proteins, vitamins and minerals, creatine, beta alanine etc. The results of macro and micro nutrient intake suggested that athletes were consuming on average 374 g of carbohydrate (39% TE), 240 g of protein (30% TE) and 122 g of fat (31% TE) daily. The excessive use of protein supplements caused the increased in energy derived from protein followed by inadequate energy intake from carbohydrates. The Recommended daily intake of vitamins and

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minerals was mostly overreached (B6, B12, C, E, K, Ca, Fe, Mg, P, K, Na) causing health concern in case of liposoluble vitamins.

Therefore, there is a necessity for the professional guidance in regard to elite canoe sprint athlete’s diet during preparation and competition seasons.

Keywords: dietary supplements, canoe sprint, sport nutrition

Acknowledgment: The authors appreciate funding from the Ministry of Education, Science and Technological Development of the Republic of Serbia (Project No. ON172012 and TR31029) for supporting this e�ort.

4. PRIMENA FORENZIČKIH METODA U ANTIDOPINGUEmilija Radić

Institut za plućne bolesti Vojvodine Sremska Kamenica

UVOD. Forenzika kao multidisciplinarna nauka, daje odgovor na pitanje šta se do-godilo, kada se događaj zbio i ko je uklju-čen u taj događaj. Forenzička nauka koristi i primenjuje metode primenjenih i funda-mentalnih nauka. Danas nema bilo kakve vrste spora gde forenzičke metode nema-ju svoju primenu, uključujući i sport.

CILJ. Pokazati primenu forenzičkih metoda u anti-dopingu na Zimskim Olimpijskim igrama u Sočiju 2014. godine kroz analizu izveštaja Prof. dr Richarda Macklarena.

MATERIJAL I METODE. Istraživanja i ispiti-vanja koja je sprovela nezavisna komisija (IP) oformljena od strane Svetske Anti Do-ding Agencije (WADA) u cilju utvrđivanja sistemskog prikrivanja i manipulacijom procesa doping kontrole na ZOI Soči 2014.

godine obuhvatila je korišćenje mnogo-brojnih forenzičkih i laboratorijskih anali-za.Sproveden je cyber i forenzička analiza dokaza uzetih sa hard diskova, backup, sigurnosnih kopija.Na osnovu dokumen-tacije dobijene tim putem IP je je kreirao radnu bazu podataka i izvršio reviziju 4237 Exel tabela uključujući dokumentaciju i emailove.Na bocama urina B utvrđene su mikroskopskom tehnikom ogrebotine a takođe korišćena je DNK analiza za potvr-du identiteta.

REZULTATI. Nezavisna komisija (IP) je anali-zirala 96 bočica B uzorka sportista na Olim-pijskim igrama iz Sočija i 21 uzoraka Pa-raolimpijaca koji su bili na listi zaštićenih sportista. Na 44 B uzorka urina utvrđeni su dokazi o ogrebotinama i oznakama koje ukazuju da su uzorci menjani.Zatim, su analizirane odgovarajuće bočice A uzorka na utvrđivanje koncentracije soli, u 6 uzo-raka je sadržaj bio viši od zioloških mogu-ćih granica.DNK ispitivanje sprovedeno je na 19 odgovarajućih boca A uzorka od 33 zaštićenih sportista.Nisu utvrđene nikakve nedoslednosti, ali DNK analizom ženskog hokej tima koji u početku nisu bili deo za-štićenih sportist u 2 uzorka urina ženskih igrača otkrivena je muška DNK. Analizom 21 uzoraka Paraolimpijaca utvrđeno je 18 poklopaca imalo ogrebotine što dokazuje da su uzorci otvarani a na preostale 3 bo-čice nisu utvrđene nikakve nepravilnosti.

ZAKLJUČAK. Prevare i varanje u sportu nisu nova pojava u Olimpijskom takmiče-nju ali metode koje se koriste u tu svrhu postaju sve inovativnije i sveobuhvatnije.Primena forenzičkih metoda postaje sa-stavni deo procesa dopinga, sve u cilju njegovog sprečavanja i suzbijanja kako korisnici dopinga ne bi išli korak ispred.


APPLICATION OF FORENSIC METHODS IN ANTI-DOPING CONTROLEmilija Radic

The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia

INTRODUCTION. As a multidisciplinary discipline, the forensic science answers the questions about an event: WHAT has happened, WHEN did it happen, and WHO was involved in it. The forensic science utilizes and applies methods and techniques of fundamental and applied sciences, Nowadays, there is no type of a dispute which does not require the application of a forensic method, including sport as well.

OBJECTIVE. To review the application of forensic methods in anti-doping control at the 2014 Winter Olympics (WO) held in Sochi, analyzing the report by prof. Richard Macklaren.

MATERIAL AND METHODS. The research and investigations carried out by the Independent Commission (IC) of the World Anti-Doping Agency (WADA), aimed at detecting a systemic deceit and manipulation with the WO “Sochi 2014“ anti-doping control process, included a variety of forensic and laboratory assays. Cyber and forensic analyses of the evidence obtained from hard discs, back-ups, safety copies were performed. Based on this way obtained information, the IC created the working data base and revised the total of 4237 Excel tables, including documentation and mails. The applied microscopic technique has revealed scratches on urine B sample bottles, and the DNA analysis has also been used for identity con rmation.

RESULTS. The IC analzyed 96 B sample bottles, taken from the sportmen

participating at the Sochi Olimpics, as well as 21 samples from the paraolympics in the list of protected sportsmen. The evidence of scratches and signs suggesting sample alterations was registered on 44 B sample bottles. The respective A sample bottles were then analyzed regarding salt concentrations, revealing excessive, physiologically impossible levels in 6 samples. The DNA investigation was carried out on 19 A sample bottles from 33 protected sportrsmen. No inconsistency was detected, but the DNA assay of a women hockey team members who initially were not included in the protected category revealed a male DNA in two urine samples from female players. Analyzing 21 samples from paraolympic participants, 18 bottle covers were found to have scratches, suggesting the bottles had been opened, unlike the remaining 3 bottles free of any malformations.

CONCLUSION. Cheating and frauds are not unknown in sport, even at the Olympics, but the methods used for that purpose are becoming increasingly ingenious and ubiquitous. Therfore, the application of forensic methods is becoming an integral part of anti-doping control, aimed at doping prevention and precluding doping users to take leadership in sports.

5. NOVE PSIHOAKTIVNE SUPSTANCE – POTENCIJALNI DOPING?Snežana Đorđević1,2, Vesna Kilibarda1,2, Slavica Vučinić1,2

1 Nacionalni centar za kontrolu trovanja, Vojnomedicinska akademija, Beograd2 Medicinski fakultet, Vojnomedicinska akademija, Univerzitet odbrane, Beograd

Psihoaktivne supstance su poznate kao supstance koje se koriste kao doping u sportu. Nove psihoaktivne supstance (NPS)

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su dizajnirane da imitiraju efekte ilegalnih supstanci kao što su kanabis, kokain i eksta-zi, ali su još uvek legalne. Uprkos restriktiv-noj regulativi, poslednjih nekoliko godina broj novosintetisanih psihoaktivnih sup-stanci je dramatično povećan (više od 700 od 2009.). NPS su veoma zanimljive mladoj populaciji zbog njihove lake dostupnosti i niske cene. Takođe, zbog stimulativnih efe-kata koje poseduju, postoji opasnost nji-hove upotrebe kao potencijalnog doping sredstva u sportu. Prodaju se kao legalne zamene droga („legal highs“) ili „dodaci hrani“ i mogu se kupiti u „smart shop“-ovi-ma, preko interneta ili na ilegalnom tržištu. Veliki problem vezan za NPS je taj da kori-snici nisu svesni sastava i doze psihoaktivne supstance koje sadrže neki proizvodi. One potencijalno imaju veoma ozbiljan rizik po zdravlje ljudi. Postoje brojni probleni u de-tekciji, identi kaciji, praćenju, razumevanju upotrebe, ozbiljnih i neželjenih efekata, kao i kliničkog praćenja NPS.

Poslednjih godina sintetski kanabinoidi (SK) su dominantni kao sredstva zloupo-trebe među NPS. SK imaju efekte slične Δ9-tetrahidrokanabinolu (THC), aktivnom sastojku marihuane. Uobičajeno je da se biljni materijal isprska SK i tako mogu da se puše („herbal incense“) ili prodaju kao tečnosti koje mogu da isparavaju i inhali-raju. Prodaju se kao „osveživači vazduha“ lažnim reklamama, kao biljne mešavine koje nisu za ljudsku upotrebu i različitog su sastava i sadržaja SK. Očekivani efekti su: euforija, bolje raspoloženje, opuštanje, promena vizuelne percepcije. Neželjeni efekti su anksioznost, povraćanje, para-noja, glavobolja, psihoza („šizofrenija“), halucinacije, konvulzije. Mogu da izazovu hipertenziju, tahikardiju, zavisnost i smrt.

Na osnovu podataka Nacionalnog centra za kontrolu trovanja (NCKT) Srbije, prvi

slučaj neželjenih efekata SK zabeležen je 2013. Značajan porast njihove zloupotre-be zabeležen je 2015. (36 pacijenata sa neželjenim efektima). U 2016. notirano je 9, a u 2017.god. 6 pacijenata sa sumnjom na neželjene efekte NPS sa stimulativnim efektima na CNS. Takođe, u NCKT lečeni su pacijenti zbog neželjenih efekata nakon zloupotrebe GHB, DMT (iz Ajahuaske), sin-tetičkog ibogaina i muskatnog oraščića.

Zloupotreba NPS predstavlja rastući pro-blem u populaciji mladih ljudi zbog njiho-vih nedovoljno poznatih efekata, sastava i doza u preparatima. To je i potencijalni pro-blem u sportu, zbog njihovih stimulativnih efekata i moguće upotrebe kao dopinga, a imajući u vidu da su lako dostupni i jeftini.

Ključne reči: nove psihoaktivne supstance, stimulansi, neželjeni efekti

NEW PSYCHOACTIVE SUBSTANCES – POTENTIAL DOPINGSnežana Đorđević1,2, Vesna Kilibarda1,2, Slavica Vučinić1,2

1 National Poison Control Center, Military medical academy, Beograd2 Medical faculty, Military medical academy, University of defense, Beograd

Psychoactive substances are well known as a doping substance in sport. New psychoactive substances (NPS) are drugs which were designed to replicate the e�ects of illegal substances like cannabis, cocaine and ecstasy whilst remaining legal. In recent years number of newly sintesized psychoactive substances has been dramaticaly increased (more than 700 since 2009.) despite restrictive regulation. NPS are highly atractive to young people beause of their easy availability and low prices. Thanks to their stimulative e�ects, they can be used as a potential doping in sport. NPS are sold


as „legal highs” or „food supplements“ and can be easily bought in smart shops, on the web, or directly on the illicit drug market. The big problem with NPS is that users are unaware of the content and the dosage of the psychoactive substances contained in some products. They potentially have serious health risks. There are numerous problems in detection, identi cation, monitoring, understanding use, severe and adverse e�ects and clinical management of NPS.

In recent years in group of NPS synthetic cannabinoids (SC) dominate in abusing. SC have similar e�ects to Δ9-tetrahydrocannabinol (THC), active ingredient of marijuana. They are usually sprayed on dried plant material so they can be smoked („herbal incense“) or sold as liquids to be vaporized and inhaled. They are sold as „air fresheners” by false advertising as herbal mixture which are not for human use with di�erent quantities and compsition of SC. Expected e�ects are euphoria, better mood, relaxation, change of visual perception. Side e�ects are anxiety, vomiting, paranoia, headache, psychosis („schizophrenia”), hallucination, convulsions. They can provoce hypertension, tachycardia, addiction, death.

According to National Poison Control Centre (NPCC) Serbia data, rst case of side e�ects of SC was noticed in 2013. Dramatic increase of their consumption (36 patients with side e�ects) was noticed in 2015. We had 9 patients suspected on NPS with stimulative e�ects in 2016, and 6 in 2017. In NPCC also reported patients that used GHB, DMT (from Ayahuasca), synthetic ibogain and nutmeg.

Abuse of NPS is increasing problem in young population because of their unknown e�ects, composition and dosage

in preparation. It is а potential problem in sport, because of their stimulative e�ects and potential use as doping, having in mind that they are easily available and cheap. This is the reason why it is very important to work on prevention of their use.

Key words: new psychoactive substances, stimulant, side e�ects

6. OKRUGLI STO: TEREN LABORATORIJI NE VERUJE – PROBLEM IZNENADNE SRČANE SMRTI U SPORTUDikić Nenad1, Nedeljković Ivana2, Nikolić Ivan3.1Fakultet za �zičku kulturu i menadžment u sportu, Univerzitet Singidunum, 2Klinički centar Srbije, Medicinski fakultet, Univerzi-tet u Beogradu 3Ordinacija Vita Maxima, Beograd

Iznenadna srčana smrt Davida Astorija (FK Fjorentina), Tomasa Rodrigeza (FK Tours), Adrijana Lilebeka Olivijena (FK Kongsvin-ger), Bruna Bobana (FK Marsonija) i Zeka Apšoa, (BK Grand Repid Drajv) tokom samo dve nedelje u martu 2018. godine uticala je na veliko interesovanje medija i javnosti. Tako je Informer u članku Fudbal najsmrtonosniji sport intervjuišući Prof. dr Miljka Ristića izneo tezu i da nema mno-go sportista koji dožive duboku starost. Portal Telegraf u članku Šta uništava srca fudbalera, zbog čega padaju na terenu i van njega i kako to sprečiti? u razgovoru sa Prof.dr Ivanom Nedeljković ukazao na pro-blem adaptacije srca na napor. List Danas u članku Milice Radenković pod nazivom Teren laboratoriji ne veruje na kraju teksta kaže da Astori nije bilo bolestan i da nije-dan od prethodnih pregleda nije pokazao nikakvo srčano oboljenje, a da je premi-nuo od infarkta. I ovako letimice poređani naslovi u novinama otvaraju mnogo pita-nja. Da li je fudbal zaista najsmrtonosniji?

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Koji sportovi su najrizičniji? Da li je u pita-nju problem adaptacije srca na napor? Za-što umiru sportisti koji su na prethodnim pregledima bili zdravi?

Analizom literature objavljene u poslednjih 10 godina dolazi se do podataka da izne-nadna srčana smrt nije rezervisana samo za profesionalni sport, već da se u 90% slu-čajeva događa u rekreativnom sportu, gde ne postoji medijska pažnju, a da u prvih pet sportova po smrtnosti spadaju bicikli-zam (30, 61%), džoging (21,34%), fudbal (13,05%), hajking (5%) i plivanje (3,78%) (Marijon i sar, 2011). S druge strane inci-denca iznenadne srčane smrti varira od 1: 917 000 do 1: 3000, dok je u studijama sa višim metodološkim kvalitetom inciden-ca iznenadne srčana smrti u rasponu od 1:40 000 do 1:80 000. Pri tom neke sport-ske podgrupe, muškarci, afro-američki crni sportisti, kao i košarkaši, izgleda da imaju veći rizik. (Harmon, 2014). Konačno odgo-vor na pitanje zašto umiru sportisti koji su na prethodnim pregledima bili zdravi nije lak, jer je činjenica da je u 25% slučajeva obdukcijski nalaz negativan tzv. AN-SUD (Harmon, 2015).

Udruženje za sportsku kardiologiju Srbi-je je problemu iznenadne srčane smrti u sportu posvetilo veliku pažnju, izdava-njem knjiga Iznenadna srčana smrt u sport (2005), Evropske preporuke za učestvova-nje u rekreativnom i takmičarskom sportu (2007), Sportska kardiologija - klinički slu-čajevi (2010) i Stres test (2014). Istovreme-no se radilo na postavljanu i primeni svih standarda pregleda sa ciljem što sveobu-hvatnijeg pregleda sportista i otkrivanja stanja ili oboljenja koje može da dovede do iznenadne srčane smrti.

U okviru okruglog stola Prof. dr Ivana Ne-deljković će napraviti revijalni prikaz rado-va koji govore o problemu iznenadne sr-

čane smrti u sportu, dok će dr Ivan Nikolić pored predstavljana standardnih metoda govoriti i o primeni novih dijagnostičkih metoda za otkrivanje uzroka iznenadne sr-čane smrti. Konačno dr Marija Zdravković će govoriti o kardiomaghnetnoj rezonan-ci, kao state of the art metodi za otkrivanje stanje i bolesti koje mogu da dovedu do iznenadne srčane smrti.

ROUND TABLE: THE PITCH DOES NOT TRUST THE LABORATORY - THE PROBLEM OF SUDDEN CARDIAC DEATH IN SPORTDikić Nenad1, Nedeljković Ivana2, Nikolić Ivan3.1Faculty for physical education and management in sport. Singidunum University, 2Clinical canter Serbia, Medical Faculty, University of Belgrade, 3Medical o�ce Vita Maxima, Beograd

The sudden cardiac death of Davide Astoria (Fiorentina FC), Tomas Rodriguez (Tours FC), Adrian Lillebekk Ovlien (Kongsvinger FC), Bruno Boban (FC Marsonia) and Zeke Upshaw (BC Grand Rapids Drive) in just two weeks in March 2018. has increased attention of the media and the public. Thus, Informer in the article Football the deadliest sport interviewing Prof. Dr Miljko Ristic presented the thesis and that there are not many athletes who are living long. Portal Telegraf in the article What harm the hearts of the football players, why they fall on the eld and how to prevent it? in a discussion with Prof. Dr. Ivan Nedeljkovic, pointed out the problem of adaptation of the heart to physical activity. The newspaper Danas in the article by Milica Radenkovic under the name Pitch does not believe the laboratory at the end of the text she said that Astori was not ill, that none of the previous examination showed any heart disease, and that he died of a stroke. And this list of headlines in the newspapers


open many questions. Is football really the deadliest? Which sports are the riskiest? Is the problem of cardiac adaptation to physical activity? Why are athletes who were healthy at previous examinations dying? An analysis of literature published in the last 10 years shows that sudden cardiac death is not reserved for professional sports only, but in 90% of cases it occurs in recreational sports, where there is no media attention, and that in the rst ve sports by mortality include biking (30, 61%), jogging (21.34%), football (13.05%), hiking (5%) and swimming (3.78%) (Marion, 2011). On the other hand, the incidence of sudden cardiac death varies from 1: 917 000 to 1: 3000, while in studies with a higher methodological quality the incidence of sudden cardiac deaths ranges from 1:40 000 to 1:80 000. In this case, some sports subgroups, men, African-American black athletes, as well as basketball players, seem to have a higher risk. (Harmon, 2014). The nal answer to the question why athletes who were healthy at the previous examinations are dying, is not easy, because the fact that in 25% of cases the autopsy is negative, so-called autopsy negative sudden unexplained death (AN-SUD) (Harmon, 2015).

Sports Cardiology Association of Serbia dedicated a great attention to the problem of sudden cardiac death in sport, by issuing books Sudden cardiac death in Sport (2005), and European Recommendations for Participation in Recreational and Competitive Sport (2007), Sports Cardiology - Clinical Cases (2010) and Stress Test (2014). At the same time, it was aimed at setting and applying all standards of examination with the aim of making a more comprehensive examination of athletes and discovering the condition or disease that could lead to sudden cardiac death.

Within the round table Prof. Dr Ivana Nedeljković will make a review of the papers that deal with the problem of sudden cardiac death in sport, while Dr. Ivan Nikolić will present standard methods and new diagnostic methods for diagnosing the causes of sudden cardiac death. Finally, dr Marija Zdravkovic will speak about the cadiomagnetic resonance, state of the art method for ddiagnosing condition and diseases who could lead to SCD.

7. IZNENADNA SRČANA SMRT U SPORTU: RIZIK KOJI SE MORA PREPOZNATI Ivana Nedeljković1, Nenad Dikić2, Marija Andjelković2, Ta-mara Stojmenović2,Vojislav Giga1 ,, Marija Zdravković3, Ivan Nikolić2, Tatjana Malić2, Marija Ristić1

1Medicinski fakultet Univerziteta u Beogradu, Klinika za kadriolo-giju, KCS, 2 Ordinacija sportske medicine “Vita maxima”, Beograd, 3Klinika za kardiologiju, KBC B Kosa

Blagotvoran efekat sportna na zdravlje je dobro poznat. Međutim, kod osoba sa sr-čanim smetnjama koje se bave sportom, i učestvuju na takmičenjima može doći do doživjeti iznenadne srčane smrti (SCD). Zbog svog značaja SCD je tema brojnih rasprava posebno kada su u pitanju mere prevencije, i primena dijagnostičkih meto-da što predstavlja i trošak za klubove.

Veliki problem predstavlja procena popu-lacije sportista koji su “u riziku” od SCD. De- nicije SCD kod sportista su različite; neke procene uključuju samo smrt tokom trenin-ga ili ubrzo (<1 sat) nakon napora, dok drugi uključuju bilo koju SCD kod sportista (to-kom ili van treninga), a takođe i epizode rea-nimacije iznenadnog srčanog zastoja (SCA).

Najčešći uzroci SCD kod sportista su dobro de nisani. Kod sportista ispod 35 godina

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starosti, preovlađuju nasleđena srčana oboljenja, sa hipertro čnom kardiomio-patijom (HCM) i anomalijama koronarnih arterija koji su dva najčešća uzročnika. Kod sportista starijih od 35 godina, većina SCD događaja je posledica stečene ateroskle-rotske bolesti koronarnih arterija (CAD). Mnoge od ovih dijagnoza možda nisu kli-nički praćene simptomima i SCD može biti prva manifestacija. Procena broja sporti-sta sa prodromalnim simptomima je teška. Međutim, za oko 30% sportista sa SCD-om ipak je imalo simptome kao što su bol u grudima, dispnea, smanjenje tolerancije napora, palpitacije, pre-sinkope ili sinko-pe. Evaluacija takvih simptoma od strane kvali kovanog tima sportske medicine i kardiologa je važan aspekt medicinske za-štite sportista i prevencije SCD.

Mnoga srčana oboljenja koja su uzrok SCD kod sportista možda ne daju jasne upozora-vajuće simptome, i zbog toga postoji nesla-ganje o ulozi testiranja sportista i procene pre početka bavljenja sportom sa svrhom otkrivanja okultne kardiovaskularne bolesti.

Ispitivanje uključuje detaljnu ličnu, poro-dičnu i socijalnu anamnezu, uvid u medi-cinsku dokumentaciju, zikalni pregled, na raspolaganju su: elektrokardiogram (EKG), rentgen (RTG) i ultrazvuk srca (EHO) sa Doppler ehokardiogra jom i proce-nom pritiska u plućnoj arteriji, magnetna rezonancu (MRI) . Preporučuju se upitnici za procenu simptoma kao i test zičkim opterećenjem (TFO) ili TFO sa analizom gasova u izdahnutom vazduhu - ergospi-rometrija (CPX) za procenu funkcionalnog kapaciteta. Koriste se različiti protokoli uz EKG praćenje, procenu maksimalne srča-ne frekvencije (HR), krivnog pritiska (BP) i maksimalne potrošnje kiseonika (VO-2max). Takodje se TFO može kombinovati i sa vizualizacionim metodama kao što je EHO ili nuklearne metode (SPECT).

Kao što je već prikazano, incidenca i uzroci SCD-a variraju u velikoj mjeri u zavisnosti od starosti, pola, rase, zemlje i sporta atlet-ske grupe. Zbog toga je malo verovatno da će svaki program za skrining biti e ka-san u svim grupama, treba ga individuali-zovati, ali mora biti deo rutinskog pregle-da sportista. Tačnije preporuke moraju biti standardizovane, lekari ih moraju pozna-vati i primenjivati.

To su upravo osnovni ciljevi medicine spor-ta i sportske kardiologije u našoj zemlji.

SUDDEN CARDIAC DEATH IN ATHLETES: RISK TO BE RECOGNIZEDIvana Nedeljkovic1, Nenad Dikic2, Marija Andjelkovic2, Tamara Stojmenovic2, Vojislav Giga1, Marija Zdravković3, Ivan Nikolić2, Tatjana Malić2, Marija Ristić1

1 School of Medicine, University of Belgrade, Cardiology Clinic, KCS2 Sports medicine medicine “Vita maxima”, Belgrade3 University Hospital Medical Center Bezanijska kosa

Patients with cardiac conditions who engage in exercise and athletic competition may on rare occasion experience sudden cardiac death (SCD). There is ongoing debate about the optimal mechanism for SCD prevention, speci cally regarding the inclusion of the ECG and/or cardiac imaging in routine preparticipation sports evaluation.

Therefore, when estimating SCD incidence, the population of athletes “at risk” may be di�cult to quantify. The de nition of SCD in athletes also varies; some estimates of incidence include only deaths with exertion or shortly (< 1 hour) after exertion, while others include any SCD in an athlete (exertional or outside of exertion) and also episodes of resuscitated sudden cardiac arrest (SCA).


The most common causes of SCD in athletes are well de ned. In athletes under 35 years of age, inherited cardiac conditions predominate, with hypertrophic cardiomyopathy (HCM) and anomalous origin of a coronary artery being the two most common causes. In athletes older than 35, most SCD events are due to acquired atherosclerotic coronary artery disease (CAD). Many of these diagnoses may not be clinically apparent and may rst present with sudden death. Estimates of the proportion of athletes with prodromal symptoms is di�cult. However, upwards of approximately 30% of athletes with SCD have been reported to have had symptoms such as chest pain, shortness of breath, performance decline, palpitations, pre-syncope, or syncope leading up to the event. Evaluation of such exertional symptoms by a quali ed team of sports medicine and cardiology physicians is an important aspect of the medical care of athletes and of SCD prevention.

Many of the cardiac conditions that cause SCD in athletes may not present with warning symptoms, and there has been considerable discussion about the role of preparticipation screening tests to evaluate for occult cardiovascular disease.

Examination includes detailed personal, family and social history, insight into medical documentation, physical examination, electrocardiogram (EKG), X-ray (RTG), and echocardiography (EHO) with Doppler echocardiography and assessment of pressure in the pulmonary artery, magnetic resonance (MRI). The questionnaires for the assessment of symptoms as well as the exarcise ECG test or cardiopulmonary exercise test - ergospirometry (CPX) for assessing functional capacity are recommended.

Di�erent protocols are used with ECG monitoring, maximum heart rate (HR), curve pressure (BP), and maximal oxygen consumption (VO2max). Exercise test can also be combined with visualization techniques such as EHO or nuclear medicine (SPECT, PET).

The value of any screening test is determined by the characteristics of the population to which it is applied. As demonstrated above, the incidence and causes of SCD vary widely depending on the age, gender, race, country, and sport of the athlete group. Therefore, it is unlikely that any single screening program will be e�ective across all groups, it should be individualized but it must be a part of routine examination of athletes.

These are the main goals of the sport medicine and sports cardiology in our country.

8. PROZOR U IZNENADNU SRČANU SMRT - KARDIOMAGNETNA REZONANCAMarija Zdravković1, Maja Popović1, Ivana Nedeljković2, Ne-nad Dikic3, Milica Vesic4, Vladimir Jakovljevic5

1 Medicinski fakultet u Beograddu, KBC Bežanijska Kosa, 2 Medi-cinski fakultet Univerziteta u Beogradu, Klinika za kadriologiju, KCS, 3Ordinacija sportske medicine “Vita maxima”, Beograd, 4Antidoping agencija Srbije, 5Medicinski fakultet u Kragujevcu, Institut za �ziologiju

Kardiomagnetna rezonanca (CMR) je ne-invazivna metoda koja predstavlja zlatni standard anaatomske i funkcionalne eva-luacije srčanog mišića kao i velikih krvnih sudova. Indikovana je kod sportista kod ko-jih postoji nedijagnostikovano patološko stanje radi dijagnostke, ali i kod onih kod kojih je poznata kardiološka dijagnoza, u cilju strati kacije rizika od naprasne srčane smrti (NSS) i pravovremenog lečenja.

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CMR pregled predstavlja niz de nisanih frekvenci sa T1 i T2 procenom miokarda. Pojednostavljeno rečeno T1 sekvence se koriste za procenu distribucije masti, a T2 sekvence za procenu edema miokarda.

Primenom gadolinijuma dobijaju se nove informacije u smislu segmenata miokar-da koji su oštećeni po tipu „svetlo je loše“, jer upravo delovi miokarda gde je došlo parcijalne ili transmuralne miokardne ne-kroze – smrti miokardnih ćelija i njihove zamene broznim, manje plemenitim tki-vom, nakupljaju gadolinijum, te se bolje prebojavaju na sekvencama, odnosno do-bijaju se tzv. belje slike.

CMR tehnike tipa T1 mapinga sa modi -kovanim Look-Locker inverzionim opo-ravkom (MOLLI) sekvecama se koriste za procenu izračunavanja ekstracelularnog volumena (ECV), parametra koji predstavlja vrlo jak prognostički faktor za procenu br-roznih promena u samom srčanom mišiću.

CMR je zlatni standard za dijagnostiku hi-pertro čne kardimiopatije, aritmogene displazije desne komore kao i subendo-kardnih ishemija i mioperikarditisa. Način i raspodela gadolinijuma u sekvencama koje predstavljaju LGE fenomen (late gadolini-jum enchecement) ukazuju sa velikom ve-rovatnoćom na sam patološki supstrat na srčanom mišiču, odnosno pratećim struktu-rama, perikardu i velikim krvnim sudovima. Raspodela gadolinijuma prati pato ziolo-ške procese, te sa velikom verovatnoćom ukazuje na uzročno-posledični odnos obo-ljenja i oštećenja srčaanog mišića.

Smatra se da CMR može sa velikom sigur-nošću da da odgovore na sva pitanja koja se odnose na moguće uzroke naprasne srčane smrti, odnosno da daje dodatne podatke kod sportista na osnovu kojih je moguće postaviti diagnozu i izvršiti strati- kaciju rizika.

THE NEW INSIGHT IN THE SUDDEN CARDIAC DEATH – CARDIOMAGNETIC RESONANCEMarija Zdravkovic1, Maja Popovic1, Ivana Nedeljkovic2, Nenad Dikic3, Milica Vesic4, Vladimir Jakovljevic51 Faculty of Medicine, University of Belgrade, CHC Bezanijska kosa2 Faculty of Medicine, University of Belgrade, Clinical Center Serbia3 Sport medicine ordination “Vita maxima”, Beograd4 Serbian Antidoping Agency5 Faculty of Medicine, University of Kragujevac, Institute for Physiology

Cardiomagnetic resonance (CMR) is noninvasive diagnostic tool, considered to be the golden standard for the anatomical and functional evaluation of the heart muscle and great vessels. In athletes with undiagnosed patological changes in heart as well as in those with known heart disease CMR is indicated to be performed, in risk strati cation of the sudden cardiac death (SCD) and proper timing of the treatment.

CMR eamination is de ned through the serial well de ned sequances with T1 and T2 myocardial evaluation. Usually it can be calculated that T1 sequances are used for the evaluation of the fat distribution and T2 sequances for the evaluation of the myocardial oedema.

Gadolinuim use is very important, identifying myocardial segments with myocardial lesion following the rule „bright is bad“. In fact, myocardial segments with partial or transmural myocardial necrosis are the parts with death of the myocardial cells and consequent replacement of the brotic, less valuable tissue. These segments are the part of the myocardium that can easily accumulate gadolinium, hance with the consequent brighter images.

CMR techniques with T1 mapping and modi ed Look-Locker inversive recovery (MOLLI) sequences are widely used for the extracelular volume calculation (ECV).


This parameter has very strong prognostic impact on development of the brous changes in heart muscle.

CMR is the golden standard for the diagnosis of the hypertrophic cardiomyopathy (HCM), arrhythmogenic right ventricle dysplasia (ARVD) as well as myopericarditis and subendocardial ischemia. Gadolinium localization is closely related to the pathophyiology of disease and can easily leed to the diagnosis. Late gadolinium enchancement LGE phenomena (late gadolinijum enchancement) can easily give right answers about underlying heart disease.

CMR is a powerfool diagnostic tool in athlete`s heart assessment, revealing underlying causes of the sudden cardiac death.

9. ISTRAŽIVANJE POTENCIJALNIH NOVIH NEINVAZIVNIH SKRINING METODA PRI PREDTAKMIČARSKOM SPORTSKO-MEDICINSKOM PREGLEDUIvan Nikolić1, Tamara Stojmenović1, Tatjana Malić1, Ivana Nedeljković2, Nenad Dikić3, Marija Andjelković3

1 Ordinacija sportske medicine “Vita maxima”, Beograd, 2 Udruže-nje za medicinu Sporta Srbije3 Medicinski fakultet Univerziteta u Beogradu, Klinika za kardiologiju, KCS

Predtakmičarski skrining pregled sportista je predmet debate, posebno u svetlu tro-škova i cost/bene t odnosa. U evropskim zemljama pregled obuhvata obaveznu dvanaestokanalnu elektrokardiogra ju, za šta postoje dokazi da je jeftina meto-da koja doprinosi otkrivanju čestih stanja koja prethode iznenadnoj srčanoj smrti, ali smanjuju i troškove upućivanja pacije-nata na naknadne analize. Pravac daljih is-traživanja je da li se klasičnoj elektrokardi-ogra ji može pridodati sličan metod, koji može poboljšati senzitivnost i speci čnost pregleda. Jedan od njih je ispitivanje vari-jabiliteta QT intervala.

QT interval predstavlja vreme repolarizacije komora i zavisi od pola, rase, srčane frekven-ce i stanja zičke utreniranosti. Dokazano je da je QT interval kod sporista duži nego u opštoj populaciji. Poremećaj u trajanju može nastati kod hereditarnih kanalopa-tija (long QT ili short QT sindrom), jonskog disbalansa kao posledica dehidracije ili vo-mitusa ili akutnog dejstva pojedinih lekova, suplemenata ili doping supstanci. Klasič-nom elektrokardiogra jom meri se dužina trajanja QT/QTc intervala u II ili V5 odvodu.

Varijabilitet QT intervala procenjuje vari-jabilnost i trajanje QT intervala tokom 30 konsekutivnih QRS kompleksa bez inter-poniranih komorskih ili pretkomorskih ek-strasistola. Time se indirektno procenjuje stanje repolarizacione rezerve. Koncept repolarizacione rezerve se koristi u drugoj fazi kliničkog ispitivanja lekova u sklopu procene rizika proaritmogenog dejstva.

Eksperimentalni modeli na pacovima i zečevima su pokazali aritmogeno dejstvo pojedinih lekova u stanjima kod kojih je postojala hipertro ja miokarda i povećan varijabilitet QT intervala. Studije pokazuju povećan varijabilitet QT interala u huma-nim subjektima kod kojih postoji hipertro- ja miokarda (hipertro čna kardiomiopa-tija, tumori hipotalamusa, sportsko srce). Potrebno je utvrditi značaj ove metode kao potencijalnog novog skrining metoda i de nisati cut-o� vrednosti.

NEW POTENTIONAL NON-INVASIVE SCREENING METHODS IN ADDITION TO PRE-PARTICIPATION SCREENING EXAMIvan Nikolić1, Tamara Stojmenović1, Tatjana Malić1, Ivana Nedeljković2, Nenad Dikić3, Marija Andjelković3

1 Sports medicine clinic “Vita maxima”, Belgrade, 2 Sports-medical Association of Serbia, 3 Belgrade School of medicine, Cardiology clinic, KCS

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Preparticipation screening exam (PPE) is being debated about considering nancial and cost/ene t analysis. PPE in Europe consists of 12-lead EKG, which is proved to be a cheap and e�ective method for detecting frequent morbidities that precede sudden cardiac death and also lower the cost of additional diagnostic exams. Further studies are being made whether a new metohod simmilar to the EKG could be added that could enhance sensitivity and speci ty. One of them is short-term QT variability.

QT interval represents time needed for chamber repolarisation and it’s dependent on gender, race, heart rate and physical tness. It is shown that QT interval is prolonged in athletes compared to general population. Duration disturbances can occur due to hereditary canallopaties (long QT or short QT syndrome), ions imballance due to dehydration or vomitus and/or action of medicaments, supplements or doping substances. QT interval is measured in 12-lead EKG using QT/QTc duration in II or lead V5.

QT variability asseses duration and variability in 30 consecutive QRS complexes without interploated ventricular or supraventricular premature beats. Repolarisation reserve is being indirectly assesed. The concept of repolarisation reserve is used in second stage of drug clinical research in assesment of proarrhytmogenic risk of drugs.

Rat and rabbit experimental models that had myocardial hypertrophy were shown to have prolonged QT variability along with proarrhytmogenic action of some medicaments. Studies show prolonged QT variability in human subjects that have myocardial hypertrophy (HCM, hypophisis tumours, athlete heart). Further studies are needed to determine cut-o� values

and potential signi cance of short-term variability as a new screening method.

10. PRAVA SPORTISTA POSMATRANA KROZ RAD ANTDOPING AGENCIJE REPUBLIKE SRBIJE U POSLEDNJIH 12 GODINA – okrugli stoVukašinović Vesić M., Vajagić B., Anđelković M., Cvjetičanin M., Jakovljević B., Stefanović M., Đurđević N., Mileusnić V., Dikić N.Antidoping agencija Republike Srbije

UVOD – Prava sportista u vezi borbe protiv dopinga u sportu mogu se posmatrati kao deo jedinstvenog korpusa ljudskih prava. Još je Elenor Ruzvelt rekla: “Gde, posle sve-ga, zapravo počinju univerzalna ljudska prava? U malim mestima, blizu kuće – to-liko blizu i toliko malim da se ne mogu vi-deti ni na jednoj mapi sveta”. Univerzalna ljudska prava su garancija jednakosti svih ljudi i predstavljaju poslednju odbranu slobode čoveka. Upravo zbog toga što prava sportista u vezi borbe protiv dopin-ga u sportu možemo posmatrati kao deo univerzalnih ljudskih prava, možemo sa pravom reći da nijedna država prisiljava-njem sportista na doping, kao i nijedna dr-žava ili sportska organizacija nametanjem kolektivne krivice sportistima ne može i ne sme da ugrožava prava sportista.

U tom smislu problem koji se pojavio pre nekoliko godina a u vezi sa doping skanda-lom u Rusiji (2010. uočene nepravilnosti – 2015. suspenzija RUSADA, atletskog saveza Rusije i konačno olimpijskog i paralimpij-skog tima – 2018. još uvek bez konačnog ishoda) doveo je do postavljanja pitanja ne samo o dopingu ruskih sportista nego i o slabostima i poverenju sportista u ceo si-stem borbe protiv doping u svetu.

Svetska antidoping agencija smatra da sportista zauzima centralno mesto i da je on taj koji u sistemu borbe protiv dopin-


ga u sportu treba da podstiče druge na fer plej i čist sport.

Takođe, Svetska antidoping agencija radi na tome da sportisti u celom svetu pored toga što sistem od njih zahteva veliki broj obaveza imaju i pravo na isti način testira-nja u celom svetu, pravo na zaštitu čistog sportiste bez obzira na njegovu nacional-nost, vrstu sporta kojim se bavi i zemlje odakle dolazi.

Antidoping agencija Republike Srbije je u prethodnih 12 godina rada na svaki na-čin pokušala da sportistima pomogne pri ostvarivanju njihovih prava i zaštiti pre sve-ga čistog sportiste. U tom smislu obezbe-dili smo: transparentnu proceduru doping kontrole, mogućnost apliciranja za Izuzeće za terapeutsku upotrebu (TUE), formirali Registrovanu test grupu (RTG), omogućili transparentan i pravičan proces kažnjava-nja dopingovanih sportista, razvili različite načine edukacije svih sportista, sportskih radnika i lekara, razvili smo platforme mi-šljenje o leku i mišljenje o suplementu itd.

METODE – U ovoj studiji preseka analizirali smo zvaničnu bazu podataka Antidoping agencije Republike Srbije za poslednjih 12 godina.

REZULTATI – U periodu od 12 godina testi-rano je 7821 sportista od tog broja bilo je 67 doping pozitivnih slučajeva u 29 razli-čitih sportova. U istom periodu utvrđeno 12 doping pozitivnih slučajeva od strane međunarodnih sportski federacija, pored toga utvrđene su i 4 druge povrede anti-doping pravila što nas dovodi do ukupne cifre od 83 povrede antidoping pravila. Analizirajući doping pozitivne slučajeve došlo se do zaključka da su doping po-zitivni sportisti koristili 92 različite sup-stance koje se nalaze na listi zabranjenih supstanci iz grupa anaboličkih agenasa, stimulansa, kanabinoida, diuretika, hor-mona i metabiličkih modulatora, beta 2 agonista i beta blokatora. Najveći broj doping pozitivnih slučajeva je zabeležen u 2010. godini, da bi ponovo zabeležili po-rast povrede doping pravila 2017. godine.

Tabela 1. Broj povreda antidoping pravila u Srbiji u periodu od 2006. do 2017. godine

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DISKUSIJA – Postignut uspeh u smanje-nju povrede antdoping pravila od 2010. do 2016. godine narušen je 2017. godine, kada su naši sportisti imali 10 povreda an-tidoping pravila u zemlji i 3 povrede anti-doping pravila na inostranim takmičenji-ma. Tri povrede su nastale nakon grešaka lekara koji prate sportiste propisivanjem zabranjenih supstanci. Istovremeno je uo-čeno da se učešće zabranjenih supstanci promenilo, tako da je zabeleženo više sti-mulansa nego prethodnih godina, a ma-nje anaboličkih steroida, što ne prati svet-sku antidoping statistiku. Uočeni trendovi zahtevaju analizu, kao i ostala otvorena pitanja: Da li svi sportisti imaju ista prava na čist i fer sport, jednake mogućnosti, jednake procedure za ravnopravno i fer testiranje, pravo na odgovornost, pravo na zaštitu zdravlja, pravo na sport bez korup-cije, pravo na slobodan pristup informaci-jama, pravo na slobodu izražavanja, pravo na obrazovanje, pravo na jednako učešće u sportskim događajima.

Odgovore na ova pitanja pokušaćemo da dobijemo od naših najboljih sportista, ro-ditelja sportista, ali i predstavnika struke, tokom okruglog stola koji će organizovati Antidoping agencija Republike Srbije.

ZAKLJUČAK – Zaključci će biti de nisani nakon okruglog stola i predstavljaće deo zaključaka kongresa koji će predstavljati platformu koju bi trebalo svi stručnjaci u sportu da razumeju sa ciljem unapređenja uslova i načina na koji naši sportisti rade.

ATHLETES RIGHTS SURVEYED THROUGH WORK OF ANTIDOPING AGENCY OF THE REPUBLIC OF SERBIA IN THE LAST 12 YEARS - round tableVukašinović Vesić M., Vajagić B., Anđelković M., Cvjetičanin M., Jakovljević B., Stefanović M., Đurđević N., Mileusnić V., Dikić N.Anti-doping Agency of Serbia

INTRODUCTION – The athletes right related to ght against doping in sports can be seen as part of a entire corpus of human rights. Eleanor Roosevelt once said: “Where, after all, are the universal human rights started? In small places, near the house - so close and so small that you can not see it on any map of the world”. Universal human rights guarantee the equality of all people and represent the last defense of human freedom. Just because the rights of athletes in the ght against doping in sport can be seen as part of universal human rights, we can rightly say that no state can forced athletes to doping, as well as any state or sports organization by imposing collective guilt on athletes can not endangers the rights of athletes.

In that sense, the problem that happened several years ago in connection with the doping scandal in Russia (2010 detected irregularities - the 2015 suspension of RUSSIA, the Athletic Federation of Russia and the nal Olympic and Paralympic team - 2018 is still without a nal outcome) led to the placement of questions not only about the doping of Russian athletes, but also about the weaknesses and con dence of athletes in the whole anti-doping system in the world.

The World Anti-Doping Agency considers that the athlete takes a central place and that athlete is the one who, in the system of ght against doping in sports, should encourage others for fair play and clean sport.

Also, the World Anti-Doping Agency is working to ensure that athletes around the globe, in addition of that a system requiring a large number of obligations, have right to be tested all over the world


on the same way, the right to protect a clean athlete regardless of his nationality, the kind of sport and the country they are coming from.

Anti-Doping Agency of Serbia in last 12 years of its existence tried in any possible way to assist athletes in execution of their rights and protection of clean athlete. In that sense we assured: transparent doping control procedure, possibility for application of Therapeutic Use Exemption (TUE), forming of Registered Test Group (RTG), enable transparent and fair process of sanctioning for doping positive athletes, di�erent ways of educating all athletes, sports workers and doctors, we developed some platforms - opinion on medicine and opinion on supplements, etc.

METHODS – In this cross-section study, we analyzed the o�cial database of the Anti-Doping Agency of the Republic of Serbia for the past 12 years.

RESULTS – In the period of 12 years, 7821 athletes were tested, 67 of them were doping positive in 29 di�erent sports. In the same period, 12 doping positive cases were identi ed by international sports federations, and, beside that, 4 other anti-doping rules violation were found that lead us to an overall gure of 83 anti-doping rules violations. Analyzing doping positive cases, it was concluded that doping positive athletes used 92 di�erent substances from the list of prohibited substances from groups of anabolic agents, stimulants, cannabinoids, diuretics, hormones and metabolic modulators, beta 2 agonists and beta blockers. The largest number of doping positive cases was reported in 2010, with a repeated increase in the doping rule violation in 2017.

DISCUSSION – The success achieved in reducing the violation of doping rules from 2010 to 2016 was damaged in 2017,

Table 1. The number of anti-doping rule violations in Serbia in the period from 2006 to 2017

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when our athletes had 10 violations of anti-doping rules in the country and 3 at competitions abroad. Three violations occurred after the mistakes of doctors who treated athletes by the use of prohibited substances. At the same time, total share of di�erent substances in total number of doping positive cases changed, so more stimulus was observed than in previous years, and less number of anabolic steroids, which is not in line with global anti-doping statistics. Trends we noticed require further analysis, as well as other open questions: Do all athletes have the same rights to clean and fair sport, equal opportunities, equal procedures for equal and fair testing, the right to responsibility, the right for protection of their health, the right to sport without corruption, the right to free access to information, the right to freedom of expression, the right to education, the right to equal participation in sporting events.

We will try to get answers on these questions from our top athletes, parents of athletes, as well as representatives of the profession, during the round table organized by the Anti-Doping Agency of the Republic of Serbia.

CONCLUSION – The conclusions will be de ned after the round table and will be part of the overall conclusions of the congress, which will represent a platform that all sports professionals should understand in order to improve the conditions and the way our athletes work.

11. NUTRITIVNI STATUS SRPSKIH SPORTISTAAnđelković M., Dikić N., Vukašinović Vesić M., Baralić I., Đorđević B., Blaženčić Mladenović V., Bekić J., Popović M., Jovanović Z.Centar za sportsku ishranu i suplementaciju (CIS); Udruženje za medicinu sporta Srbije

UVOD – Nutritivni status opisuje stanje organizma u zavisnosti od načina ishrane,

nivoa makro i mikronutrijenata i njihove sposobnosti da održe normalan metabo-lički integritet. Nutritivni status je pojam koji se koristi radi objašnjenja složenih na-vika, potreba i ciljeva koje sportisti imaju u pogledu ishrane i suplementacije. Nutri-tivni status sportiste određivan je u ovoj analizi pomoću 5 osnovnih parametra: antropometrijskih merenja, internističkog pregleda, krvnih i biohemijskih nalaza, analize dijetarnog unosa mirko i makroe-lemenata i energetske potrošnje sportista. Navedeni parametri otkrivaju greške koje sportisti prave i cilj je njihovo korigovanje do ostvarivanja energetskog balansa. Ne-pravilna ishrana sportista uzrokovana je nedovoljnom edukacijom, nerazvijenim kulinarskim veštinama, nansijskom ogra-ničenošću u izboru namirnica i nedostatku vremena za spremanje hrane. Kao posledi-ca toga sportisti imaju varijacije u telesnoj masi, monotonu ishranu bez svih grupa namirnica, preskakanje obroka sa velikim razmacima između i nedovoljan unos tečnosti. Navedeni problem postaju lako vidljivi kada se analizira energetski unos sportista i zastupljenost makro i mikronu-trijenata u ishrani. Opšta zdravstvena, ali i sportska sposobnost, vremenom postaju ugrožene zbog nepravilne ishrane.

METODOLOGIJA – Ovom studijom preseka obuhvaćeno je 115 sportista koji su u pret-hodnih 5 godina došli u Centar za sportsku ishranu i suplementaciju kako bi dobili indi-vidualni program ishrane i suplementacije. Svi sportisti su zadovoljili kriterijum da ima-ju minimum 10 sati treninga nedeljno i da imaju takmičarski nivo bavljenja sportom. Individualni program ishrane i suplementa-cije obuhvatio je sledeće metode kojima su prikupljeni podaci: pregled lekara sa odre-đivanjem telesne kompozicije bioimpe-dancom (Tanita vaga), intervju o navikama u ishrani i suplementaciji, uvid u krvne i bio-


hemijske analize krvi, vođenje trodnevnog dnevnika ishrane (merenje energetskog unosa), nošenje akcelerometra (COSMED) i vođenje dnevnika zičke aktivnosti (me-renje energetske potrošnje), analiza dnev-nika ishrane pomoću nutritivnog softvera CIS-a (baziranog na namirnicama našeg podneblja iz EuroFIR-a), davanje predloga dijete i programa suplementacije, detaljan razgovor sa sportistom prilikom predaje izveštaja radi edukacije i redovne kontrole.

REZULTATI – Od 115 sportista 64.3% su bili muškarci a 35.7% žene iz 27 različitih spor-tova od kojih su najzastupljeniji bili tenis (20.9%), plivanje (13%), košarka (11.3%), fudbal (10.4%), atletika (7.0%), vaterpolo (6.1%), odbojka (5.2%) i tekvondo (3.5%). Godine starosti bile su u rasponu od 12 godina – 35 godina dok je srednja vred-nost bila 18.8±4.6 godina. U tabeli ispod prikazani su antropometrijski podaci za analizirane sportiste.

Tabela br.1 – Antropometrijske karakteristike sportista merene bioimpedancom

Parametar Sportisti Sportistkinje

Telesna visina (cm) 182.5±10.9 170.9±8.1

Telesna masa (kg) 75.9±14.3 61.0±9.2

BMI (kg/m2) 22.6±2.9 20.8±2.1

BMR (kcal) 2063.2±297.4 1521.9±163.0

TBW (kg) 48.1±9.3 35.2±4.8

FFM (kg) 65.5±12.5 48.2±6.6

FM (kg) 10.6±4.9 13.1±4.5

FP (%) 13.7±5.7 20.6±5.6

* vrednosti izražene kao srednja vrednost±SD

* BMI-indeks telesne mase (body mass index); BMR – bazalni metabolizam; TBW – količina tečnosti u organizmu; FFM – bezmasno tkivo; FM – masno tkivo; FP% - procenat masti u organizmu

Tabela br.2 – Razlozi zbog kojih su sportisti tražili pomoć stručnjaka u Centru za sportsku ishranu i suplementaciju

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ZAKLJUČAK – Razlozi koji su srpske sportiste opredelili da potraže pomoć stručnjaka za is-hranu pokazuju da je najveći procenat njih želeo savet o pravilnoj ishrani i suplementaciji, dok se drugi po učestalosti oni koji su hteli da smanje ili povećaju telesnu masu. Ova činjenica ide u prilog tome da se svest o značaju ishrane

u sportu podigla na viši nivo. Parametri krvne slike koji direktno utiču na sportsku sposobno-sti kao što su eritrociti, hemoglobin, gvožđe i feritin pokazuju velike raspone, i to značajnije kod sportistkinja, što znači da postoji određen broj njih koji moraju da ih koriguju u cilju po-boljšanja performansi. Činjenica da je energet-

Tabela br.3 – Vrednosti krvne slike i biohemijskih parametara srpskih sportistaSportisti Sportistkinje

Eritrociti (x10*12/L) 5.0±0.3 4.5±0.2Leukociti (x 10*9/L) 5.9±1.4 6.4±2.3Hemoglobin (g/L) 147.9±9.7 133.7±8.2Hematokrit (L/L) 0.43±0.29 0.39±0.02Trombociti (x 10*9/L) 227.9±50.2 244.0±49.5Sedimentacija (mm/h ) 4.2±3.4 6.4±3.4Glukoza (mmol/L) 5.1±0.4 4.8±0.4Kreatinin (µmol/L) 82.5±17.6 73.3±12.4Urea (mmol/L) 5.7±1.4 5.2±1.9Bilirubin (µmol/L) 14.4±9.1 11.6±7.3LDH (U/L) 276.4±108.4 211.5±77.0Albumin (g/dl) 46.7±3.5 45.6±3.6Holesterol (mmol/L) 4.08±0.8 4.42±0.8HDL holesterol (mmol/L) 1.4±0.3 1.8±0.5LDL holesterol (mmol/L) 2.3±0.6 2.2±0.5Trigliceridi (mmol/L) 0.7±0.3 0.7±0.2AST (U/L) # 26.8±9.7 25.6±9.5ALT (U/L) # 23.4±14.7 21.6±14.6Gvožđe (μmol/L) 19.6±7.2 17.6±5.5Feritin (μg/L) # 74.8±52.8 45.1±20.2Kreatin kinaza (U/L) 286.6±188.7 147.8±74.5


Tabela br.4 – Energetska potrošnja, prosečan dnevni energetski unos i unos makronu-trijenata srpskih sportista

Jedinica Sportisti Sportistkinje

Energetski unos (EU) kcal / dan 2859.0±911.5 2034.2±555.1Energetska potrošnja (EP) kcal / dan 3123.8±505.0 2440.3±441.5

Ugljeni hidrati g/dan 316.6±111.7 231.2±77.2% EU 45.7±6.5 46.8±7.0

Masti g/dan 107.4±40.0 75.5±26.8% EU 35.1±4.9 34.4±6.4

Proteini g/dan 128.2±40.7 89.9±23.9% EU 19.0±3.7 18.7±3.6

Voda (g/dan) 2430.9±1512.3 1839.9±926.2



ska potrošnja kod oba pola veća od energet-skog unosa pokazuje da se sportisti ne nalaze u energetskom balansu već u de citu, pri čemu imaju nedovoljan unos ugljenih hidrata, a po-većan unos masti u odnosu na preporuke. Pro-sečan unos tečnosti govori u prilog tome da su sportisti nedovoljno hidrirani. Od značajnih mi-kronutrijenata sportisti u Srbiji pokazuju de cit u unosu gvožđa, joda, kalijuma, magnezijuma, selena, biotina, pantotenske kiseline i vitamina D, E, K. Putem hrane unose više od preporuče-nih vrednosti za kalcijum, bakar, folate, natri-jum, fosfor, niacin, ribo�avin, tiamin, kobalamin i vitamin C. Preporučen dnevni unos za mikro-elemente određen je za nesportsku populaciju pri čemu i dalje ostaje velika dilema koje vred-nosti treba da važe za zički aktivne osobe. Pro-centualna zastupljenost masti u energetskom unosu je veća od 30%, unos omega 6 m.k. je veći od preporučenih vrednosti, unos omega 3 m.k. je na donjoj granici, a o povećanom unosu mononezasićenih m.k. sportisti treba da pove-du računa. Iz svega navedenog proističu prak-tične preporuke za sportiste:

• Povećati unos ugljenih hidrata, • Unositi više tečnosti, • Smanjiti unos masti, i to pre svega za-

sićenih i • Voditi računa o balansiranom unosu

voća i povrća radi postizanja optimal-nog unosa vitamina i minerala.

Pošto sportisti često ne mogu da ispune ove preporuke, treba da koriste suple-mente uz savet stručnjaka. Pravilna suple-mentacija može da koriguje nedostatke u ishrani sportista i dodatno pomogne u poboljšanju sportskih sposobnosti.

Ključne reči: nutritivni status, sportista, energija, mikronutrijenti, makronutrijenti, preporučen dnevni unos

NUTRITIONAL STATUS OF SERBIAN ATHLETESAnđelković M., Dikić N., Vukašinović Vesić M., Baralić I., Đorđević B., Blaženčić Mladenović V., Bekić J., Popović M., Jovanović Z.

Center for Sports Nutrition and Supplementation (CIS); Sport medicine association of Serbia

INTRODUCTION – Nutritional status describes the condition of the organism that depends on the diet, level of macro and micronutrients and their ability to maintain normal metabolic integrity. Nutritional status is a term used to explain the complex habits, needs, and goals that athletes have in terms of nutrition and supplementation. The nutritional status of athletes was determined in this analysis using 5 basic parameters: anthropometric measurements, internistical examination, blood and biochemical analyses, analysis of dietary intake of micro and macroelements and energy expenditure of athletes. These parameters reveal mistakes that athletes make and the goal is to correct them to achieve an energy balance. The inadequate nutrition of athletes is caused by inadequate education, undeveloped culinary skills, nancial limitations in food choices and lack of time to prepare food. As a result, athletes have variations in body weight, monotonous food without all food groups, skipping meals and insu�cient �uid intake. This problem becomes easy to see when analyzing the energy intake of athletes and the view of macro and micronutrients in the diet. General health, as well as sports ability, become endangered due to irregular nutrition.

METHODOLOGY – This section study included 115 athletes who came to the Center for Sports Nutrition and Supplementation in the past 5 years to get an individual nutrition and supplementation program. All athletes have met the criteria to have minimum 10 hours of training per week and have a competitive level of sport. The individual nutrition and supplementation program included the following methods for collecting data: a physician’s examination of the body composition with bioimpedance (Tanita scale), an interview on eating habits and supplements intake, review of blood and biochemical analysis, a three-day diet diary (energy intake measurement ), wearing an

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accelerometer (COSMED) and keeping a log of physical activity (energy expenditure measurement), analyzing dietary diets using nutritional CIS software (based on the foods of serbian region from EuroFIR), report with diet and supplementation program, a detailed interview with an athlete when submitting reports for education and regular control.

Results: Out of 115 athletes, 64.3% were men and 35.7% were women from 27 di�erent sports, of which tennis was the most frequent (20.9%), then swimming (13%), basketball (11.3%), football (10.4%), athletics %), water polo (6.1%), volleyball (5.2%) and tekvondo (3.5%). Age ranged from 12 years to 35 years, while the mean value was 18.8 ± 4.6 years. The table below shows anthropometric data for athletes.

Table 1 - Anthropometric characteristics of athletes measured by bio impedance

Parameter Men athletes Female athletes

Body height (cm) 182.5±10.9 170.9±8.1

Body weight (kg) 75.9±14.3 61.0±9.2

BMI (kg/m2) 22.6±2.9 20.8±2.1

BMR (kcal) 2063.2±297.4 1521.9±163.0

TBW (kg) 48.1±9.3 35.2±4.8

FFM (kg) 65.5±12.5 48.2±6.6

FM (kg) 10.6±4.9 13.1±4.5

FP (%) 13.7±5.7 20.6±5.6

* values expressed as mean ± SD* BMI-body mass index; BMR - basal metabolic rate; TBW – total body water; FFM – fat free mass; FM – fat mass; FP% - body fat percentage

Table no.2 - Reasons why athletes ask help from experts in Center for Sports Nutrition and Supplementation


Table 3 - Values of blood and biochemical parameters of Serbian athletes

Men athletes Female athletes

Erythrocytes (x10 * 12/L) 5.0±0.3 4.5±0.2

Leukocytes (x 10 * 9/L) 5.9±1.4 6.4±2.3

Hemoglobin (g/L) 147.9±9.7 133.7±8.2

Hematocrit (L/L) 0.43±0.29 0.39±0.02

Platelets (x 10*9/L) 227.9±50.2 244.0±49.5

Sedimentation (mm/h ) 4.2±3.4 6.4±3.4

Glucose (mmol/L) 5.1±0.4 4.8±0.4

Creatinine (µmol/L) 82.5±17.6 73.3±12.4

Urea (mmol/L) 5.7±1.4 5.2±1.9

Bilirubin (µmol/L) 14.4±9.1 11.6±7.3

LDH (U/L) 276.4±108.4 211.5±77.0

Albumin (g/dl) 46.7±3.5 45.6±3.6

Cholesterol (mmol/L) 4.08±0.8 4.42±0.8

HDL (mmol/L) 1.4±0.3 1.8±0.5

LDL (mmol/L) 2.3±0.6 2.2±0.5

Triglycerides (mmol/L) 0.7±0.3 0.7±0.2

AST (U/L) # 26.8±9.7 25.6±9.5

ALT (U/L) # 23.4±14.7 21.6±14.6

Iron (μmol/L) 19.6±7.2 17.6±5.5

Ferritin(μg/L) # 74.8±52.8 45.1±20.2

Creatine kinase (U/L) 286.6±188.7 147.8±74.5

* values expressed as mean ± SD

Table no.4 – Average energy expenditure, energy and macronutrients intake of Serbian athletes

Unit Man athletes Female athletes

Energy intake (EI) kcal / day 2859.0±911.5 2034.2±555.1

Energy expenditure (EE) kcal / day 3123.8±505.0 2440.3±441.5

Carbohydrates g/dan 316.6±111.7 231.2±77.2

% EI 45.7±6.5 46.8±7.0

Fat g/dan 107.4±40.0 75.5±26.8

% EI 35.1±4.9 34.4±6.4

Proteins g/dan 128.2±40.7 89.9±23.9

% EI 19.0±3.7 18.7±3.6

Water (g/dan) 2430.9±1512.3 1839.9±926.2

* values expressed as mean ± SD

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CONCLUSION – The reasons that Serbian athletes have chosen to seek the help of food specialists show that the largest percentage of them wanted advice on proper nutrition and supplements, while others wanted to reduce or increase body weight. This statistics supports the fact that awareness of nutrition importance in sports has been raised to a higher level. Blood-image parameters that directly a�ect sports performance such as erythrocytes, hemoglobin, iron and ferritin show large ranges, and this is more important for female athletes, which means that there are a number of them who need to make correction to improve performance. The fact that energy expenditure in both sexes is higher than energy intake shows that athletes are not in the energy balance but in the de cit, with insu�cient carbohydrate intake, and increased fat intake compared to recommendations. An average �uid intake suggests that athletes are not su�ciently hydrated. Of the signi cant micronutrients, athletes in Serbia show a de cit in the intake of iron, iodine, potassium, magnesium, selenium, biotin, pantothenic acid and vitamins D, E, K. Through food they enter more than the recommended values for calcium, copper, folate, sodium, phosphorus, niacin, ribo�avin, thiamine, cobalamin, and vitamin C. The recommended daily intake for microelements was determined for the non-sport population, and there remains a great dilemma about which values should apply to physically active people. The percentage of fat content in the energy intake is greater than 30%, the omega 6 fatty acid is higher than the recommended values, omega 3 fatty acid is at the lower limit, and the intake of mono-unsaturated fatty acid is increased. The practical recommendations for athletes that arise from above are:

• Increase carbohydrate intake,• Drink more �uids,• Reduce fat intake, primarily saturated

fat and• Take into account the balanced input

of fruits and vegetables to achieve an optimum intake of vitamins and minerals.

Since athletes often can not meet these recommendations, they should use supplements with expert advice. Proper supplementation can correct de ciency in athletes’ diet and further help to improve sports skills.

Key words: nutritional status, athletes, energy, micronutrients, macronutrients, and recommended daily intake

12. PRAVA „SNAGA” ANTIOKSIDANASABaralić Ivana1Kliničko-bolnički centar Zvezdara, Beograd, Srbija2Udruženje za medicine sporta, Beograd, Srbija

Antioksidansi su supstance koje u malim količinama mogu prevenirati i odložiti oksidativne promene na važnim biomole-kulama. Primena antioksidanasa je i dalje veoma aktuelna tema u sportskoj ishrani i ziologiji vežbanja. Tokom poslednjih ne-koliko decenija antioksidansi su prvenst-veno ispitivani kao nutritivna strategija za prevenciju i smanjenje negativnog uticaja slobodnih radikala (reactive oxygen and nitrogen species – RONS) koji se generišu u toku i nakon intenzivne zičke aktiv-nosti. Suplementacija antioksidansima je postala uobičajena praksa kod sportista kao način da se smanji oksidativni stres, ubrza oporavak i u unaprede sportske per-formanse. Tema istaživanja koja su spro-vedena u poslednjih nekoliko godina bila su fokusirana na tohemikalije kao što su razni polifenoli (kvercetin, polifenoli soka


višnje) i karotenoidi (astaksantin). Ove supstance imaju već potvrđeno antioksi-dativno delovanje, ali pored toga pokazu-ju i druge povoljne ziološke efekte posre-dovane raznim mehanizmima delovanja, a mogu povoljno uticati na oporavak, sman-jenje oštećenja mišića, unapredjenje imu-niteta i poboljšanja performansi. Ipak, do sada, potrebe za mikronutrijentima I sup-stancama sa antioksidativnim delovanjem još uvek nisu precizno utvrđene.

Novija istraživanja ukazuju da RONS funk-cionišu i kao signalne molekule koje učestvuju u regulaciji mišićne aktivnosti i koje iniciraju adaptivni odgovor na ve-žbanje. Visoke doze antioksidanasa (u prvom redu vitamina C i E) mogu imati i negativni efekat, tako što interferiraju sa ključnim procesima adaptacije na trening, koje dovode do unapredjenja performan-si i poboljšanja zdravlja. Prepoznavanje da antioksidansi mogu da interaguju sa signalnim putevima važnim za adaptivni odgovor može doprineti prepoznavanju novih aspekata primene antioksidanasa kao i količine u kojima ih treba koristiti.

Adekvatan unos antioksidanasa je veoma važan za održavanje odgovarajućeg anti-oksidativnog statusa, a u većini situacija se može postići konzumiranjem optimalno izbalansirane i raznolike ishrane. Time se postiže optimalna bioraspoloživost i kom-binovana aktivnost tohemikalija i antiok-sidativnih supstanci iz hrane. Ipak, umere-na i vremenski ograničena suplementacija antioksidansima može biti neophodna u pojedinim okolnostima kao što su periodi intenzivnih treninga, zatim tokom akut-nog vežbanja visokog intenziteta koje tra-je nekoliko sati ili u periodima smanjenog energetskog unosa. Krajnji i najvažniji cilj je optimizovati ishranu i suplementaciju sportiste u skladu sa njegovim individual-nim potrebama.

REAL “POWER” OF ANTIOXIDANTSIvana Baralić1Zvezdara University Medical Center, Belgrade, Serbia, 2Sports Medicine Association of Serbia, Belgrade, Serbia

An antioxidant can be de ned as ‘a compound that in a relatively low concentration prevents or delays the oxidation of biomolecules’. Antioxidants in acute physical exercise and exercise training remain a hot topic in sport nutrition and exercise physiology. During the past few decades, antioxidants have received attention predominantly as nutritional strategy for preventing or minimizing detrimental e�ects of reactive oxygen and nitrogen species (RONS), which are generated during and after strenuous exercise. Antioxidant supplementation has become a common practice among athletes as a means to reduce oxidative stress, promote recovery and enhance performance.

Recent research has been focused on phytochemicals derived from food, such as various polyphenols (quercetin, polyphenols in cherry juice) and carotenoids (astaxanthin). These compounds are well recognized for their antioxidant properties, but their bene cial physiological e�ects, such as reduced muscle damage, enhanced recovery, immunomodulatory e�ect and improved sports performance, may be promoted by a multitude of mechanisms. However, until now, requirements of antioxidant micronutrients and antioxidant compounds for athletes training for and competing have not been determined su�ciently.

RONS are not only damaging agents, but also act as signaling molecules for regulating muscle function and for initiating adaptive responses to exercise.Evidence has been emerging that

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higher dosages of antioxidants (mainly vitamin C and E) may elicit detrimental e�ects by interfering with performance-enhancing and health-promoting training adaptations. The recognition that antioxidants could interact with the signaling pathways underlying the responses to exercise has contributed important novel aspects to the continued discussion on antioxidant requirements for athletes.

Adequate antioxidant intake during exercise training is very important in order to maintain an appropriate physiological antioxidant status, and can be achieved by consumption of a balanced and well-diversi ed diet. In that way the optimal bioavailability and combined action of multiple phytochemical and antioxidant compounds derived from fruits, vegetables, whole grains and nuts is achieved. Moderate and timely limited antioxidant supplementation may be warranted in speci c situations, for example, during periods of intensi ed training, during acute bouts of intense endurance exercise lasting several hours and in the early recovery period thereafter or during energy restriction/weight loss programmes. Nevertheless, the ultimate goal is certainly to optimize the nutrition and supplementation in accordance to individual need of each athlete.

13. UPOTREBA PROBIOTIKA U SPORTSKOJ POPULACIJIDanica Michaličková1, Nevena Ivanović2 1Katedra za farmakologiju, Prvi medicinski fakultet, Karlov univerzitet, Prag, Republika Češka, 2Katedra za bromatologiju, Farmaceutski fakultet, Univerzitet u Beogradu, Beograd, Republika Srbija

Umerena zička aktivnost (FA) ima pozitiv-ne zdravstvene efekte, u vidu prevencije i

smanjenja rizika od hroničnih nezaraznih bolesti, kao što su gojaznost, dijabetes, kardiovaskularna oboljenja. S druge stra-ne, intenzivna FA izaziva prolazne, ali i dugoročne posledice po različite kom-ponente imunskog sistema, što dalje ima negativne implikacije u domenu infekcija gornjeg respiratornog trakta, posebno tokom zimskog perioda. Pored toga, in-tenzivno treniranje uzrokuje povećano stvaranje slobodnih radikala, što usled narušavanja strukture i funkcije biomole-kula, vodi ka oštećenju mišića i smanjenju sportskih performansi. Redukovana perfu-zija splanhičnih organa i povišena telesna temperatura tokom intenzivne FA mogu da dovedu do povećanja intestinalne per-meabilnosti i posledično izazovu gastroi-netestinalnu nelagodnost.

Aktuelne kliničke studije sprovedene na vrhunskim sportistima ukazuju na spo-sobnost probiotskih sojeva da smanje učestalost, dužinu i težinu simptoma re-spiratornih infekcija. Pored toga, probi-otici smanjuju rizik od GI infekcija, što je posebno važno za sportiste prilikom puto-vanja u insostranstvo, neretko u područja gde je kvalitet hrane neadekvatan. Ovi bene ti se pripisuju interakciji probiotika sa imunitetom: suplementacija probioti-cima povećava nivo salivarnih IgA anti-tela (sIgA), tj. ojačava mukozni imunitet, povećava nivo proin�amatornih citokina, smanjuje nivo anti-an�amatornih citokina i ima bitnu ulogu u očuvanju humoralnog imuniteta. Određeni probiotski sojevi ima-ju sposobnost da ojačaju intestinalnu mu-koznu barijeru, tj. smanje intestinalnu per-meabilnost, posredstvom ojačanja tesnih veza između enterocita i na taj način spre-če ili umanje GI smetnje tokom treniranja.

Probiotici pokazuju i ergogene efekte, tj. mogu poboljšati zičke performanse. Do sada su, prema našim saznanjima, obja-


vljene 2 publikacije koje ukazuju na er-gogena svojstva probiotskih sojeva. Ipak, potrebno je više istraživanja u ovoj oblasti istraživanja, kako bi se potvrdili ovi rezul-tati. Konačno, određeni probiotski sojevi imaju sposobnost da smanje oskidativni stres i ojačaju antioksidativnu zaštita vr-hunskih sportista.

Probiotici obezbeđuju razne korisne zdravstvene efekte u sportskoj popula-ciji. Buduća istraživanja o imunskom de-lovanju probiotskih sojeva moraju da se baziraju na dobro dizajniranim placebo--kontrolisanim kliničkim studijama koje će obuhvatiti procenu kako klinički značajnih ishoda, tako i imunoloških parametara, jer se jedino na taj način mogu obezbediti kvalitetni dokazi o e kasnosti suplemen-tacije probioticima u sportu.

USE OF PROBIOTICS IN ATHLETESDanica Michaličková1, Nevena Ivanović2 1Institute of Pharmacology, First Faculty of Medicine, Charles University, Prague, Czech Republic, 2Department of Bromatology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia

Moderate physical activity (PA) exerts positive health e�ects, such as prevention and risk reduction of chronic diseases (obesity, diabetes and cardiovascular diseases). Intensive PA, however, causes transient and long-term perturbations of the immune system, resulting in increased incidence of upper respiratory illness (URTI) and gastro-intestinal (GI) infections. Strenuous training also causes increased production of free radicals, causing the destruction of important biomolecules and muscle damage. In addition, reduced splanchnic perfusion and elevated body core temperature during strenuous PA may result in compromised gut permeability and consequent GI discomfort in athletes.

The most commonly studied e�ect in athletes and active individuals is their in�uence on URTI. Emerging number of clinical studies have showed that probiotic supplementation reduces the incidence, duration and severity of URTI symptoms in elite athletes. In addition, another potential bene t of probiotics was reported – a reduced risk of GI infections, which are a particular concern when travelling abroad. These e�ects were ascribed to probiotic interaction with the gut-associated lymphoid tissues, leading to positive e�ects on the immunity: increase of salivary IgA (sIgA) antibodies, elevation of pro-in�ammatory cytokines, and preservation of humoral immunity. In addition, certain probiotic strains have the ability to strengthen the intestinal mucosal barrier by the tight junctions’ enhancement. Probiotics reduce exercise-induced GI permeability and its associated symptoms, such as nausea, stomach and intestinal cramps and diarrhea.

Probiotics can even exert ergogenic e�ects, i.e. they can enhance physical performance. To the best of our knowledge, there are two studies indicating that probiotic supplementation alone or in combination with casein reduces parameters of muscle damage, improves recovery and maintains physical performance subsequent to damaging exercise. However, more research in this area is needed to con rm these results. Finally, probiotics might enhance antioxidant protective mechanisms and decrease oxidative stress in elite athletes.

It appears that probiotics can provide clinical bene ts in athletes and other highly active individuals. Although this is a promising area of research, more well-designed clinical trials are warranted to con rm that taking probiotics can

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decrease the number of training days lost to illness and to establish the most e�ective probiotics since their e�ects are highly strain-speci c.

14. IMUNSKI SISTEM I PROBIOTICIRajna MinićInstitut za virusologiju, vakcine i serume, Torlak

Imunski sistem je odbrambeni sistem orga-nizma. Genetski je determinisan, nasleđen i posledica je miliona godina koevolucije sa spoljašnjom sredinom. Nije nezavisan od posledica interakcije sa spoljašnjom sredinom u smislu da podleže toksičnim delovanjima, kao i kalorijskom unosu. In-toksikacija, kao i nedovoljan kalorijski unos ili speci čan nedostatak nekog od nutrije-nata prvenstveno može dovesti do slablje-nja imunskog odgovora. Povećan kalorijski unos, gojaznost takođe ima uticaja i to kroz hiperaktivaciju. Negativan efekat na imun-ski sistem mogu imati i intenzivan zički napor kao i psihički stres.

Imunski sistem se uobičajeno deli na dve grane urođenu i adaptivnu. Urođeni imu-nitet se tako naziva zato što je predetermi-nisan, tj. postoji kao takav i pre kontakta sa patogenom. Receptori urođenog imu-niteta genetski su nepromenljivi u okviru jedinke u normalnim uslovima, mada i oni podležu regulaciji ekspresije. Ovi receptori prepoznaju uobičajene i zajedničke mole-kule na mikroorganizmima tako da pokri-vaju širok opseg, oni su neophodni i neka-da sasvim dovoljni za odbranu. Reakcija pri vezivanju za ove receptore prilično je brza i može biti vrlo intenzivna. Ćelije uro-đenog imuniteta makrofage, mastociti i dendritične ćelije nalaze se na mestima na kojima je povećana verovatnoća prodora stranog tela, dok su granulociti kratko-ži-veće, cirkulišuće ćelije koje se vrlo brzo

grupišu na mestu prodora. Kada se kaže adaptivni imunitet prvenstveno se misli na diferencirane limfocite, tj. B i T ćelije. Ove ćelije imaju promenljive receptore, pomoću kojih imunski sistem organizma uči i pamti pređašnje susrete. Obe grane imunskog sistema funkcionišu kao jedna nerazdvojna celina.

Mukozne površine su kritične u obdra-ni organizma, jer da bi ostvarivale svoju osnovnu funkciju razmene sa spoljašnjom sredinom nalaze se u polupropustljivom stanju, vlažne su i predstavljaju idealno mesto za prodor mikroorganizama.

Gastrointestinalni sistem predstavlja je-dan takav sistem za čiju odbranu je opre-deljeno puno resursa. Zapravo koevolucija sa mikrobima dovela je do toga da je orga-nizam potpuno pripremljen za tu interak-ciju i da mu je ona neophodna za normal-no funkcionisanje.

Laktobacilusi i druge probiotske kulture ulaze u sastav normalne gastrointestinal-ne, kao i vaginalne mikro�ore i poželjno ih je koristiti u određenim situacijama kada je ova mikro�ora narušena. Početni uslov za korišćenje bilo kog mikroorganizma za suplementaciju kod ljudi je da je huma-nog porekla i da se smatra bezbednim.

Iako se u poslednje vreme insistira na tome da se termin probiotik izostavi iz naziva ovakvih suplemenata, prvenstveno jer je previše uopšten i jer često izostaju pozitiv-ni efekti trend ide ka tome da se broj živih organizama po dozi poveća za 40-70 puta, kao i da se jasno ustanovi koje vrste i sojevi dovode do kakvih speci čnih efekata.

THE IMMUNE SYSTEM AND PROBIOTICSRajna MinićInstitute of Virology, Vaccines and Sera “Torlak”


The immune system is the body’s defense system. It is genetically determined, inherited1 and is the result of millions of years of coevolution with the environment. It is dependent on the interaction with the environment, especially to intoxication and caloric intake. Intoxication, as well as insu�cient calorie intake or speci c nutrient de ciency can primarily lead to weakening of the immune response. Increased caloric intake, obesity also has an impact through hyperactivation. Both physical and mental stress can have negative impact on the immune system.

The immune system is historically divided into innate and adaptive. Innate immunity is so called because it is pre-de ned, i.e. exists as such before contact with the pathogen. The innate immunity receptors do not undergo somatic recombination or hypermutation within an individual, although they are subjected to regulation of expression. These receptors recognize common molecules on microorganisms and cover a broad range. They are necessary and sometimes quite su�cient for defense. The binding reaction for these receptors is quite fast and can be very intense.

Cells of the innate immunity macrophages, mast cells and dendritic cells are strategically located at sites where the probability of penetration of microorganisms is increased, while granulocytes are short-lived, circulating cells that rapidly cluster at the penetration site.

Adaptive immunity is represented by lymphocytes, or B and T cells. These cells have variable receptors, by which the body’s immune system learns and remembers previous encounters. Both branches of the immune system function in unity2.

From the perspective of defense mucosal surfaces are critical, because in order to

achieve their basic function of exchange with the external environment they are in a semipermeable state, moist and hence an ideal place for the penetration of microorganisms.

The gastrointestinal system is one such system for which the defense system has allocated a lot of resources. In fact, coevolution with microbes has led to the conditioning of the organism such that this interaction is normal and necessary for optimal functioning.

Lactobacilli and other probiotic cultures can be part of the steady state gastrointestinal, as well as vaginal microbiota, and it is desirable to use them in certain situations when this microbiota is disturbed. The initial requirement for the use of any microorganism for supplementation in humans is that it is proven safe.

Recently much deliberation was made about the term probiotic and the conclusion was that it should be omitted from the name of certain supplements, primarily because it is too generalized, and because the health claims are often absent3. The general trend is that the number of living organisms per dose increases by more than 10 times in case of Lactobacillus supplements, and that it should be clearly established which species and strains lead to which speci c e�ects.

15. BILJNI LEKOVITI PROIZVODI U SUPLEMENTACIJI SPORTISTAZoran MaksimovićKatedra za farmakognoziju, Univerzitet u Beogradu - Farmace-utski fakultet

Mnogi sportisti, na svim takmičarskim nivoima, poklanjaju pažnju redovnoj upotrebi dijetetskih suplemenata očekujući povoljne efekte na njihove takmičarske performanse.

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Ovi efekti bi mogli da se ostvare direktno, putem speci čnog uticaja na takmičarski učinak, ili indirektno, pri oporavku, putem prevencije ili terapije oboljenja, poboljšanja adaptacije na intenzivni trening, podržavanja funkcije imunskog sistema, ili nadoknađivanja nedostataka neadekvatne ishrane.

Suplementi za primenu u sportu se de nišu i kategorišu na više načina, ali nijedna od ovih de nicija i podela nije zadovoljavajuća. Dijetetski suplement može da se opiše kao proizvod koji je namenjen dopuni ishrane, a koji sadrži jedan ili više vitamina, minerala, aminokiselina, biljnih preparata koncentrata, metabolita, konstituenasa, ekstrakata ili razne kombinacije svega navedenog. Generalno, u sportske suplemente spadaju sportska hrana, medicinski suplementi (hrana posebnih namena), ergogeni suplementi, funkcionalna i “super hrana”, kao i “ostalo” - što se obično odnosi na čitav spektar biljnih ekstrakata i koncentrata za sniženje ili povećanje telesne mase, povećanje energije i/ili libida, itd.

Čini se da biljni suplementi spadaju u svaku od navedenih kategorija, ali u isto vreme - ni u jednu od njih, jer sam po sebi termin “biljni suplement” nije jasan. Prema jednima, odnosi se na proizvode izvedene direktno iz biljaka (npr. ekstrakt zelenog čaja), dok drugi ovaj termin koriste kao sinonim za bilo koji proizvod koji sadrži molekule biljnog porekla (npr. izolovani kofein). U ovom prikazu, izraz “biljni suplement” se odnosi na biljne proizvode koji sadrže brojne biološki aktivne supstance, sa izuzetkom proizvoda koji se dobijaju od gljiva.

Mada rasprostranjenost korišćenja biljnih suplemenata kod sportista nije u potpunosti upoznata, čini se da sportisti koriste ove proizvode mnogo češće nego ostali. U celom svetu, proizvodnja biljnih suplemenata

čini industriju vrednu više milijardi dolara, sa dramatičnom godišnjom stopom rasta. Biljni proizvodi se agresivno reklamiraju kako takmičarima, tako i rekreativcima, iznošenjem tvrdnji o povećanju sportskih performansi i poboljšanju zičkog i mentalnog zdravlja. I pored postojanja ovako snažne industrijske grane, istraživanja efekata na humanu biologiju uglavnom ostaju bez zaključaka, a sportistima se ostavlja da svoje poverenje poklone proizvođačima ili drugim sportistima kada je potrebno doneti odluku o suplementaciji.

Ovaj pregledni rad prikazuje koristi i potencijalne rizike primene najpopularnijih biljnih proizvoda u sportu i pruža korisnicima informacije u vezi sa činjenicama iz domena zaštite pacijenata. Poseban fokus je stavljen na biljne preparate Panax ssp., Eleutherococcus senticosus, perikarpa ploda gorke narandže, Rhodiola rosea, Ginkgo biloba, Tribulus terrestris, kofeinskih droga, Capsicum ssp., Echinacea ssp., Hypericum perforatum, itd.

Mnogi biljni suplementi mogu da poboljšaju ljudsko zdravlje i atletske performanse, ali je korist od njihove primene često zamagljena spletom različitih faktora. To ukazuje na neophodnost interdisciplinarnog pristupa izučavanju njihovog delovanja, u nadi da bi se na taj način moglo doprineti razumevanju načina na koji biljni suplementi mogu da poboljšaju zdravlje sportista.

HERBAL MEDICINAL PRODUCTS IN SUPPLEMENTATION OF ATHLETESZoran MaksimovićDepartment of Pharmacognosy, University of Belgrade - Faculty of Pharmacy

Many athletes, at all levels of competition, pay a close attention on the regular use of


dietary supplements in hope of beneficial e�ects, which generally means positive e�ects on competitive performance. Such e�ects may be achieved directly, by a specific in�uence on performance in competition, or indirectly, by aiding in recovery, preventing or treating illness, enhancing the adaptation to training, supporting the immune system and compensating for inadequate diet.

Sports supplements have been defined and categorized in many ways, but none of these definitions and classifications seems to be satisfactory. A dietary supplement could be de ned as a product intended to augment the diet that contains one or more vitamins, minerals, amino acids or herbs, as well as concentrates, metabolites, constituents, extracts or their combination. In general, categories include sports foods, medical supplements, ergogenic supplements, functional food and superfoods, as well as other supplements - an array of herbal extracts and concentrates for weight loss or gain, increase of energy and/or libido etc.

Herbal supplements seem to t every category from above and, in the same time, none in particular, because the meaning of the term “herbal supplement” is unclear itself. Some use it to refer to products derived directly from plants (i.e. green tea extract), whereas others use it to mean any product containing molecules of botanical origin (i.e. isolated ca�eine). In this review, the term “herbal supplement” refers to plant-derived products containing multiple bioactive chemicals, with some exceptions for products of fungal origin.

Although the extent of herbal supplement use among athletes is still unclear, it

appears that they use herbal supplements more frequently than the general public. In the World, herbal supplements constitute a multibillion industry with dramatic annual increase rate. Herbal products are vigorously marketed to both competitive and recreational athletes with claims of performance gains and improved health and wellness. Despite this industry, research on the e�ects on human biology remains inconclusive, and athletes are often left to trust manufacturers or teammates when it comes to making choices on supplementation.

This review explores bene ts and potential risks associated with use of most popular herbs in sport and provides recommendations to consumers regarding patient care issues. Focus is placed on a number of herbs and their preparations, such as Panax ssp., Eleutherococcus senticosus, bitter orange peel, Rhodiola rosea, Ginkgo biloba, Tribulus terrestris, ca�eine-containing herbs and preparations, Capsicum ssp., Echinacea ssp., Hypericum perforatum, etc.

Many herbal supplements have the potential to improve both human health and athletic performance, but the potential bene ts are greatly in�uenced by a plethora of factors, necessitating an interdisciplinary approach to studies in hope that it will improve our understanding of how supplements work to aid human performance.

16. BOL U KOLENU – DIJAGNOSTIKA I LEČENJETamara Stojmenović1,2, Nenad Dikić2,3, Milica Vukašino-vić-Vesić2,3, Marija Anđelković2,3, Ivan Nikolić1,2

1Ordinacija sportske medicine „Vita Maxima“; 2Udruženje za medicinu sporta Srbije; 3Antidoping agencija Republike Srbije

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Uvod

Zglob kolena jedan je od najkompleksni-jih zglobova u ljudskom telu. Omoguća-va pokrete pregibanja, opružanja, kao i ograničene pokrete spoljašnje i unutrašn-je rotacije. Uzimajući u obzir kinetički lanac donjih ekstremiteta, zglob kolena pred-stavlja ključnu kariku koja obezbeđuje uspravan hod čoveka. Shodno tome, ovaj zglob izložen je velikom broju povreda i oštećenja koji dovode do pojave akutnog i/ili hroničnog bola, naročito kod sportista i dece koja se bave sportom. Adekvatna dijagnostika i lečenje od velikog su znača-ja za uspešno tretiranje ovih stanja.

Bolovi u kolenu u odnosu na anatom-sku regiju

Bol u prednjem delu kolena

Bol u prednjem delu kolena jedno je od najčešćih stanja koje se javlja kod profe-sionalnih sportista, rekreativaca, ali i kod dece u periodu rasta i razvoja. Uzevši u obzir anatomiju ove regije kolena pažnju treba obratiti na patelofemoralni zglob, patelarni ligament, burze u ovoj regiji, kao i Hofovo masno jastuče. Takođe, posebnu pažnju treba obratiti i na pojavu oseto-hondroza koje su karakteristične za decu koja se bave sportom (Tabela 1).

Tabela 1. Uzroci bola u prednjem delu kolena

SPORTISTI DECA

Patelofemoralni bolni sindrom Mb. Osgood Schlater

hofa sindrom Mb. Sinding-Larsen-Johansson

Tendinopatija patelarnog ligamenta Mb. Blount

tendinopatija m. quadriceps femoris-a Osteochondritis dissecans

burzitisi Osteosarkom

patelofemoralna nestabilnost

ruptura prednjeg ukrštenog ligamenta

akutni i hronični sinovitis

Tabela 2. Uzroci bola u medijalnom delu kolena

NAJČEŠĆI UZROCI OSTALI UZROCI

oštećenje medijalnog meniskusa Sindrom medijalne plike

povreda medijalnog kolateralnog ligamenta Pes anserinus burzitis/tendinopatija

ruptura prednjeg ukrštenog ligamenta Pellegrini-Stieda sindrom

akutni i hronični sinovitis Osteoartritis

Ruptura medijalnog patelofemoralnog ligamenta i/ili medijalnog retinakuluma čašice

Bol u medijalnom delu kolena

Medijalni meniskus i medijalni kolateralni ligament su strukture kolena koje se naj-

češće povređuju u ovoj anatomskoj regiji i samim tim su najčeći uzroci bola u predelu unutrašnjeg dela kolena. Ostali uzroci bola ove regije navedeni su u Tabeli 2.


Bol u lateralnom delu kolena

Bol u spoljašnjem delu kolena najčešće se javlja kao posledica povrede lateralnog meniskusa, zapaljenja iliotibijalne trake i

povrede lateralnog kolateralnog ligamen-ta. U obzir treba uzeti i moguću povredu peronealnog nerva, kao i oštećenje tetive m. biceps femoris-a (Tabela 3).

Tabela 3. Uzroci bola u lateralnom delu kolena


oštećenje lateralnog meniskusa Patelofemoralni sindrom

povreda lateralnog kolateralnog ligamenta Tendinopatija m.biceps femoris-a

sindrom iliotibijalne trake Kompresivna neuoropatija n.peroneus communis-a

Osteoartritis

Bol u zadnjem delu kolena

Bol u zadnjem delu kolena najčešće se javlja kao posledica efuzije nastale usled akutne povrede neke od ligamentarnih

struktura kolena. Efuzija može dovesti do razvoja tzv. Bekerove ciste koja, u zavisno-sti od veličine i lokacije, može davati ma-nje ili veće tegobe. Ostali uzročnici bola ove regije kolena prikazani su u Tabeli 4.

Tabela 4. Uzroci bola u zadnjem delu kolena


efuzija zgloba Tendinopatija m.popliteus-a

bekerova cista Tendinopatija m.gastrocnemius-a

tendinopatija m. biceps femoris-a Duboka venska tromboza

Ruptura zadnjeg ukrštenog ligamenta

Dijagnostika bola u kolenu

U cilju adekvatnog postavljanja dijagnoze neophodno je izvršiti detaljan klinički pre-gled sa prethodno uzetom anamnezom sa ciljem da se ustanovi tačan mehanizam povrede koji umnogome doprinosi posta-vljanju tačne dijagnoze. Kliničkim pregle-dom se dobija uvid u eventualno posto-janje i vrstu otoka (hemartroza ili efuzija), aktivnu i pasivnu pokretljivost, postojanje triger tačaka, stabilnost samog zgloba kolena, kao i snagu mišića povređenog ekstremitata. Ukoliko dijagnoza nije jasna nakon kliničkog pregleda, a na osnovu po-stavljene sumnje, mogu se raditi i dodatne dijagnostičke metode: rendgen, ultrazvuk, magnetna rezonanca i artroskopija.

Lečenje bola u kolenu

U zavisnosti od etiologije povrede, bol u kolenu može se lečiti konzervativnim pu-tem ili hirurški. U većini slučajeva, konzer-vativni vid lečenja, sa akcentom na funkci-onalnu rehabilitaciju (kineziterapiju), daje pozitivne rezultate u pogledu saniranja tegoba (Tabela 5). Ruptura prednjeg ukr-štenog ligamenta, kompleksne rupture meniskusa sa izraženom kliničkom slikom, izražena proliferacija sinovije, odgovaraju-ća oštećenja hrskavice, kao i hronična ne-stabilnost čašice najčešće zahtevaju ope-rativno lečenje.

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Zaključak

Bol u kolenu, kako akutne, tako i hronič-ne prirode, česta je pojava kod sportista i dece koja se bave zičkom aktivnošću. Svaka pojava bola podrazumeva kraći ili duži prekid trenažnog i takmičarskog pro-cesa i pad u sportskim performansama. Shodno tome, adekvatno postavljanje di-jagnoze i prepisivanje terapije od izuzet-nog je značaja za uspešno lečenje bola u kolenu i bezbedno vraćanje sportiste tre-nažnom procesu.

KNEE PAIN – DIAGNOSIS AND TREATMENTTamara Stojmenović1,2, Nenad Dikić2,3, Milica Vukašinović-Vesić2,3, Marija Anđelković2,3, Ivan Nikolić1,2

1Sports medicine clinic „Vita Maxima“; 2Sports medicine association of Serbia; 3Antidoping agency of Republic Serbia

Introduction

Knee joint is one of the most complex joints in human body. It permits �exion, extension and slight internal and external

rotation. Considering the kinetic chain of a lower leg, knee joint is the key link in the chain allowing upright walking. Consequently, this joint is exposed to frequent injuries and damages which all lead to acute and chronic pain, especially among athletes and physically active children. Adequate diagnosis and treatment is of great importance for the successful treatment of these conditions.

Knee pain in relation to the anatomical region

Anterior knee pain

Anterior knee pain is one of the most common conditions in athletes, recreational population, and children during growth and development. Considering the anatomy of this knee region it is important to pay attention to patellofemoral joint, patellar ligament, bursae, and Ho�a`s fat pad. Also, it is important not to miss di�erent types of osteochondrosis which are characteristic for physically active children (Table 1).

Tabela 5. Konzervativni oblici lečenja bola u kolenu. RICE (engl.): rest, ice, compression, elevation. TENS: transkutana električna nervna stimulacija.

metod vrsta povrede

rice Akutne povrede kolena sa pojavom hemartroze i efuzije u zglobnoj šupljini: rupture i istegnuća liga-menata, povrede meniskusa, sinovitis, burzitisi i sl.

zikalna terapija (elektro-, magneto-, lasero-, ultra-zvučna terapija, tens)

Tendinopatije, akutni i hronični sinovitis, parcijalne rupture medijalnog i lateralnog kolateralnog liga-menta, burzitisi, osteoartritis, sindrom iliotibijalne trake

in litracije/blokade Triger tačke, burzitisi, Bekerova cista, osteoartritis, tendinopatije, sindrom iliotibijalne trake

funkcionalna rehabilitacija (kineziterapija): obim po-kreta, snaga mišića, proprioceptivni trening, trening izdržljivosti

SVAKA POVREDA KOLENA I BOL U KOLENU


Table 1. Causes of anterior knee pain. ACL: anterior cruciate ligament

athletes children

patellofemoral syndrome Osgood Schlater disease

hofa`s syndrome Sinding-Larsen-Johansson disease

patellar tendinopathy Blount`s disease

quadriceps tendinopathy Osteochondritis dissecans

bursitis Osteosarcoma

patellofemoral instability

acl rupture

acute and chronic synovitis

Medial knee pain

Medial meniscus and medial collateral ligament are the most frequently injured

knee structures in this anatomical region. Injuries to these structures are the most common causes of medial knee pain. Other possible causes are listed in Table 2.

Table 2. Causes of medial knee pain

common causes other causes

medial meniscus injury Medial plica syndrome

medial collateral ligament injury Pes anserinus bursitis/tendinopathy

acl rupture Pellegrini-Stieda syndrome

acute and chronic synovitis Osteoarthritis

Medial patellofemoral ligament rupture or medial retinaculum rupture

Lateral knee pain

The most common causes of lateral knee pain are due to injury of lateral meniscus, iliotibial band friction syndrome and lateral

collateral ligament injury. Consideration should also be given to possible peroneal nerve injury, as well as damage to the tendon of biceps femoris muscle (Table 3).

Table 3. Causes of lateral knee pain

common causes other causes

lateral meniscus injury Patellofemoral syndrome

lateral collateral ligament injury Biceps femoris tendinopathy

iliotibial band friction syndrome Peroneal compression syndrome

Osteoarthritis

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Posterior knee pain

The most common cause of posterior knee pain is a joint e�usion occured as a result of an acute injury of knee ligamentary structures. E�usion can lead

to development of Becker`s cyst, which can provoke more or less pain in this region, depending on its size and location. Other causes of posterior knee pain are listed in Table 4.

Table 4. Causes of posterior knee pain

common causes other causesjoint e�usion Popliteus tendinopathybeker`s cyst Gastrocnemius tendinopathybiceps femoris tendinopathy Deep venous thrombosis

Posterior cruciate ligament rupture

Knee pain diagnosis

For the purpose of adequate diagnosis, it is necessary to perform a detailed clinical examination with a previously taken history in order to establish the precise mechanism of injury that greatly contributes to the correct diagnosis. Clinical examination provides an insight into the possible existence and type of swelling (hemarthrosis or e�usion), active and passive mobility, the presence of trigger points, stability of the knee joint itself, as well as the strength of the muscle of the injured extremity. If the diagnosis is not clear after a clinical examination, additional diagnostic methods can be performed: X-ray, ultrasound, magnetic resonance and arthroscopy.

Treatment of knee pain

Depending on the aetiology of injury, knee pain can be treated conservatively or surgically. In most cases, a conservative form of treatment, with an emphasis on functional rehabilitation (kinesitherapy), provides positive results in terms of resolving the symptoms (Table 5). Rupture of the anterior cruciate ligament, complex ruptures of the meniscus with pronounced clinical feautres, intensive synovial proliferation, high degree cartilage damage, and chronic patellar instability most often require surgical treatment.

Table 5. Conservative forms of knee pain treatment. RICE: rest, ice, compression, elevation. TENS: transcutaneous electrical nerve stimulation.

method injury typerice Acute knee injuries with consequent hemarthrosis

and joint e�usion: ligament ruptures and strains, menisceal injuries, synovitis, bursitis, etc.

physical therapy (electro-, magneto-, lassero-, ultra-sound therapy, tens)

Tendinopathies, acute and chronic synovitis, medial and lateral collateral ligament partial ruptures, bur-sitis, osteoarthritis, iliotibial band friction syndrome

in ltration techniques Trigger points, bursitis, Beker`s cyst, osteoarthritis, tendinopathies, iliotibial band friction

functional rehabilitation (kinesitherapy): range of motion, muscle strength, proprioceptive training, endurance training

ALL KNEE INJURY TYPES AND KNEE PAIN


Conclusion

Knee pain, both acute and chronic, is a common problem among athletes and children involved in physical activity. Each occurrence of pain implies a shorter or longer interruption of the training and competition process and a decline in sports performance. Accordingly, adequate diagnosis and therapy is of great importance for the successful treatment of knee pain and the safe return of the athlete to the training process.

17. BOLOVI U LEĐIMA U SPORTUBranislav AntićOrdinacija sportske medicine „Vita Maxima“

Učestalost bolova u leđima kod sportista se, prema različitim literaturnim podacima, kreće u rasponu između 1 i 30%, pri čemu od svih bolova u sportu na bolove u leđima otpada 10-15%. Na nastanak bola u leđima kod sportista utiču mnogi faktori kao što su: vrsta sporta, pol, intenzitet treninga, te frekvencija i tehnika izvođenja pojedinih vežbi. Bolovi u leđima su najčešći u spor-tovima koji podrazumevaju kontinuirane ponavljajuće pokrete (trčanje), uvijanja tela (pojedine plivačke discipline) i dizanje tere-ta (dizanje tegova, bodi bilding).

Bol u leđima može biti akutni i hronični. Akutni bol nastaje naglo kao rezultat od-govarajuće povrede (npr. istezanje mišića) i prolazi u kratkom vremenu, bilo spontano ili uz konzervativnu terapiju. Hronični bol nastaje postepeno kao posledica konti-nuiranih ponavljajućih pokreta (hronična repetitivna lezija), dugotrajan je i značajno umanjuje sposobnost za bavljenje sport-skim aktivnostima, a može biti i razlog za prekid profesionalne sportske karijere.

Najčešći uzroci bolova u leđima kod spor-tista su: miofascijalni sindrom, degene-racija međupršljenskog diskusa, diskus

hernija, sakroilijačni bolni sindrom, kokci-godinija, piriformni sindrom, spondiloli-steza i hiperlordoza. Miofascijalni sindrom je posledica „zamora“ pojedinih leđnih mišića usled čega dolazi do produženog mišićnog spazma i bola. Degeneracija diskusa nastaje usled dugotrajnog opte-rećenja slabinske kičme, pri čemu prvo stradaju diskusi koji imaju ulogu „šok ab-sorbera“, odnosno „upijaju“ mikrotraume štiteći tako koštane strukture kičmenog stuba. Diskus hernija je pomeranje dege-nerisanog diskusa iz svog ležišta u među-pršljenskom prostoru, pri čemu on pritiska nervne strukture i tako izaziva bol. Sakroi-lijačni bolni sindrom nastaje kao posledica hroničnog opterećenja ovih zglobova, što izaziva njihovu degeneraciju i/ili kapsulitis (zapaljenje zglobne kapsule) sa posledič-nim bolom. Kokcigodinija je bol u trtičnoj kosti i uglavnom je posledica preloma ili iščašenja ove kosti. Piriformni sindrom je uzrokovan spazmom piriformnog mišića koji nastaje usled njegovog prekomernog opterećenja. Spondilolisteza (pomeranje pršljenskog tela) kod sportista obično na-staje kod forsiranih ekstenzionih pokreta tela (savijanje unazad). Hiperlordoza je povećanje ziološke zakrivljenosti slabin-ske kičme.

Načini lečenja bolova u leđima kod sporti-sta zavise od vrste, jačine, trajanja i uzroka bola. U lečenju se primenjuju konzervativ-na terapija (analgetici, miorelaksansi, masa-že, vežbe istezanja, različite zikalne proce-dure), in ltracije-blokade i hirurško lečenje.

Vreme vraćanja redovnim sportskim ak-tivnostima je individualno i zavisi od pri-sustva i izraženosti bola, vrste sporta (brži povratak je u sportovima u kojima nema značajnijeg uvijanja tela, dugotrajnog tr-čanja i dizanja tereta), načina lečenja (hi-rurško lečenje zahteva duži oporavak) i motivacije samih sportista.

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LOW BACK PAIN IN SPORTBranislav AnticSports medicine clinic „Vita Maxima“

The frequency of low back pain in athletes ranges between 1 and 30%, according to various literature data. Of all pain in sports, back pain is represented by 10-15%. Many factors could be responsible for the onset of pain in the law back among athletes such as: type of sport, sex, intensity of training, frequency and technique of performing certain exercises. Low back pain is the most common in sports that involve continuous repetitive movements (running), body twisting (individual swimming disciplines) and lifting loads (weight lifting, body building).

Back pain can be acute and chronic. Acute pain arises suddenly as a result of certain injuries (eg. muscle stretching) and passes in a short time, either spontaneously or with conservative therapy. Chronic pain occurs gradually as a consequence of continuous repetitive movements (chronic repetitive lesion), it is time-consuming and signi cantly reduces the ability to engage in sports activities, and may be the reason for the termination of a professional sports career.

The most common causes of back pain in athletes are: myofascial syndrome, degeneration of the intervertebral discus, discus herniation, sacroiliac pain syndrome, coccigodynia, piriformis syndrome, spondylolisthesis and hyperlordosis. Myofascial syndrome is a consequence of fatigue of certain back muscles resulting in prolonged muscular spasm and pain. Degeneration of the discus occurs due to the long-term loading of the lumbar spine. Spinal discus that have the role of “shock absorber” by absorbing microtrauma and thus protect the bony structures of the spine, are the rst to be damaged. The discus herniation is the

movement of a degenerated discus from its bearing inside of intervertebral space, whereby it exerts pressure on the nerves and causes pain. Sacroiliac pain syndrome occurs as a result of chronic loading of these joints, causing their degeneration and/or capsulitis (in�ammation of the joint capsule) with consequent pain. Coccigodynia is the pain in tailbone itself and is mainly due to bone fracture or dislocation. Piriformis syndrome is caused by the piriform muscle spasm that occurs due to its excessive load. Spondylolisthesis (sliding of vertebra) in athletes usually occurs during forced extensional body movements (bending backwards). Hyperlordose is an increase in the physiological curvature of the lumbar spine.

The methods of treating law back pain in athletes depend on the type, intensity, duration and cause of pain. Treatment involves conservative therapy (NSAIL, myorelaxants, massages, stretching exercises, various physical procedures), in ltration techniques, and surgical treatment.

The time of return to regular sports activities is individual and depends on the presence and the intensity of pain, the type of sport (a faster return to normal activities in sports where there is no signi cant twisting of the body, long distance running and lifting of the load), the method of treatment (surgical treatment requires a longer recovery) and the motivation of the athletes themselves.

18. ZAŠTO TETIVE BOLE – TENDINITIS, MIT ILI STVARNOST ?-PATOLOGIJA TETIVA KROZ MODEL KONTINUUMA

Miloš BojovićSport Medical Alliance, Beograd

Sindromi propterećenja kod tetiva su če-sta pojava kod profesionalnih sportista i rekreativaca. Uglavnom se prezentiraju


kao bol u tetivama tokom i nakon aktiv-nosti. Bol se povećava sa povećanjem op-terećenja i palpatorno se može precizno lokalizovati. Ovaj bol je limitirajući, sma-njuje performanse sportista i dešava se da ih udalji iz trenažnog i takmičarskog pro-cesa na duži period.

Bol u tetivama svakako ima i zaštitnu ulo-gu. Međutim, problem koji se javlja sa ovom senzacijom, je da je veza između vizualizovane izmenjenosti tkiva i bola varijabilna. Najnovija istraživanja idu dalje od lokalnih tkivnih promena i uključuju periferne i centralne mehanizme nocio-ceptivne modulacije. Nove hipoteze se fokusiraju na potencijalnu ulogu tenocita, mehanosenzitivnih i hemosenzitivnih re-ceptora, kao i centralne mehanizme veza-ne za monitoring opterećenja.

Odgovor na pitanje šta izaziva bol u te-tivama nauka i klinička praksa traže već decenijama. Nedostatak potpunog razu-mevanja mehanizma koji dovodi do tetiv-nog bola u praksi često vodi tome da su tretmani kojima se sportisti podvrgavaju nee kasni. Terminologija same tetivne pa-tologije kroz vreme se menjala od tendini-tisa, preko tendinoze do tendinopatije. Pre i tokom devedesetih godina prošlog veka smatralo se da je bol tetivnog porekla infa-lamatorne prirode pa su strategije lečenja bile uglavnom antin�amatorne prirode, zasnivajući se na NSAIL i kortikosteroidi-ma. Krajem devedesetih i početkom dve-hiljaditih godina studije demonstriraju separaciju kolagena, njegovo stanjivanje bez in ltracije zapaljenskih ćelija u tetivno tkivo. Tretmani se zasnivaju na uvođenju kineziterapije – vežbanja sa akcentom na ekcentrične vežbe, naročito Alfredsonov protokol ekcentričnog opterećenja za Ahilovu tetivu i njegove modi kacije, kao i druge režime progresivnog opterećenja.

Do sada je ponuđeno nekoliko pato zio-loških modela za razvoj tendinopatije ali se model kontinuuma tetivne patologije pokazao kao najsveobuhvatniji u smislu objašnjenja degenerativne prirode ali ne i potpunog zanemarivanja in�amatorne komponente. Takođe razvoj terapijiskih programa postepenog progresivnog op-terećenja oslonjenih na ovaj model se na osnovu dosadašnjih randomiziranih kli-ničkih studija pokazao dobro i u praksi. U ovom modelu se razvoj tendinopatije deli na tri faze: reaktivnu, propadajuću i dege-nerativnu. Svaka od ovih faza ima svoju zasebnu kliničku prezentaciju, radiološku sliku i algoritam lečenja. Uz kliničko pre-poznavanje, gradiranje i adekvatnu terapi-ju, odnosno menadžment opterećenja od ogromnog značaja je individualizacija tera-pije, odnosno određivanje prisutnih faktora rizika naročito onih koji se mogu modi ko-vati, delimično ili potpuno, kako bi se po-stigao najbolji mogući efekat za sportistu/pacijenta. Treba napomenuti, vezano za menadžment opterećenja, i značaj sarad-nje između lekara i trenerskog osoblja.

WHAT CAUSES A PAINFUL TENDON – TENDINITIS, MYTH OR REALITY?- CONTINUUM MODEL OF TENDON PATHOLOGY

Milos Bojovic

Sport Medical Alliance, Belgrade, Serbia

Tendon overuse injuries are common pathology among professional and recreational athletes. The patient presents tendon pain during and after activity. Loading increases pain and palpation can accurately localize tendon pain. This pain disables athletes, decreases their performances, and even makes them stop training and competing for a longer period of time.

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Tendon pain certainly serves to protect the area. However, the problem of tendon pain is that the relation between pain and evidence of tissue disruption is variable. The newest investigations extends beyond local tissue changes and include peripheral and central mechanisms of nociception modulation.New hypotheses are focusing on the potential role of tenocytes, mechanosensitive and chemo sensitive receptors, and central mechanisms associated with load monitoring.

Science and clinical practice are searching for the answer to the question ”What causes a painful tendon?’’ for decades, but it has still remained unanswered. Without a proper understanding of the mechanism behind tendon pain, it is no surprise that treatments of athletes are often ine�ective. Pathology terminology had been changed during the time, from tendinitis, tendinosis to tendinopathy. Prior to the 1990s pain arising from tendons was referred to as tendinitis, implying that in�ammationwas responsible for pathological processes. Therefore, treatment strategies were mainly anti-in�ammatory in nature andrelied heavily on non-steroidal anti-in�ammatorydrugs (NSAIDs) and corticosteroids. At the end of 1990s and beginning of 2000 the studies proved collagen separation, thinning and disruption without an in�ammatory cells in ltrate. The treatments became based on exercise therapy with emphasis on eccentric exercises, especially Alfredson eccentric protocol for Achilles tendon and its modi cations, as well as other progressing loading programs.

Several pathophysiological theories for tendinopathy occurrence have been developed, but the model of continuum of tendon pathology proved to be the most

comprehensive regarding explanations of degenerative nature without neglecting in�ammatory component. Also, development of therapeutic slowly progressed loading programs in�uenced by this model proved to be e�ective by numbers of randomized clinical studies. This is a three phase model, as follows: reactive, dysrepair and degenerative tendinopathy. Each of the phases has its own clinical presentation, imaging modalities and treatment protocol. Proper clinical examination with recognizing tendinopathy phase is essential for load management. Also, an important factor is to determine risk factors, especially the ones that can be modi ed partially or entirely in order to achieve the best healing process for an athlete, or a patient. Regarding load management, it is also signi cant to mention the importance of cooperation between doctors and coaching stu�.

19. OZONOTERAPIJABojana BožovićSport Medical Alliance, Beograd

Ozon je molekul koji se sastoji od tri atoma kiseonika, hemijske formule O3. Ozon je alotropska modi kacija kiseonika koja je mnogo nestabilnija od uobičajenog dvoa-tomskog oblika kiseonika O2. Ozon prime-njen u niskim koncentracijama, podstiče sopstvenu otpornost organizma, i na taj način (re)aktivira imuni sistem. Kao odgo-vor na ovu aktivaciju ozonom, ćelije imu-nog sistema proizvode posebne glasnike koji se nazvaju citokini (uključujući važne medijatore poput interferona ili interle-ukina). Oni informaciju prenose drugim ćelijama imunog sistema i tako pokreću čitav niz pozitivnih promena u imunom si-stemu, koji se na taj način stimuliše u bor-


bi protiv bolesti. Sve ovo govori u prilog tome da je primena medicinskog ozona izuzetno korisna za podsticanje imunog sistema kod pacijenata sa oslabljenim imunitetom ili imunim de citom. Spolja-šnja primena ozona se primarno postiže u zatvorenom sistemu koristeći ozonski gas, koji se uvodi u specijalne plastične „čizme“ (za tretman nogu i stopala), odnosno kese, folije i dr. koje odgovaraju određenom delu tela. Ovaj metod je veoma e kasan u lečenju čireva, rana, otvorenih rana, post-operativnih lezija, herpes zostera i zara-ženih područja kože itd. Intraartikularna primena ozona (primena putem injekcije u zglob) se koristi u tretmanu bola i upale u zglobovima (artritis, rekurentna artroza, opšta patološka ukočenost zgloba). Ozo-noterapija je isključivo komplemetarna terapija, nije terapija izbora kod diskus hernija.U bilo kom obliku terapije ozonom , udisanje ozonskog gasa je zabranjeno.Ozono terapija se aplikuje kod diskus her-nije isključivo u L-S kičmi.Nikada se ne daje direktno na mesto prblema već para-vertebralno, 2 cm lateralno od oštećenog pršljena. Ozon je komplementarna terapi-ja koja svoj puni efekat daje uz sprovođe-nje zikalne terapije.

OZONE THERAPYBojana BozovicSport Medical Alliance, Belgrade, Serbia

Ozone is a molecule consisting of three oxygen atoms. Its chemical formula is O3. Ozone is an allotrope of oxygen that is much more unstable than the normal diatomic allotrope O2. Ozone applied in low concentration, generates its own resistance of the organism, and thus(re)activates the immune system. In response to this activation, cells of the immune system produce special mediators that are termed cytokines (including

important mediators such as interferons or interleukins). They transmit information to other cells of the immune system and trigger a series of positive changes in the immune system. In this way, it gets stimulated to ght against disease. This proves the fact that the use of medical ozone is extremely useful for stimulating the immune system in patients with weakened immune systems or immune de ciency. External application of ozone is primarily achieved in a closed system using ozone gas, which is introduced into a special plastic “boots” (for the treatment of legs and feet), or bags, foils etc., corresponding to a speci c part of the body. This method is very e�ective in the treatment of ulcers, wounds, open wounds, postoperative lesions, shingles (herpes zoster) and infected areas of skin and so on. Intra-articular application of ozone (application by injection into the joint) is used in the treatment of pain and in�ammation in the joints (arthritis, recurrent arthrosis, general pathological sti�ness of the joint). Ozone therapy is exclusively complementary therapy, but it is not the treatment for herniated disc. Inhalation of ozone gas is prohibited. With herniated disc, ozone therapy can be applied only in LS spine. It is never applied directly in the point of a problem, but paravertebral, 2 cm lateral from the damaged vertebrae. Ozone is a complementary therapy. Its full e�ect is achieved together with physical therapy.

20. TRENAŽNA TEHNOLOGIJA – IZAZOVI I PRIMENA Predrag Nemec, Vesna NemecFakultet za �zičku kulturu i menadžment u sportu, Univerzitet Singidunum, Beograd, Srbija

Dominacija u vrhunskom sportu u veli-koj meri zavisi od spremnosti takmičara,

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uvođenja racionalnih inovacija u trenažnu tehnologiju, e kasnih rešenja i naučnih do-stignuća u svim oblastima koje čine sport. Da bi uspešnost u sportu bila na nivou po-tencijala takmičara, moraju se upotrebiti i sistematizovati načini primene proverenih vrsta treninga, uloga u timu, pravovremene upotrebe Ketmena, kao i procesi humaniza-cije sporta, stvaranja timizacije, klimata na treningu i svih drugih faktora koji pospešuju postizanje vrhunskih rezultata. Osim toga, cilj je smanjiti količinu opterećenja i izbeći mogućnost povrede koja najčešće proistiće iz sporog oporavka. Ako se u vrhunskom i amaterskom sportu ceni disciplina, onda je primena sublimativnih treninga neophodna za razvoj mladih takmičara, a ona u velikoj meri zavisi od količine znanja njihovih tre-nera. Danas se dostupna literatura retko čita i traži, pa internet predstavlja dobru priliku za pronalaženje krajnjih dometa u sportskoj nauci, posebno zvog svoje rasprostranjeno-sti i pristupačnosti. Hrabrost i istrajnost tre-nera u istraživanju i primeni inovacija u tre-ningu svakako ima posebno mesto u daljem razvoju trenažne tehnologije.

TRAINING TECHNOLOGY - CHALLENGES AND APPLICATIONPredrag Nemec1, Vesna Nemec1

1 Faculty of physical education and sports management, Singidunum University, Belgrade, Serbia

Domination in elite sport to a large extent depends on the level of physical preparation, the introduction of rational innovations in training technology, e�cient solutions and scienti c achievements in all areas of the sport. In order to have success in the sport at the competitor’s potentials, the methods of applying the proven types of training, roles in the team, the timely use of Ketmen, as well as the processes of humanization

of sports, team creation, training climate and all other factors that promote the achievement of top-result, must be used and systematized. In addition, the goal is to reduce the amount of treaning load and avoid the possibility of injury that most often comes from a slow recovery. If discipline is appreciated in elite and amateur sport, then the application of sublimative training is necessary for the development of young competitors, and it to a great extent depends on the amount of knowledge of their trainers. Today’s available literature is rarely read and requested so the Internet presents a good opportunity to nd the ultimate reach in sports science, especially because of its prevalence and accessibility. The courage and perseverance of trainers in research and application of innovation in training certainly has a special place in the further development of training technology.

21. PRIMENA MEDIJA VIRTUALNE REALNOSTU U RAZVOJU MOTORIČKIH SPOSOBNOSTI I UNAPREĐENJU MOTORNIH PROGRAMA VRHUNSKIH SPORTISTAPredrag Nemec1, Miloš Milošević1, Branko Šujić2

1Fakultet za �zičku kulturu i menadžment u sportu, Univerzitet Singidunum, Beograd, Srbija2Fakultet dramskih umetnosti, Univerzitet umetnosti, Beograd, Srbija

Cilj ovog rada je da predstavi potencijal u implementaciji medija virtualne realnosti u trenažnom procesu vrhunskih sportista. E kasnost primene tehnike vizuelizacije u razvoju motoričkih sposobnosti i una-pređenju motornih programa vrhunskih sportista, kao proces uticaja centra na pe-riferiju (top down), dokazana je u brojnim studijama. Sa druge strane preliminarni rezultati istraživanja medija virtualne re-


alnosti pokazuju da senzorna stimulacija može uticati na centralne procese (botom up) vezane za upravljanje kretanjem, čak i one bazične kao što je doživljaj telesne šeme. Kombinacija principa tehnike vizu-elizacije i medija virtuelne realnosti, kao posebna vrsta dvosmernog modeliranja, odnosno spoj senzorne stimulacije, kog-nitivnih procesa i kretanja otvara širok prostor za istraživanja. Kao posledica pri-mene nove tehnologije može se očekivati značajno bolji rezultat u razvoju motorič-kih sposobnosti i unapređenju motornih programa vrhunskih sportista nego bilo koja do sada poznata psihološka (mental-na) trenažna tehnika. Ova vrsta istražvanja trebala bi da nađe i svoju primenu u zi-kalnoj terapiji i rehabilitaciji.

APPLICATION OF VIRTUAL REALITY MEDIUM IN MOTOR CAPACITY DEVELOPMENT AND MOTOR PROGRAMS IMPROVEMENT OF ELITE ATHLETESPredrag Nemec1, Miloš Milošević1, Branko Sujić2

1Faculty of Physical Education and Sports Management, University Singidunum, Belgrade, Serbia2Faculty of Drama Arts, University of Arts, Belgrade, Serbia

The aim of this paper is to present the potential of implementing the media of virtual reality in the training process of elite athletes. E�ciency of applying visualization techniques to developing motor skills and enhancing elite athlete’s motor programs as a top-down process has been proven in numerous studies. On the other hand, the preliminary results of the research of the virtual reality media show that sensory stimulation can a�ect the central processes of motion management, even basic ones, such as a body schema. The combination of the

principle of visualization techniques and the virtual reality media as a special type of two-way modeling, combination of sensory stimulation, cognitive processes and motion, opens up a wide space for research. As a result of the application of new technology, a signi cantly better result can be expected in the development of motor skills and the improvement of motor programs of elite athletes than any previously known psychological (training) technique. This type of exploration should also nd its application in physical therapy and rehabilitation.

22. POVEZANOST OSNOVNIH MORFOLOŠKIH KARAKTERISTIKA I RAVNOTEŽE UČENIKA V RAZREDA OSNOVNE ŠKOLE Aleksandar Gadžić, Sandra Miladinović

Fakultet za �zičku kulturu i menadžment u sportu, Univerzitet Singidunum, Beograd, Srbija

UVOD – Morfološke karakteristike pred-stavljaju primarnu informaciju o psiho-somatskom statusu čoveka. Određuje ih sistem antropometrijskih, prikrivenih (ili latentnih) dimenzija koje mogu biti ra-zvijene pod različitim uticajima, odnosno spoljašnjim faktorima, na primer trening. Morfološke karakteristike uslovljene su brojnim faktorima, kakvi su pol, uzrast, ali i generički i socijalni činioci (Bala, 1981).

Morfološke karakteristike dece predsta-vljaju osnov za izučavanje antropološkog statusa čoveka. Praćenje morfoloških ka-rakteristika dece predmet je više naučnih disciplina. Kada je u pitanju nastava zič-kog vaspitanja, morfološke karakteristike i njihovo poznavanje služe pravilnom oda-biru i primeni telesnih vežbi, kao i pravil-nom određivanju opterećenja u nastavi zičkog vaspitanja. Morfološke karakteri-

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stike, između ostalog, utiču i na ravnotežu kao motoričku sposobnost.

Motoričke sposobnosti se razvijaju od samog rođenja i njihove promene su vi-dljive iz godine u godinu. To se posebno uočava u periodu puberteta i bitno je na-pomenuti da je različit razvoj motoričkih sposobnosti kod devojčica i kod dečaka. Za svaku motoričku sposobnost posto-ji određen period u kojem se na najbolji mogući način ona realizuje, odnosno u kojem ona egzistira. Na motoričke spo-sobnosti utiču različiti faktori. Posebno je značajan uticaj niza endogenih i egzo-genih faktora (Prskalo, Kraljević i Kovačić, 2011). Faktori koje nazivamo endogenim su najzastupljeniji u periodu puberteta, a reč je o hormonalnim i genetski uslovlje-nim promenama i poznato je da se u tom dobu najviše promena dešava pod utica-jem hormona i naravno genetike.

Neki autori ističu da se još uvek ne može govoriti o konačnom modelu motoričkih sposobnosti. Problem dobija na značaju uzme li se u obzir da pojedini autori, iste pojmove, obeležavaju različitim imenima i suprotno. U praksi se upotrebljavaju ter-mini: snaga, izdržljivost, brzina, koordina-cija, �eksibilnost, ravnoteža... (Stojanović, Stojanović i Nešić, 2011).

Tema ovog istraživanja vezana je za mor-fološke karakteristike i sposobnost ravno-teže kod dece uzrasta 11godina. Sposob-nost ravnoteže se javlja kao posebna vrsta motoričke sposobnosti koja je zaslužna za održavanje izbalansiranog položaja tela kako u kretanju tako i u mirovanju. Ispi-tivanje ravnoteže u predadolescentnom uzrastu je poseban izazov kada se u obzir uzmu individualna odstupanja tempa ras-ta i razvoja, a zatim i polna razlika perioda ulaska u pubertet koja je još više individu-alno determinisana. Uzrast od 11 do 15 go-dina prati činjenica da se biološka starost

često ne poklapa sa hronološkom. Pored toga ni motoričke sposobnosti se ne razvi-jaju ravnomerno. Naime, poznato je da se javljaju periodi kada dolazi do ubrzanog razvoja određene motoričke sposobnosti, nakon čega dolazi do usporenijeg razvoja, odnosno stagnacije.

U ranijim istraživanjima relacija između morfoloških karakteristika i sposobnosti ravnoteže, autori su došli do različitih za-ključaka. Jedna grupa autora (Ljubojević, Višnjić i Ilić, 2012) je utvrdila da je mogu-će, na osnovu obima potkolenice, pretpo-staviti rezultate u testovima �eksibilnosti, ali da ne postoji povezanost između mor-foloških varijabli i stajanja na jednoj nozi zatvorenih očiju kod devojčica, kao testa za procenu sposobnosti ravnoteže.

Grupa autora (Castro, Morales, David i Lopes, 2013) su ispitivali sposobnost rav-noteže kod devojčica i dečaka uzrasta 7-8 godina primenom testova stajanja na jednoj nozi i na obe noge sa otvorenim očima. Autori su došli su do zaključka da devojčice imaju bolju kontrolu ravnoteže od dečaka u stavu na jednoj nozi.

U relativno skorijem longitudinalnom istraživanju statičke ravnoteže (Ghosh, 2015), na uzorku od 60 dečaka i 60 devoj-čica uzrasta od 10 do 11 godina, pokazalo se da devojčice konstantno beleže bolje rezultate od dečaka.

CILJ ISTRAŽIVANJA – Cilj istraživanja je bio da se utvrdi da li postoji značajna po-vezanost između nekih morfoloških ka-rakteristika i sposobnosti ravnoteže kod učenika i učenica petog razreda osnovne škole. Drugi cilj jeste upoređivanje rezulta-ta dečaka i devojčica. U ranijim istraživa-njima utvrđene su značajne razlike u ovoj sposobnosti između polova (Jertec, 2011; Kraljević, Gadžić i Vučković, 2013; Panta, Arulsingh, Raj, Sinha & Rahman, 2015). Komparativnim pristupom na najlakši i


najpouzdaniji način doći će se do rezultata na osnovu kojih će se steći uvid u kakvom su odnosu morfološke karakteristike i rav-noteža kod dečaka i devojčica.

MATERIJAL I METOD – Uzorak ispitanika u ovom istraživanju činilo je 56 učenika (32 dečaka i 24 devojčice) petog razreda osnovne škole „Stanislav Binički“ iz Jasike uzrasta 11±6 meseci. Uzorak su predsta-vljali zdravstveno sposobni učenici, bez povreda za vreme testiranja. Učenici su redovno pohađali nastavu zičkog vaspi-tanja u spomenutoj osnovnoj školi.

Svi testovi rađeni su u prepodnevnim satima, na časovima zičkog vaspitanja. Ispitanici su bili u opremi za čas zičkog vaspitanja (majica, šorc i patike). Pre mo-toričkih testiranja, ispitanici su prošli me-renja osnovnih morfoloških karakteristika, telesne visine i telesne mase, na osnovu kojih je izračunat indeks telesne mase (BMI). Motorička sposobnost ravnoteže procenjena je pomoću dva testa za rav-notežu – Flamingo balans test i Roda test ravnoteže. U cilju što kvalitetnije procene kompleksne motoričke sposobnosti kao što je ravnoteža, ispitanici su radili testove sa otvorenim i zatvorenim očima, kao i na dominatnoj, odnosno nedominatnoj nozi.

Ispitanici su prvo radili Flamingo balans test na dominantnoj nozi otvorenih očiju (FOD), zatim na nedominantnoj nozi otvo-renih očiju (FON), pa na dominantnoj nozi zatvorenih očiju (FZD) i na kraju na ne-dominantnoj nozi zatvorenih očiju (FZN). Zatim Roda testove na dominantnoj nozi otvorenih očiju (ROD), na nedominantnoj nozi otvorenih očiju (RON), pa na domi-nantnoj nozi zatvorenih očiju (RZD) i na kraju na nedominantnoj nozi, zatvorenih očiju (RZN).

Podaci su statistički obrađeni u programu SPSS 21. Izračunati su osnovni deskriptivni parametri, a povezanost između ispitiva-nih prostora ispitana je primenom Pirso-nove linearne korelacije. Provera statistič-ke značajnosti razlika između ispitivanih grupa izvršena je primenom Mann Whit-ney U testa.

REZULTATI – U Tabeli 1. dat je prikaz osnov-nih parametara deskriptivne statističke analize (raspon podataka – Range, srednja vrednost – Mean, minimalna – Minimum i maksimalna vrednost – Maximum, sta-tistička devijacija – Std. Dev., kao i mere oblika distribucije: mera asimetrije distri-bucije – Skewness i mera homogenosti distribucije – Kurtosis).

Tabela 1. Deskriptivni statistički pokazatelji morfoloških karakteristika i testova za pro-cenu ravnoteže učenika V razreda

Varijabla N Range Minimum Maximum Mean SD Skewness KurtosisTV 32 28 138 166 150.63 7.07 0.43 0.31TM 32 57 32 89 45.19 12.8 1.59 2.98BMI 32 16.78 15.52 32.3 19.7 4.24 1.4 1.29FOD 32 24 0 24 10.16 6.26 0.11 -0.56FON 32 28 0 28 11.34 7.58 -0.18 -0.65FZD 32 29 0 29 15.91 12.82 -0.41 -1.81FZN 32 29 0 29 12.31 13.5 0.21 -2ROD 32 17.1 1.45 18.55 5.58 3.97 1.57 2.56RON 32 12.68 1.29 13.97 3.5 2.69 2.69 7.95RZD 32 5.19 1 6.19 2.19 1 2.16 7.29RZN 32 2.4 1.22 3.62 1.95 0.55 1.09 1.35

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Tabela 2. Deskriptivni statistički pokazatelji morfoloških karakteristika i testova za pro-cenu ravnoteže učenica V razreda

Varijabla N Range Minimum Maximum Mean SD Skewness Kurtosis

TV 24 26 138 164 149 7.52 0.36 -1

TM 24 56 28 84 45.67 13.23 1.27 1.95

BMI 24 23.06 14.27 37.33 20.4 5.05 1.73 4.36

FOD 24 17 0 17 8.33 7.1 -0.19 -1.85

FON 24 22 0 22 9.79 8.49 -0.08 -1.74

FZD 24 29 0 29 10.63 12.92 0.4 -1.95

FZN 24 29 0 29 9.17 13.25 0.76 -1.55

ROD 24 24.93 2.51 27.44 6.2 5.13 3.36 13.33

RON 24 7.43 1.32 8.75 3.83 2.26 1.07 -0.12

RZD 24 2.66 0.97 3.63 2.31 0.84 0.27 -1.22

RZN 24 2.26 1.11 3.37 2.05 0.59 0.44 -0.4

Analizom Tabele 1. kod učenika V razreda primećuje se da distribucija rezultata u ve-ćini varijabli nema značajnih odstupanja od normalne distribucije. Samo kod dve varijable RON (roda test, otvorenih očiju na nedominantnoj nozi) i RZD (roda test, zatvorenih očiju na dominantnoj nozi), se primećuje da vrednost koe cijenta za-krivljenosti prelazi 1.00, što ukazuje da je više ispitanika u tim testovima imalo ne-što slabiji rezultat. Može se takođe prime-titi da je koe cijent zaobljenosti kod ove dve varijable veći nego kod ostalih (RON

=7.95 i RZD =7,25) što pokazuje da postoje neki rezultati koji značajno odstupaju od proseka. Takođe se primećuje da postoji nešto više boljih rezultata ispitanika kod testova FON i FZD sa obzirom na nega-tivnu asimetriju rezultata. Kod vrednosti standardne devijacije i raspona rezultata primećujemo veću heterogenost kod Fla-mingo testova ravnoteže i morfoloških karakteristika nego kod ostalih testova, što ukazuje na velike individualne razlike u ovim testovima.

Kod učenica V razreda (Tabela 2.) vidi se da većina procenjenih varijabli ne odstupa značajno od normalne distribucije. Prime-ćuje se da ROD (roda test, otvorenih očiju na dominantnoj nozi) odstupa od ostalih varijabli što ukazuje na slabije rezultate is-pitanika, a takođe se primećuje da je koe- cijent zaobljenosti kod ove varijable uve-

ćan. Primećuje se da je kod testova FOD = -0.19 i FON = -0.08 negativna asimetrija rezultata što ukazuje na to da su ispitanici kod ovih testova imali nešto bolje rezulta-te nego kod ostalih. Kao i u prethodnoj ta-beli evidentno je da kod Flamingo testova i morfoloških karakteristika postoje veće individualne razlike ispitanika.


Tabela 3. Koe cijenti korelacije svih ispitivanih varijabli učenika V razreda

Varija-bla TV TM BMI FOD FON FZD FZN ROD RON RZD RZN

TV 1

TM .700** 1

BMI .455** .950** 1

FOD .141 -.012 -.133 1

FON .104 -.062 -.180 .481** 1

FZD -.022 -.345 -.432* -.033 .398* 1

FZN .115 -.097 -.169 -.210 .172 .650** 1

ROD -.288 -.297 -.264 -.046 -.070 .273 .371* 1

RON -.323 -.330 -.295 -.212 -.099 .247 .382* .787** 1

RZD -.053 -.073 -.063 -.212 -.053 .125 .023 .270 .324 1

RZN -.053 -.170 -.211 .130 .071 .369* -.113 .062 .053 .289 1

** Korelacija značajna na nivou 0.01* Korelacija značajna na nivou 0.05

Rezultati iz Tabele 3. ukazuju na sledeće značajne korelacije ispitivanih varijabli kod učenika V razreda:

• Telesna visina (TV) značajna poveza-nost sa BMI i telesnom masom (TM).

• Telesna masa (TM) ima značajnu kore-laciju sa BMI.

• BMI ima značajnu negativnu korelaciju sa FZD (�amingo test, zatvorenih očiju na dominantnoj nozi) -.432 na nivou p<0.05.

• FOD (�amingo test, otvorenih očiju na dominantnoj nozi) ima značajnu kore-laciju sa FON (�amingo test, otvorenih očiju na nedominantnoj nozi) .481 na nivou značajnosti p<0.01.

• FON (�amingo test, otvorenih očiju na nedominantnoj nozi) ima značajnu korelaciju .398 na nivou p<0.05 sa FZD

(�amingo test, zatvorenih očiju na do-minantnoj nozi).

• FZD (�amingo test, zatvorenih očiju na dominantnoj nozi) ima značajnu kore-laciju sa FZN (�amingo test, zatvorenih očiju na nedominantnoj nozi) na nivou značajnosti od p<0.01 i značajnu ko-relaciju sa RZN (roda test, zatvorenih očiju na nedominantnoj nozi) na nivou značajnosti od p<0.05.

• FZN (�amingo test zatvorenih očiju na nedominantnoj nozi) ima značajnu po-vezanost sa RON (roda test, otvorenih očiju na nedominantnoj nozi) .382 na nivou značajnosti od p<0.05.

• ROD (roda test, otvorenih očiju na do-minantoj nozi) vezi ima značajnu pove-zanost sa RON (roda test, otvorene oči na nedominantnoj nozi) .787 na nivou značajnosti od p<0.01.

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Tabela 4. Koe cijenti korelacije svih ispitivanih varijabli učenica V razreda

Varijabla TV TM BMI FOD FON FZD FZN ROD RON RZD RZN

TV 1

TM .562** 1

BMI .251 .939** 1

FOD -.322 -.186 -.081 1

FON -.250 -.111 -.018 .969** 1

FZD -.312 -.285 -.198 .497* .552** 1

FZN -.361 -.200 -.081 .445* .483* .791** 1

ROD -.393 -.171 -.030 .291 .306 .402 .530** 1

RON -.394 -.320 -.210 .202 .232 .537** .567** .695** 1

RZD .088 -.421* -.516** .141 .100 .241 .166 .039 .207 1

RZN -.422* -.529** -.450* .105 .084 .459* .454* .357 .490* .318 1

** Korelacija značajna na nivou 0.01* Korelacija značajna na nivou 0.05

U Tabeli 4. prikazane su značajne korelaci-je varijabli učenica V razreda:

• TV (telesna visina) ima značajnu ko-relaciju sa TM (telesna masa) .562 na nivou značajnosti p<0.01. i značajnu negativnu korelaciju sa RZN (roda test, zatvorene oči na nedominantnoj nozi) -.422 na nivou od p<0.05.

• TM (telesna masa) ima značajnu po-vezanost sa BMI .939 na nivou značaj-nosti od p<0.01, takodje ima značajnu negativnu korelaciju sa RZD (roda test, zatvorene oči na dominantnoj nozi) -.421 na nivou od p<0.05 i sa RZN (roda test, zatvorene oči na nedominantnoj nozi) na nivou od p<0.01.

• BMI ima značajnu negativnu poveza-nost sa RZD (roda test, zatvorene oči na dominantnoj nozi) -.516 na nivou od p<0.01 i sa RZN (roda test, zatvore-ne oči na nedominantnoj nozi) -.529 na nivou od p<0.05.

• FOD (�amingo test, otvorene oči na do-minantnoj nozi) ima značajnu poveza-nost od p<0.01 sa FON .969 (�amingo

test, otvorene oči na nedominantnoj nozi), a na nivou od p<0.05 sa FZD (�a-mingo test, zatvorene oči na dominant-noj nozi) .497 i FZN (�amingo test, zatvo-rene oči na nedominantnoj nozi) .445.

• FON (�amingo test, otvorene oči na nedominantnoj nozi) ima značajnu korelaciju sa FZD (�amingo test, zatvo-renih očiju na dominantnoj nozi) .552 na nivou od p<0.01 i sa FZN (�amingo test, zatvorenih očiju na nedominant-noj nozi) .483 na nivou od p<0.05.

• FZD (�amingo test, zatvorenih očiju na dominantnoj nozi) ima značajnu korelaciju na nivou p<0.01 sa FZN (�a-mingo test, zatvorenih očiju na nedo-minantnoj nozi) .791 i RON (roda test, otvorene oči na nedominantnoj nozi) .537, a na nivou p<0.05 sa RZN (roda test, zatvorenih očiju na nedominant-noj nozi) .459.

• FZN (�amingo test, zatvorenih očiju na nedominantnoj nozi) ima značajnu povezanost na nivou p<0.01 sa ROD (roda test, otvorenih očiju na dominan-toj nozi) .530 i RON (roda test, otvorene


Tabela 5. Razlika između dečaka i devojčica V razreda u sposobnosti ravnoteže

Varijabla Mann-Whitney U pSrednja vrednost rangova

Dečaci Devojčice

FOD 335.00 .413 30.03 26.46

FON 363.00 .725 29.16 27.63

FZD 291.50 .106 31.39 24.5

FZN 334.50 .357 30.05 26.44

ROD 322.00 .305 26.56 31.08

RON 335.50 .403 26.92 30.60

RZD 327.00 .345 26.72 30.88

RZN 331.00 .380 26.84 30.71

oči na nedominantnoj nozi) .567, a od p<0.05 sa RZN (roda test, zatvorenih očiju na nedominantnoj nozi) .454.

• ROD (roda test, otvorenih očiju na do-minantoj nozi) ima značajnu korelaciju na nivou od p<0.01 sa RON (roda test, otvorene oči na nedominantnoj nozi)

.695.• RON (roda test, otvorene oči na nedo-

minantnoj nozi) ima značajnu korelaci-ju na nivou p<0.05 sa RZN (roda test, zatvorenih očiju na nedominantnoj nozi) .490.

U Tabeli 5. prikazani su rezultati Mann--Whitney testa uzorka dečaka i devojčica V razreda u sposobnosti ravnoteže. Vred-nosti p nivoa statističkog zaključivanja ukazuju da između ovih grupa ispitanika ne postoje statistički značajne razlike u is-pitivanim sposobnostima.

ZAKLJUČAK – Na osnovu sprovedenih te-stiranja i statističke obrade dobijenih po-dataka došlo se do značajnih informacija u vezi sa povezanosti morfoloških karakte-ristika i ravnoteže kod učenika uzrasta 11 godina. Sprovedeni testovi pokazali su da je ravnoteža značajno uslovljena polom kao osnovnom varijablom, ali i telesnom masom, visinom i indeksom telesne mase.

Dobijeni rezultati omogućavaju da se konstatuje nekoliko činjenica. Prisonov

koe cijent linearne korelacije ukazao je na uslovljenost rezultata u zavisnosti od morfoloških karakteristika. Kod učenika V razreda utvrđeno je da veći BMI najviše negativno utiče na Flamingo test, zatvore-nih očiju na dominantnoj nozi (FZD) -.432.

Kod učenica V razreda utvrđeno je da te-lesna visina (TV) najviše negativno utiče na Roda test zatvorenih očiju na nedomi-nantnoj nozi (RZN) -.422. Takođe, uočeno je da telesna masa (TM) najviše negativno utiče na Roda test, zatvorenih očiju na do-minantnoj nozi (RZD) -.421, a da najviše pozitivno utiče na Roda test, zatvorenih očiju na nedominantnoj nozi (RZN) -.529. BMI najviše negativno utiče na Roda test zatvorenih očiju na dominantnoj nozi (RZD) -.516 i na Roda test zatvorenih očiju na nedominantnoj nozi (RZN) -.450.

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Bitno je ukazati i na činjenicu da su različiti rezultati u zavisnosti od toga da li je reč o testiranju na dominantnoj ili nedominant-noj nozi, odnosno da li je testiranje spro-vedeno sa otvorenim ili zatvorenim očima. U većini testova bolje rezultate učenici su ostvarivali na dominantnoj nozi i sa otvo-renim očima, što je u skladu sa očekivanji-ma. Devojčice su u većini rezultata imale bolje prosečne rezultate u odnosu na de-čake, ali su se maksimalni i minimalni re-zultati razlikovali i oscilacije između ostva-renih rezultata često su bile neočekivano velike što je verovatno posledica manjeg uzorka ispitanika.

Na kraju, potrebno je ukazati na već po-tvrđeni trend povećanja BMI kod učenika osnovne škole (Gajević, 2009), a koji očito negativno utiče na ispoljavanje, u mno-gim zičkim aktivnostima, važne motorič-ke sposobnosti kao što je ravnoteža.

Ključne reči: morfološke karakteristike, ravnoteža, učenici, osnovna škola

LITERATURA

Bala, G. (1981). Struktura i razvoj morfol-ških i motoričkih dimenzija dece SAP Voj-vodine. Novi Sad: Fakultet zičke kulture.

Castro, O., Morales, A., David, A., Lopez, G., (2013). Balance comparison between boys and girls during double leg stance and single leg stance. Natal: XXIV Congress of international society of biomehanics, XV Brazilian congress of biomehanics.

Jertec, N. (2011). Razlike u sposobnosti ravnoteže s obzirom na spol kod djece predškolske dobi. U V. Findak (Ur.) Zbornik radova 20. ljetne škole kineziologa ,,Dija-gnostika u područjima edukacije, sporta, sportske rekreacije i kineziterapije“ Poreč

(str. 124 – 128). Zagreb: Hrvatski kinezio-loški savez.

Kraljević, R., Gadžić, A. i Vučković, I. (2013). Di�erences in motor skills of seventh-gra-de boys and girls, Acta Kinesiologica 7(2), 62‐66.

Gajević, A. (2009). Fizička razvijenost i zič-ke sposobnosti dece osnovnoškolskog uz-rasta. Beograd: Republički zavod za sport.

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Ljubojević, M., Višnjić, D., Ilić, J., (2012). Relacije morfoloških varijabli i ravnoteže i �eksibilnosti kod učenica sedmog razreda. Sportske nauke i zdravlje 2(1): 11 – 15.

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THE CORRELATION OF BASIC MORPHOLOGICAL CHARACTERISTICS AND BALANCE IN FIFTH GRADE PUPILSAleksandar Gadžić¹, Sandra Miladinović¹¹ Faculty of physical education and sports management, Singidunum University, Belgrade, Serbia

INTRODUCTION. Morphological characteristics are elementary information of human psychosomatic status. They are determined by system of anthropometric, latent dimensions that can be developed under various in�uences or external factors, for example training. Morphological characteristics in�uence all motor abilities among them balance ability as well.

AIM. To assess signi cance of correlation between some morphological characteristics and balance in fth grade pupils of both sexes. Secondary aim was to compare the results of boys and girls.

MATERIAL AND METHOD. A sample was composed of 56 pupils (32 boys and 24 girls) from fth grade of primary school „Stanislav Binički“, Jasika, aged 11 years ±6 months. All pupils were in good health and regularly attending physical education classes. Balance, as a complex motor ability, was assessed with eight motor tests: Flamingo balance test on dominant leg with open and closed eyes (FDOE, FDCE), Flamingo balance test on non-dominant leg with open and closed eyes (FNOE, FNCE). Stork balance test on dominant leg with open and closed eyes (SDOE, SDCE), Stork balance test on non-dominant leg with open and closed eyes (SNOE, SNCE).

Basic morphological characteristics variables were: body weight (BW), body height (BH) and body mass index (BMI). For

statistical data analysis, central tendency measures were calculated. Connection between two sets of variables (motor and morphological) was determined by Pearson’s correlation coe�cient.

RESULTS. For boys subsample, body height has signi cant correlation with body weight and body mass index. Several balance tests have signi cant interrelations. BMI has signi cant negative correlation with Flamingo balance on dominant leg with closed eyes test. In girls subsample, body height has signi cant correlation with body weight. However, few balance tests have negative correlation with body weight and BMI. Similarly to boys subsample, several balance tests have signi cant interrelations.

Comparison of the results between boys and girls did not reveal any statistically signi cant di�erences.

CONCLUSION. The results of the study indicate that morphological characteristics have signi cant correlation with balance in both, boys and girls. However, there are no signi cant di�erences between boys and girls in this motor ability.

Key words: morphological characteristics, balance, pupils, primary school

23. VAŽNOST UKLJUČIVANJA BODY&MIND TEHNIKA VEŽBANJA( PILATESA I BODYART TEHNIKE) U VRHUNSKOM,AMATERSKOM I REKREATIVNOM SPORTUTamara RatkovićFakultet za �zičku kulturu i menadžment u sportu, Univerzitet Singidunum, Beograd, Srbija

UVOD. Vrhunski sport zahteva pronala-ženje što boljeg načina za racionlnijim

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korišćenjem treninga u cilju ostvarenja vrhunskih rezulata.Nezaobilazna je činje-nica da kvantitativna metoda treninga jos uvek ima veliku primenjivost u vrhunskom sportu. Propratni efekat kvantitativne me-tode treninga je pretreniranost koja za posledicu često ima zamor i nemogućnost dovoljnog oporavka od prevelike količine opterećenja. Pre svega je neophodno iz-beći povredu. Što bolji i uspešniji sportski rezultati u prvi plan stavljaju cilj i rezultat koji se želi postići, ali istovremeno zbog prevelike trenažne opterećenosti često nose i određene rizike od povređivanja.

CILJ. Koliko su važne body&mind tehnike vežbanja (pilates i bodyART) u primeni kod vrhunskih sportista kao dopunskog faktora u cilju postizanja što boljih rezu-latata cilj je i ovog rada. Primenom funk-cionalnog pilatesa i bodyART metoda treninga kroz sve tri ravni tela, možemo poboljšati rezulatete, a istovremeno sma-njiti mogućnosti od povreda. Primenom speci čnih vežbi i sagledavajući telo kao celinu, primenom pravilne tehnike disanja kao i body&mind vežbi, menjamo focus i e kasnost trenažnog procesa. To je samo jedan od razloga primene ovih tehnika ve-žbanja u rehabilitaciji i prevenciji u mno-gim savremenim sportskim klubovima.

OSVRT NA DOSADAŠNJA ISTRAŽIVANJA I PRIMENU KROZ PRAKSU. Uključivanje pilates i bodyART vežbi u svakodnevni trenažni proces, ima za cilj povećavanje �eksibilnosti mišića vežbača, ali i pozitiv-no delovanje na kompenzatorne mišićne promene koje se dešavaju u telu usled stalne primene određenih pokreta-vežbi, kao i svakodnevnim stečenim životnim navikama. Ovim metodma delujemo na povećavanje �eksibilnosti, koordinacije, snage, brzine i ravnoteže kao i mišićne iz-držljivosti, ali isto tako i na ubrzavanje pro-cesa oporavka između treninga što je veo-ma značajno u životu vrhunskog sportiste.

PREDLOG PROGRAMA. Trajanje samog časa je 60 minuta, uz implementaciju bo-dy&mind tehnika vežbanja (pilatesa i bo-dyART-a) sa ciljem poboljšanja rezultata i uspeha u određenom sportu. Kao i način delovanja na poboljšanju karakteristika i mogućnosti samog sportiste, odnosno re-kreativca ili amatera.

ZAKLJUČAK. Body&mind tehnike vežbanja sve više imaju individulanu primenu u tre-nažnom procesu sportiste. Iako su snaga, izdržljivost i brizna, dominnatne u vrhun-skom sportu, sve više značaja i prostora se daje �eksibilonosti i mobilnosti. Ne samo sa ciljem poboljšanja individualnih rezulta-ta takmičara/sportiste već i sa ciljem spre-čavanja povreda kao i odlaganja umora. Stavljanjem akcenata na disanje i poveća-vanje fokusiranosti u odlučujućim momen-tima kod sportista, su temelj uključivanja body&mind tehnika u njihove programe treniranja. U vrhunskom sportu ulaganja su sve veća tako da se akcenat stavlja na poboljšavanju rezultata, ali i na prevenciju povreda kao i prolongiranja vremenskog perioda u kome je sportistima znažajno održavanje vrhunskih rezultata. Pravilnom primenom i korišćenjem pilates i bodyART tehnika pospešujemo kvalitetniji, zdraviji i uspešniji dolazak do rezultata.

KLJUČNE REČI: pilates, bodyART, vrhunski sport, �eksibilnost, mobilnost

THE IMPORTANCE OF INCLUDING BODY & MIND TECHNIQUES (PILATES AND BODYART) IN PROFESIONAL, AMATEUR AND RECREATIONAL SPORTSTamara RatkovićFaculty of Physical Education and Sports Management, Singidunum University, Belgrade.


INTRODUCTION.Top-class sport requires nding the best way to get a more rational use of training in order to achieve top results. It is remarkable that quantitative training methods still have great applicability in top-notch sports. The accompanying e�ect of the quantitative training method is excessiveness which, as a consequence, often restrained and the inability to recover su�ciently from an excessive amount of load. First of all, it is necessary to avoid injury. The better and more successful sports results in the foreground set the goal and the result to be achieved, but at the same time, due to excessive load training, it often carries certain risks of injury.

AIM. How important are body & mind exercise techniques (Pilates and bodyART) in the use of top athletes training as a complementary factor in order to achieve the best possible results is the goal of this work. By using functional Pilates and bodyART training methods throughout all three planes of the body, we can improve the results while at the same time reducing the possibility of injury. By applying speci c exercises and perceiving the body as a whole, applying the right breathing technique as well as body & mind exercises, we change the focus and e�ciency of the training process. This is just one of the reasons for the application of these techniques of exercise in rehabilitation and prevention in many modern sports clubs.

INSPECTING THE CURRENT RESEARCH AND APPLICATION THROUGH PRACTICE. The inclusion of Pilates and bodyART exercises in the daily training process, aims to increase the muscle �exibility of practitioner, as well as the positive e�ect on compensatory muscular changes occurring in the body

due to the constant application of certain movement exercises as well as daily life habits. This method works to increase �exibility, coordination, strength, speed and balance as well as muscular endurance, but also to accelerate the process of recovery between training, which is very important in the life of a top athlete.

PROGRAM PROPOSAL. The duration of the time is 60 minutes, with the implementation of body & mind exercise techniques (Pilates and bodyART) in order to improve results and success in a particular sport. As well as the way of acting on improving the characteristics and possibilities of an athlete, that is, a recreational player or an amateur

CONCLUSION. Body & mind exercise techniques are increasingly being used individually for the athlete’s training process. Although strength, endurance and speed are dominant in top sport, more and more signi cance and space are given to �exibility and mobility. Not only with the aim of improving the individual results of competitors but also with the aim of preventing injuries and delaying fatigue. Putting emphasis on breathing and increasing focus at critical moments with athletes is the cornerstone of involving body & mind techniques into their training programs. In top-notch sports, investments are increasing so the emphasis is placed on improving the results, but also on the prevention of injuries and the prolongation of the time period in which athletes are characterized by the maintenance of top results. Proper use and utilization of Pilates and bodyART techniques promote a better, healthier and more successful approach to the results.

KEY WORDS: Pilates, bodyART, top sport, �exibility, mobility

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24. JAČINA STISKA ŠAKE I POSTURALNA STABILNOST KOD STARIH ŽENAMarija Trajkov¹, Ivan Ćuk2, Milivoj Dopsaj3

1 Visoka zdravstvena škola strukovnih studija u Beogradu, Beograd, 2 Fakultet za �zičku kulturu i menadžment u sportu, Univerzitet Singidunum, Beograd, 3 Fakultet sporta i �zičkog vaspitanja, Univerziteta u Beogradu, Beograd.

UVOD. Fizička aktivnost, mišićna jačina i sposobnost održavanja posturalne stabil-nosti su važni za kvalitet života u starosti. Test stiska šake je jedan od najperspektiv-nijih testova za brzu procenu zičke spo-sobnosti starije populacije. Takvi i slični testovi mogu poslužiti za procenu ranih faktora rizika za različite zdravstvene pro-bleme kod starih osoba.

CILJ. Prvi cilj ove studije bio je procena kontraktilne sposobnosti mišića šake kod zički aktivnih i sedentarnih starijih žena. Drugi cilj bio je ispitivanje povezanosti između kontraktilnih sposobnosti mišića šake i pokazatelja posturalne stabilnosti kod starijih žena.

MATERIJAL I METOD. Uzorak od 75 starijih žena (uzrasta 65-86 godina) podeljen je

na zički aktivnu i sedenternu grupu. Kon-traktilne sposobnosti mišića šake procenji-vane su Testom stiska šake (HGS) i Testom izdržljivosti stiska šake (HGE). Posturalna stabilnost (PS) je procenjena putem Modi- kovanog originalnog kliničkog testa sen-zorne interakcije u balansu, Testa oslonca na jednu nogu, Testa promene položaja („sedni i ustani“) i Testa „korak gore i pre-ko”. Razlike između grupa i testirane ruke su procenjivane putem dvostruke ANOVE, primenje odvojeno na tri različite varijable stiska šake [Maksimalna sila (Fmax), Maksi-malna brzina razvoja sile (RFDmax) i Mišićna izdržljivost ImpF50 %]. Za procenu povezano-sti između varijabli stiska šake obe ruke i varijabli posturalne stabilnosti, primenje-na je Pearsonova korelacija.

REZULTATI. Razlike između kontraktilnih sposobnosti mišića šake (RFDmax i ImpF50%) su bile u korist zički aktivnih starih žena. Razlike između zički aktivnih i sedenter-nih starih žena nisu uočene kod varijable Fmax (Slika 1). Varijable HGS and HGE testo-va pokazale su umerenu povezanost sa indikatorima posturalne stabilnosti, bez obzira na testiranu ruku (r > 0.232 < 0.391; p < 0.05).


Slika 1. Prosečne vrednosti dobijenih rezultata obe grupe testirane na dominantnoj i nedominantnoj ruci (podaci u prikazani kao srednja vrednost ± standardna devijacija)

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ZAKLJUČAK. Dobijeni rezultati mogu otvo-riti prostor za dizajniranje rutinskih HGS i HGE testova koji se lako mogu primeniti na velikom broju ispitanika. Rezultati ovih testova mogu takođe poslužiti kao poten-cijalna “prescreening” analiza kod starih osoba. To bi moglo ukazati na rane faktore rizika od padova, zajedno sa drugim zdrav-stvenim problemima starih osoba.

Ključne reči : Fizička aktivnost, Mišićna sila – Motorna kontrola – Ravnoteža – Brzina razvoja sile

HAND GRIP STRENGTH AND POSTURAL STABILITY IN OLDER WOMENMarija Trajkov¹, Ivan Ćuk2, Milivoj Dopsaj3

¹High Medical School of Professional Studies in Belgrade, Belgrade, ² Faculty of Physical Education and Sports Management, Singidunum University, Belgrade, 3 Faculty of Sport and Physical Education, University of Belgrade, Belgrade.

INTRODUCTION. Physical activity, muscle strength and the ability to maintain postural stability are important for well-being in old age. Muscle hand grip tests are one of the most promising nominees for the brief evaluation of the physical function of older population, and they could also serve as prescreening tests for early risk factors for di�erent age-related health issues.

AIM. The rst aim of this study was to assess the contractile abilities of the hand muscles in physically active and sedentary older

women. The second aim was to examine the relationship between contractile abilities of the hand muscles and postural stability indicators in older women.

MATERIAL AND METHOD. The sample of 75 randomly selected older women (aged 65–86 years), was divided into physically active and sedentary group. Contractile abilities of the hand muscles were assessed through Hand grip strength test (HGS) and Hand grip endurance test (HGE). Postural stability (PS) was assessed through Modi ed Clinical Test of Sensory Interaction on Balance, Unilateral stance test, Sit-to-stand test and Step up/over test. Di�erences between groups and tested hand was assessed by a two-way mixed-model ANOVAs, separately applied on three di�erent hand grip variables [i.e., Maximum force (Fmax), Maximum rate of force development and Muscular endurance (RFDmax) and Muscle endurance ImpF50%]. For assessment of relationships between the hand grip variables (acquired from both hands) and PS variables, Pearson correlation analysis was conducted.

RESULTS. Di�erences in the contractile abilities of the hand muscles (RFDmax and ImpF50%) were con rmed in favor of physically active women, whereas, no di�erences were found between active and sedentary older women in Fmax (Figure 1). HGS and HGE variables were moderately associated with postural stability indicators, regardless of hand dominance (r > 0.232 < 0.391; p < 0.05).


Figure 1. Averaged across subjects’ data, obtained from both subjects’ group and both hands (data showed as mean ± standard deviation)

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CONCLUSION. Obtained results could open space for designing routine HGS and HGE tests that can easily be applied to a large number of subjects. The results of these tests might also serve as potential prescreening analysis, which could indicate early risk factors for falls along with other age related health issues.

Key words: Physical Activity – Muscle – Motor Control – Balance – Rate of force development

25. BIOMEHANIČKE RAZLIKE KOD DVE TEHNIKE ČUČNJA - IMPLIKACIJE ZA REHABILITACIJU I TRENAŽNI PROCES. Aleksandar Dejanović¹, Bojana Petrovački - Dejanović¹,²¹ Vertex – Istraživači centar za primenjena nauke u zdravlju i vežbanju - Novi Sad. 2 Inistitut za zdravstvenu zaštitu dece i omladine, Odsek za neuromišićne bolesti klinike za dečiju habilitaciju i rehabilitaciju, Novi Sad.

UVOD. Duboki čučanj i polučučanj su dva najčešća oblika jačanja celog tela sa po-sebnim osvrtom na povećavanje snage donjih ekstremiteta i opružača lumbalnih ekstenzora. Izmene položaja krivine lum-balnog i cervikalnog segmenta, kolena i kuka tokom ovih tehnika menjaju kom-pletnu kinematsku interakciju između kičme i tela i mogu biti rizik za zdravstveni status kičme sa multifaktorijalnom patolo-škom slikom.

CILJ. Utvrditi razlike i veze između 8 kine-matskih parametara kod dubokog čučnja i polučučnja u krajnoj poziciji.

MATERIJAL I METOD. Selekcijom slučajnog izbora je obuhvaćeno 86 adolescenata - godine starosti, (SD) - 12.02 godine (0.394) i 64 adolescentkinje 12.02 godine (0.441)

starosti. Prosečna telesna težina (SD) - mu-škog subuzorka je 55.94 kg (13.62) a žen-skog subuzorka 50.58 kg (7.53). Telesna visina (SD) - muškog subuzorka je 164,69 cm (8.10), a ženskog 160.66 cm (5.69). Slu-čajnim izborom su formirane dve grupe; prva grupa je izvodila polučučanj (N=75) a druga – duboki čučanj (N=75). Kompletna kinematika je praćena sa 8 kamera Opti-Track sistemom Flex 13 i u MatLab R2013a softveru su analizirani svi parametri. Poseb-ni markeri su postavljeni na spinalne tačke L5, L1 i C7. Posmatrano je osam telesnih pa-rametara tokom dve tehnike čučnja u kraj-njoj poziciji: centar roatcije kolena i kuka (ATK-A i ATH-A); uglovi potkolenice i skoč-nog zgloba (SIA), potkolenice i natkolenice (TSA), natkolenice i trupa (TTA); inklinacija trupa (TIA) sa re�eksijom na lumbalni seg-ment kičme – inklinacija lumbalnog (LIA) i cervilaknog segmenta (CIA). U statističkoj obradi podataka korišćene su ANOVA i Pe-arsonov koe cijent korelacije.

REZULTATI. ANOVA je pokazala da nema značajnih razlika u izmedju muškog i ženskog pola u telesnoj masi (F=0.944; p=0.333) i telesnoj visini (F=0.594; p=0.467) ali da postoje razlike u svim ki-nematskim parametrima ove dve tehnike (p >0.001). Duboki čučanj ima pozitivnu korelaciju (r=.280; p=0.015) između varija-bli centra kuka (ATH-A) i ugla potkolenice i nadkolenice (TSA) dok je kod polučučnja u negativnoj vezi (r = -.391; p = 0.001). Tako-dje duboki čučanj negativno utiče na vezu lumbalne inklinacije (LIA) i ugla natkole-nice i potkolenice (TSA; r=-.368; p=0.001) dok kod polučučnja ona ne postoji . Du-bokim čučanj formira umerenu pozitivnu korelaciju nagiba trupa (TIA) i lumbalne inklinacije (LIA) (r = .410, p >0.001) pove-ćavajući je i menjejući sve krivine kičme što potvrđuje negativna povezanost nagi-ba trupa (TIA) i cervikalne inklinacije (r =


-.298, p >0.009). Polučučanj stvara visoku korelaciju nagiba trupa (TIA) i lumbalne inklinacije (LIA) (r = .857, p >0.000) odra-žava na cervikalnu inklinaciju bez kom-promitacije cervikalne inklinacije (CIA) (r = .092, p >0.433).

ZAKLJUČAK. Na osnovu multifaktorijalne matrice interkorelacija konstatovano je

da duboki čučanj tehnika gde dominira

većim delom pokret iz kolenskog zgloba i

�eksijom lumbalne krivine kičme poveća-

vajuć stres opterećenje na koštana i meka

tkiva što nije slučaj kod polučučanja gde

je izvor pokreta iz zgloba kuka uz očuvanu

ziološku geometriju kičme.

Tabela 1. Multifaktorijalna matrica interkorelacija ki-nemtatskih parametala tela kod tehnike polučučnja. Pirsonov koe cijent korelacije.

Tabela 2. Multifaktorijalna matrica interkorelacija ki-nemtatskih parametala tela kod tehnike dubokog čuč-nja. Pirsonov koe cijent korelacije.

Slika 1. Prikaz tehnika polučučnja i dubokog čučnja i kinematskih parametara analiziranih u radu.

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BIOMEHANICAL DIFFERENCES BETWEEN TWO SQUAT TECHNIQUES IMPLICATIONS FOR REHABILITATION AND SPORT TRAINING.Aleksandar Dejanović¹, Bojana Petrovački - Dejanović¹,²

¹Vertex – Istraživači centar za primenjena nauke u zdravlju i vežbanju - Novi Sad, 2Inistitut za zdravstvenu zaštitu dece i omladine, Odsek za neuromišićne bolesti klinike za dečiju habilitaciju i rehabilitaciju, Novi Sad.

INTRODUCTION. Deep squat and half squat are the two most common forms of strengthening the whole body, with a special emphasis on increasing the power of the lower extremities and the lumbar extensors. Changing the position of the lumbar and cervical curvature of the, knee and hips during these techniques alter the complete kinematic interaction between the spine and the body and may be a risk to the spine health status with the multifactorial pathological conditions.

AIM. To document di�erences and connections between the eight kinematic parameters of the deep and the half squat in the nal body position.

MATERIAL AND METHOD. The random selection includes 86 adolescents – Mean age, (SD) - 12.02 years (0.394) and 64 adolescents 12.02 years (0.441) of age. The mean body weight (SD) - male subset is 55.94 kg (13.62) and the female subset is 50.58 kg (7.53). The Mean body height (SD) - male subset is 164.69 cm (8.10) and female 160.66 cm (5.69). By random selection two groups were formed; the rst group performed half squat (N = 75) and the other - deep squat (N = 75). Complete kinematics was monitored with the eight motion capture cameras OptiTrack system Flex 13 and all parameters were analyzed

in MatLab R2013a software. Special markers are placed at the spinal points L5, L1 and C7. Eight physical parameters were observed during the two squatting techniques in the nal position: the center of the knee and hip rotation (ATK-A and ATH-A); hip and hip joints angle (SIA), lower legs and thighs angle (TSAs), thighs and hips (TTA); Trunk inclination angle (TIA) with re�ection on the lumbar segment of the spine - inclusion of the lumbar inclination angle (LIA) and cervical inclination angle (CIA). For statistical data analysis, ANOVA and Pearson’s correlation coe�cient were used.

RESULTS. ANOVA showed no signi cant di�erences between males and females in body weight (F = 0.944; p = 0.333) and body height (F = 0.594; p = 0.467), but there are signi cant di�erences in all kinematic parameters of these two techniques (p > 0.001). The deep squat has a positive correlation (r = .280; p = 0.015) between the variables (ATH-A) and (TSA), while the half squat has a negative relationship (r = -.391; p = 0.001). Also, deep squatting has a negative e�ect on the (LIA) and (TSA; r = - 368; p = 0.001) while in the half squat group does not exist. Deep squat form a moderate positive correlation between variables (TIA) and (LIA) (r = .410, p> 0.001), by changing all the spine curves, which is con rmed by the negative correlation between (TIA) and CIA variables (r = .298, p> 0.009). Half squat creates a high correlation between (TIA) and (LIA) (r = .857, p> 0,000) remaining the cervical inclinations intact (r = .092, p> 0.433).

CONCLUSION. The multi factorial correlation matrix document that deep squat technique where govern mainly from the knee joint, �exing the lumbar curvature into kyphotic shape and imposing high


load stress on the bone and tissues while the with half squat motion start primarily from the hip joints preserving the whole

physiological spine geometry which have more healthy bene ts when compared with deep squat form.

Table 1. Multi correlation matrix. Pearson’s correlation coe�cient . Half squat technique.

Table 2. Multi correlation matrix. Pearson’s correlation coe�cient . Deep squat technique.

Figure 1. Deep squat and half squat techniques. Kinematic angles.

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26. SPORTSKA MEDICINA – OD EKSPERIMENTALNIH ISTRAŽIVANJA DO PRIMENE U PRAKSIJakovljević Vladimir1,6, Čubrilo Dejan2, Jovanović Marina3, Srejović Ivan1, Živković Vladimir1, Jeremić Nevena4, Nikolić Turnić Tamara4, Milosavljević Isidora4, Jeremić Jovana4, Djurić Dragan5

1Katedra za Fiziologiju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Srbija2Fakultet za Sport i turizam, Univerzitet EDUCONS, Novi Sad, Srbi-ja, 3Odsek za Farmaciju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Srbija, 4Odeljenje za Internu medicinu, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Srbija4Institut za Medicinsku Fiziologiju “Rihard Burijan”, Medicinski fakultet, Univerzitet u Beogradu, Srbija, 5Katedra za Humanu Patologiju, Prvi Moskovski Državni Medicinski Univerzitet IM Sečenov, Ruska Federacija

Vežbanje povećava produkciju reaktivnih kiseoničnih (ROS) i azotnih vrsta (RONS) putem nekoliko mehanizama. Između ostalog, povećani protok krvi tokom ve-žbanja izlaže endotelne ćelije naponu smicanja, što rezultuje povećanom pro-dukcijom azot monoksida (NO). Sa druge strane, povećana potrošnja kiseonika ili hipoksija tokom vežbanja, kao i maksi-malni mišićni napor izazivaju povećanu proizvodnju ROS i RONS. Osim toga, di-namika produkcije ROS i RONS tokom vežbanja još uvek nisu dovoljno ispitane. Ovaj abstrakt predstavlja sumaciju naših nedavnih istraživanja u ovoj oblasti. Ispi-tivali smo efekte produženog bavljenja sportovima sa različitim energetskim za-htevima (aerobni, anaerobni, aerobno/anaerobni) na parametre oksidacionog stresa tokom progresivnog testa optere-ćenja. Koncentracije laktata, nitrita (NO2

-), superoksid anjon radikala (O2

-) i indeksa lipidne peroksidacije (TBARS) su određi-vane kod vrhunskih veslača, biciklista, i tekvondo boraca. Rezultati su pokazali da su svi sportisti imali sličen koncentracije laktata i O2

- u miru. Koncentracije nitrita u miru su bile najniže kod tekvodno boraca,

dok su veslači imali najviše vrednosti. Re-dosled veličine vrednosti TBARS-a u miru su bile sledeće: biciklisti > tekvondo borci > veslači. Tokom maksimalnog testa opte-rećenja koncentracije laktata su značajno porasle kod svih grupa sportista, bile su sličnih vrednosti i ostale su povišene u 4. i 10. minutu oporavka. Nije bilo statističkih razlika u vrednostima O2

-, nitrita i TBARS--a tokom maksimlanog testa opterećenja kao i tokom oporavka u odnosu na peri-od mirovanja. Naši rezultati su pokazali da dugotrajne trenažne strategije izaziva-ju različiite bazalne koncetracije nitrita i TBARS-a sportista. Međutim, progresivno vežbanje ne utiče na bazalne vrednosti ni-trita i parametara oksidacionog stresa to-kom prvih 10 minuta oporavka. Ispitivanje oksdiacionog statusa profesionalnih roni-laca je pokazalo povišene vrednosti NO2

- i TBARS-a nakon ronjenja, dok nije bilo sta-tistički značajnih razlika u vrednostima O2

-, H2O2, SOD i CAT. Pokazali smo da ronjenje ispitivanih karakteristika samo neznatno remeti redoks homeostazu, bez ozbiljnih intermolekulskih promena koje mogu da dovedu do izraženog oksidacionog stre-sa. Pored toga, naša bazična istraživanja iz ove oblasti se zasnivaju na modelu pli-vanja kao zičke aktivnosti pacova. Imali smo za cilj da ispitamo vrednosti citokina i parametara redoks statusa u krvi i srcu pa-cova podvrgnutih različitim režimima pli-vanja. Pacovi su bili svrstani u 3 grupe: 1) kontrole, 2) pacovi trenirani umerenim in-tezitetom i 3) pretrenirani pacovi. Srednji tip trenažnog protokola je izazvao sniže-nje TBARS-a u plazmi, dok su oba trenažna protokola indukovala sniženje O2

- i H2O2 u koronarnom e�uentu. Nije bilo značajnih razlika u vrednostima citokina izmedju grupa. Rezultati ove studije su potvrdili pozitivne efekte umerenog tipa treninga na sistemski i srčani redoks status pacova i pokazali da kontinuirano vežbanje, uko-liko ostane umernog stepena, ne mora da ispolji štetne efekte.


Ključne reči: sportisiti, vežbanje, reaktivne kiseonične vrste, sport, pacovi

SPORT MEDICINE – FROM BASIC INVESTIGATIONS TO APPLICATION IN PRACTICEJakovljevic Vladimir1,6, Čubrilo Dejan2, Jovanovic Marina3, Srejovic Ivan1, Zivkovic Vladimir1, Jeremic Nevena4, Nikolic Turnic Tamara4, Milosavljevic Isidora4, Jeremic Jovana4, Djuric Dragan5

1Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Serbia, 2Faculty for Sport and tourism, University EDUCONS, Novi Sad, Serbia3Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Serbia, 4Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Serbia, 5Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, Serbia, 6Department of Human Pathology, 1st Moscow State Medical University IM Sechenov, Russian Federation

Exercise increases production of reactive oxygen (ROS) and nitrogen species (RONS) via several mechanisms. Inter alia, increased blood �ow during exercise exposes endothelial cells to shear stress, resulting in increased nitric oxide (NO) production. On the other hand, increased oxygen consumption or hypoxia during exercise, as well as, maximal workload induces increased production of ROS and RONS. Furthermore, dynamics of ROS and RONS production during exercise are not fully explored. This abstract is summary of our recent investigations in this eld. We tried to examine the e�ects of long-term engagement in sports with di�erent energy requirements (aerobic, anaerobic, aerobic/anaerobic) on oxidative stress parameters during progressive exercise test. Concentrations of lactates, nitrites (NO2

-), superoxide anion radical (O2-) and

TBARS as index of lipid peroxidation were determined in plasma of top level competitors in rowing, cycling and

taekwondo. Results showed that sportmen had similar concentrations of lactates and O2

- in rest. Nitrite concentrations in rest were the lowest in taekwondo ghters, while rowers had the highest levels among examined groups. The order of magnitude for TBARS level in the rest was: bicycling > taekwondo > rowing. During exercise at maximal intensity the concentration of lactate signi cantly elevated to similar levels in all tested sportsmen and they were persistently elevated during recovery period of 4 and 10 minutes. There were no signi cant changes in O2

-, nitrite and TBARS levels neither at the maximum intensity of exercise nor during the recovery period comparing to the rest period in examined individuals. Our results showed that long term di�erent training strategies establish di�erent basal nitrite and TBARS levels in sportsmen. However, progressive exercise does not in�uence basal nitrite and oxidative stress parameters level neither at maximal load nor during the rst 10 minutes of recovery in sportsmen studied. Examination of oxidative status in scuba divers showed signi cant increases in levels of NO2

- and TBARS after the dive, while there were no statistically relevant changes in levels of O2

-, H2O2, SOD and CAT. We have shown that a dive with these characteristics only slightly disturbs redox homeostasis, without serious intermolecular changes that can lead to prominent oxidative stress. Furthermore, our basic investigations are based on a swimming model in rats. We aimed to evaluate the changes in levels of cytokines and redox state parameters in blood and isolated heart of rats subjected to di�erent swimming protocols. Rats were divided into 3 groups: 1) controls, 2) moderately trained rats and 3) overtrained rats. Moderate training protocol induced the decrease of TBARS in plasma, while both training protocols induced the decrease of O2

- and H2O2 in coronary e�uent. There was no signi cant di�erence in levels of

74


cytokines between groups. The results of study add evidence about bene cial e�ects of moderate-intensity training on blood and cardiac redox state of rats, and furthermore, shows that exercising frequently, if the intensity stays within moderate range, may not have detrimental e�ects.

Key words: athletes, exercise, reactive oxygen species, sports, rats

27. PROMENE BAZALNOG REDOKS STATUSA MLADIH FUDBALERA NAKON ŠESTOMESEČNOG TRENAŽNOG PROGRAMA Živković Vladimir, Lazarević Predrag2, Čubrilo Dejan2, Macu-ra Marija4, Jeremić Nevena5, Srejović Ivan1, Djurić Dragan6, Jakovljević Vladimir1,7

1Katedra za Fiziologiju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Srbija2Visoka Sportska i Zdravstvena škola, Beograd, Srbija, 3Fakultet za Sport i turizam, Univerzitet EDUCONS, Novi Sad, Srbija, 4Fakultet Sporta i �zičkog vaspitanja, Univerzitet u Beogradu, Srbija, 5Odsek za Farmaciju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Srbija, 6Institut za Medicinsku Fiziologiju “Rihard Burijan”, Medicinski fakultet, Univerzitet u Beogradu, Srbija, 7Ka-tedra za Humanu Patologiju, Prvi Moskovski Državni Medicinski Univerzitet IM Sečenov, Ruska Federacija

Fudbal je bez sumnje najpopularniji sport na svetu sa 265 miliona registrovanih igrača. U poređenju sa kontinuiranim ve-žbanjem, intermitentni tip zičkog napo-ra kakav se sreće u sportovima kao što su fudbal, košarka i rukomet, uključuje i aerobne i anaerobne komponente me-tabolizma. Cilj ove studije je bio da ispita bazalni redoks status mladih fudbalera, kako bi se procenili efekti šestomesečnog trenažnog programa na njihovu redoks homeostazu. Studija je obuhvatila 26 mla-dih fudbalera, starosti 12–13 godina, koji su učestvovali u šestomesečnom trena-žnom program, i 26 njihovih vršnjaka koji

se nisu bavili sportom i nisu bili podvrgnu-ti pomenutom trenažnom procesu. Uzorci krvi su bili prikupljani pre i nakon šesto-mesečnog programa treninga radi mere-nja sledećih markera oksidacionog stresa: indeksa lipidne peroksidacije (merenog kao TBARS), nitrita (NO2

–), superoksid anjon radikala (O2

–), hidrogen peroksida (H2O2), su-peroksid dizmutaze (SOD), katalaze (CAT) i redukovanog glutationa (GSH). Nakon šest meseci vrednosti TBARS-a i NO2

– su bile statistički veće, dok su vrednosti O2

– i H2O2

ostale nepromenjene. Sa druge strane, ak-tivnosti SOD i CAT su bile povećane, dok je aktivnost GSH bila snižena. Pažljivo pla-nirani program treninga može da poboljša aktivnost velikog dela antioksidacionog sistema zaštite i (osim lipidne peroksidaci-je) ne izaziva pojavu oksidacionog stresa. Ova saznanja mogu da pomognu u una-pređenju dizajniranja trening programa mladih fudbalera. Pored toga, posebna paznja se mora usmeriti ka značaju anti-oksidacione suplementacije fudbalera to-kom i nakon treninga.

Key words: antioksidacioni enzimi, fudba-leri, oksidacioni stress, trening program

CHANGES IN BASAL REDOX STATUS OF YOUNG MALE FOOTBALL PLAYERS AFTER A SIX-MONTH TRAINING PROGRAMMEZivkovic Vladimir1, Lazarevic Predrag2, Cubrilo Dejan2, Macura Marija4, Jeremic Nevena5, Srejovic Ivan1, Djuric Dragan6, Jakovljevic Vladimir1,7

1Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Serbia, 2College of Sports and Health, Belgrade, Serbia, 3Faculty for Sport and tourism, University EDUCONS, Novi Sad, Serbia, 4Faculty of Sport and Physical Education, University of Belgrade, Serbia, 5Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Serbia, 6Institute of Medical Physiology “Richard Burian”, Faculty


of Medicine, University of Belgrade, Serbia, 7Department of Human Pathology, 1st Moscow State Medical University IM Sechenov, Russian Federation

Football is without question the world’s most popular sport with 265 million registered players. When compared with continuous exercise, intermittent exercises such as sporting games (football, basketball, and handball) involve both aerobic and anaerobic metabolism. The purpose of this study was to investigate the basal redox state in young male football players, in order to estimate the e�ects of six-month training programme on their redox homeostasis. The study included 26 male football players, aged 12–13, who participated in a six-month training programme, and 26 age-matched non-athletes who were not implemented in the training process. Blood samples were collected (before and after six-month training programme) in order to measure the following oxidative stress markers: index of lipid peroxidation (measured as TBARS), nitrites (NO2

–), superoxide anion radical (O2

–), hydrogen peroxide (H2O2), superoxide dismutase (SOD), catalase (CAT) and reduced glutathione (GSH) level. After six-month, the levels of TBARS and NO2

– were signi cantly increased, while the O2

– and H2O2 remained unchanged. On the other hand, SOD and CAT activity increased, while GSH decreased. A carefully prepared training programme could improve most components of antioxidant defense systems and (except lipid peroxidation) does not promote oxidative stress. These ndings could help in the improvement of training programmes for young football players. In addition, attention should be paid to the in�uence of antioxidant supplementation on redox-balance in football players during and after the training season.

Key words: antioxidative enzymes, football players, oxidative stress, training programme

28. AKUTNI I HRONICNI EFEKTI NANDROLON-DEKANOATA NA KARDIODINAMIKU IZOLOVANOG SRCA I REDOKS STATUS TRENIRANIH PACOVANikolic Turnic Tamara1, Jevdjevic Maja2, Zivkovic Vladimir3, Srejović Ivan3, Jeremić Nevena1, Milosavljević Isidora1, Jere-mić Jovana1, Djurić Dragan4 i Jakovljević Vladimir3,5

1Odsek za Farmaciju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Srbija2Visoka skola zdravstvenih studija u Cupriji, Cuprija, Srbija 3Katedra za Fiziologiju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Srbija4Institut za Medicinsku Fiziologiju “Rihard Burijan”, Medicinski fakultet, Univerzitet u Beogradu, Srbija5Katedra za Humanu Patologiju, Prvi Moskovski Državni Medicin-ski Univerzitet IM Sečenov, Ruska Federacija

Nandrolon dekanoat (ND), anabolicki ste-roid i derivat 19-norandrosterona, koristi se kao dopunska terapija kataboličkih stanja nakon teških trauma ili teških hro-ničnih oboljenja praćenih kaheksijom je jedan od najcesce koriscenih anabolickih steroida u sportu u svetu, pa i kod nas. Cilj naseg istrazivanja je bio ispitivanje akut-nih i hronicnih efekata nandrolon-deka-noata na funkciju miokarda, koronarnu cirkulaciju i redoks status izolovanog srca treniranih i sedentarnih pacova. Studija je obuhvatila 208 pacova Wistar albino soja muskog pola koji su bili podeljeni u akutnu seriju eksperimenta (administraci-ja 1, 10, i 100 μmol/L ND) i hronicnu seriju eksperimenta (administracija 20 mg/kg/nedeljno ND s.c tokom 4 nedelje). U stu-diji su mereni parametri kardiodinamike (dp/dt max i min, SLVP, DLVP, HR i CF) kao i markeri oksidacionog stresa (O2

-, H2O2, NO,

76


TBARS) i markeri antioksidativne zastite (SOD, CAT i GSH). Rezultati ovog istrazi-vanja pokazuju znacajno smanjenje pa-rametara kontraktilnosti miokarda (dp/dt max i min) pod uticajem najvise doze ND (p<0,05). Kod treniranih pacova primetno je znacajno snizenje markera oksidacionih markera i povecanje enzima oksidativne zastite (p<0,05). Hronican tretman ND u kombinaciji sa zickim treningom indu-kuje povecanu aktivnost sistema antiok-sidativne zastite organizma, sto moze biti od klinickog znacaja narocito pri primeni visokih doza ND.

Kljucne reci: nandrolon dekanoat, oksidacio-ni stres, zicki trening, izolovano srce pacova

ACUTE AND CHRONIC EFFECTS OF NANDROLON DECANOATE ON CARDIODYNAMICS OF ISOLATED RAT HEART AND REDOX STATUS IN EXERCISED RATSNikolic Turnic Tamara1, Jevdjevic Maja2, Zivkovic Vladimir3, Srejović Ivan3, Jeremić Nevena1, Milosavljević Isidora1,

Jeremić Jovana1, Djurić Dragan4 and Jakovljević Vladimir3,5

1 Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Serbia, 2College of Health Studies in Cuprija, Bulevar Vojske bb, 35230 Cuprija, Serbia, 3Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Serbia, 4Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, Serbia, 5Department of Human Pathology, 1st Moscow State Medical University IM Sechenov, Russian Federation

Nandrolone decanoate (ND), anabolic steroid and 19-norandrosterone derivative, is used as an additional catabolic condition after severe trauma or severe chronic diseases followed by cachexia is one of the most commonly used anabolic steroids in sports in the world, including in our country. The aim of our research was to examine the acute and chronic e�ects

of nandrolone decanoate on myocardial function, coronary circulation and redox status of the isolated heart in exercised and sedentary rats. The study included 208 male Wistar albino male, divided into an acute series of experiments (administration of 1, 10, and 100 μmol / L ND) and a chronic experiment series (administration of 20 mg / kg / week ND s.c over 4 weeks). In this study we measured cardiodynamic parameters (dp/dt max and min, SLVP, DLVP, HR and CF) as well as markers of oxidative stress (O2

-, H2O2, NO, TBARS) and antioxidant protection markers (SOD, CAT and GSH). The results of this study show a signi cant reduction in the parameters of myocardial contractility (dp/dt max and min) under the in�uence of the highest dose of ND (p <0.05). In trained rats, a marked decrease in markers of oxidation markers and an increase in the oxidative protection enzyme (p <0.05) is noticeable. Chronic ND treatment in combination with physical training induces an increased activity of the antioxidant protection system of the organism, which can be of clinical signi cance especially in the application of high doses of ND.

Key words: nandrolone decanoate, oxidative stress, physical training, isolated rat hearts

29. EFEKTI DETRENINGA PLIVANJA: RAZLIKE PREMA POLUJeremic Jovana1, Dragojlovic Ruzicic Radica2, Zivkovic Vladi-mir3, Milosavljevic Isidora1, Nikolic Turnic Tamara1, Srejovic Ivan3, Jeremic Nevena1, Jakovljevic Vladimir3,4

1Katedra za Farmaciju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Srbija, 2Visoka medicinska škola Milutin Milankovic, Beograd, Srbija, 3Katedra za Fiziologiju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Srbija, 4Katedra za Humanu Patologiju, Prvi Moskovski Državni Medicinski Univerzitet IM Sečenov, Ruska Federacija


Cilj naše studije je bio da proceni polne razlike u kardiodinamici, koronarnom pro-toku i oksidacionom stresu između pacova u periodu treninga i detreninga. Studija je sprovedena na odraslim Wistar albino pa-covima oba pola (n = 80) podeljenih u 2 eksperimentalne i 2 kontrolne grupe, kao i na odgovarajuće podgrupe u zavisnosti od pola. Životinje iz eksperimentalnih grupa (n = 40), plivale su 8 nedelja po 1 sat dnevno, 5 dana u nedelji u specijalno izrađenom bazenu za pacove. Nakon osme nedelje treninga, polovina pacova (T grupa) je žr-tvovana, dok je druga polovina pacova (D grupa) bila izložena detreningu u dužini od 4 nedelje. Kontrolna grupa pacova je stavljana u vodu 3 minuta dnevno tokom 8 nedelja, kako bi se postigli isti stresni efekti izazvani vodom. Polovina njih je žrtvova-na posle 8 nedelja kao kontrola grupe za trening (TC, n = 20), a druga pola posle 12 nedelja kao kontrola detrening grupe (DC, n = 20). Srca pacova su izolovana i perfun-dovana prema Langendor�-ovoj tehnici pri postepenom povećanju koronarnog perfuzionog pritiska (40-120 cm H2O) dok su se sledeći parametri kontinuirano pra-tili: maksimalna i minimalna stopa razvoja pritiska u levoj komori, sistolni i dijastolni pritisak u levoj komori, srčana frekvenca i koronarni protok. Takođe, u koronarnom vensokom e�uentu spektrofotometrijski su određivani i markeri oksidacionog stresa: indeks lipidne peroksidacije, azot monok-sid, superoksid anjon radikal i vodonik pe-roksid. Značajne promene između pacova u periodu treninga i detreninga su prime-ćene u većini merenih parametara. Skoro svi korisni efekti treninga smanjeni su za svega 4-nedelje detreninga. Posmatrane razlike između muških i ženskih grupa nisu bile značajne.

Ključne reči: plivanje, oksidacioni stres, pa-covi, detrening, vežbanje

THE EFFECTS OF SWIMMING DETRAINING: GENDER-DEPENDENT DIFFERENCESJeremic Jovana1, Dragojlovic Ruzicic Radica2, Zivkovic Vladimir3, Milosavljevic Isidora1, Nikolic Turnic Tamara1, Srejovic Ivan3, Jeremic Nevena1, Jakovljevic Vladimir3,4

1Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia 2High Medical College of Professional Studies Milutun Milankovic, Belgrade, Serbia 3Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia4Department of Human Pathology, 1st Moscow State Medical University IM Sechenov, Russian Federation

The objective of our study was to evaluate the gender-related di�erences of cardiodynamics, coronary �ow, and oxidative stress between trained and detrained rats. Study was conducted on adult male and female Wistar albino rats (n=80) divided into 2 experimental and 2 control groups, and into subgroups depending on the gender. Animals of experimental groups, trained (T, n=20) and detrained (D, n=20), were subjected to swimming (1 hour a day, 5 days a week) in specially constructed rat swimming pool for 8 weeks. After that period, T rats were sacri ced while D rats were exposed to 4 weeks detraining period. Control group of rats were put in water for 3 minutes daily for 8 weeks, in order to achieve the same water-induced stress e�ects on rats. Half of them were sacri ced after 8 weeks as a control of training group (TC, n=20), and the other half after 12 weeks as a control of detraining group (DC, n=20). The hearts of rats were isolated and perfused according to the Langendor� technique at gradually increased coronary perfusion pressures (40-120 cm H2O) while following parameters were continuously monitored: maximum and minimum rate of pressure development

78


in the left ventricle, systolic and diastolic left ventricular pressures, heart rate and coronary �ow. Markers of oxidative stress: index of lipid peroxidation, nitric oxide, superoxide anion radical and hydrogen peroxide in the coronary venous e�uent were assessed spectrophotometrically. Signi cant changes between trained and detrained groups were observed in the most of measured parameters. These bene cial e�ects of training were reduced by 4-weeks detraining protocol. Observed di�erences between male and female groups were not signi cant.

Key words: swimming, oxidative stress, rats, detraining, exercise

30. BENEFITI TRENINGA VISOKOG INTEZITETA NA SRČANI MIŠIĆ MIŠEVA – ULOGA MIKRORNKNevena Jeremic1,2, Gregory Weber2, Nicholas Thelien2, Vla-dimir Jakovljevic3,4, Suesh Tyagi2

1Odsek za Farmaciju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Kragujevac, Srbija, 2Odsek za Fiziologiju, Univerzitet u Lujvilu, KY, SAD, 3Katedra za Fiziologiju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Kragujevac, Srbija, 4 Katedra za Humanu Patologiju, Prvi Moskovski Državni Medicinski Univerzi-tet IM Sečenov, Ruska Federacija

Studije na ljudima su pokazale da trening visokog intenziteta (High intensity inter-val training - HIIT) ima pozitivne efekte na srce. Glavni cilj ove studije je pokazati da 15 minuta HIIT-a ima zaštitne efekte na kardiovaskularni sistem u poređenju sa treningom izdržljivosti (Endurance tra-ining - ET) kod zdravih životinja. Koristile su se tri grupe miševa, uključujući seden-tarne kontrole, ET i HIIT grupe. Trenažni procesi trajali su 4 nedelje. Da bi se pro-cenili efekti vežbanja, ultrazvuk srca, krvni protok abdominalne aorte i western blot analize korišćeni su za testiranje kardio-vaskularnih razlika između grupa, kao i

oksidaciona oštećenja bojenjem DHE-om. Ejekciona frakcija je povećana u HIIT grupi u poređenju sa ET. Frakciono skraćivanje je povećano u HIIT grupi u odnosu na druge grupe. Protok krvi abdominalne aorte je povećan u obe grupe koje su bile podvrg-nute trenažnim procesima u poređenju sa kontrolom. DHE bojenje za ROS nije po-kazalo nikakve razlike između grupa koje su trenirale. Povećana je površina popreč-nog preseka. Ekspresija CMHC, CS, Musc-lin i SOD-2 u HIIT grupi bila je povećana u poređenju sa kontrolom. miR-302a, miR--320a, miR-322 i miR-181b pokazale su ra-zličitu relativnu ekspresiju u srcu i plazmi treniranih miševa. Ovi nalazi pokazuju da HIIT ima speci čne zaštitne efekte na kar-diovaskularni sistem. Povećanje ejekcione frakcije i mitohondrijalnog kapaciteta kroz promene u molekulima kao što su PGC-1α, musclin i SOD-2 i smanjenje regulacije ni-voa miRNK mogu biti osnovni mehanizam za kardioprotekciju.

Ključne reči: HIIT, ET, miRNK, musclin, srča-ni mišić

BENEFICIAL EFFECTS OF HIGH INTENSITY INTERVAL TRAINING (HIIT) ON CARDIAC MUSCLE – ROLE OF MIRNA Nevena Jeremic1,2, Gregory Weber2, Nicholas Thelien2, Vladimir Jakovljevic3,4, Suesh Tyagi2

1Department of Pharmacy, Faculty of Medical Sciences, University of Krafujevac, Kragujevac, Serbia, 2Department of Physiology, University of Louisville, KY, USA, 3Department of Physiology, Faculty of Medical Sciences, University of Krafujevac, Kragujevac, Serbia, 4Department of Human Pathology, 1st Moscow State Medical University IM Sechenov, Russian Federation

Human studies have shown high intensity interval training (HIIT) has bene cial e�ects on the heart. The main goal of this study is to show 15 minutes of HIIT has protective e�ects on the cardiovascular system compared to endurance training


(ET) in healthy and diseased animals. Three groups of mice were used, including sedentary-control, ET, and HIIT groups. Mice were 10-12 weeks old mice at the beginning of the study and were exercised for 4 weeks. To assess e�ects of exercise, heart ultrasonography, blood �ow of the abdominal aorta and Western blot analysis were utilized to test cardiovascular di�erences between groups, as well as DHE staining and Laminin 2 alpha protein staining. Ejection fraction was increased in HIITm compared to ETm. Fractional shortening was increased in HIIT group compared to other groups. Blood �ow of abdominal aorta was increased in both exercise groups compared to control. DHE staining for ROS revealed no di�erences among exercise groups. There were increases in cross-sectional area, CMHC, CS, Musclin, and SOD-2 in HIITm compared to control. miR-302a, miR-320a, miR-322 and miR-181b were altered in heart and plasma of exercised mice. These ndings indicate HIIT has speci c protective e�ects on the cardiovascular system. Increases in ejection fraction and mitochondrial capacity through changes in molecules such as PGC-1α, musclin, and SOD-2 and downregulation of upstream miRNA regulators might be an underlying mechanism for cardioprotection.

Key words: HIIT, ET, miRNA, musclin, cardiac muscle

31. FIZIČKA AKTIVNOST I ISHRANA KOD STARIJIH OSOBA KOJE ŽIVE SAMOSTALNO Simovska Vera1, Vidin Mila2

1Univerzitet MIT Skopje, Fakultet za upravljanje životnom sredi-nom, Studije za bezbednost hrane, Skoplje, Makedonija, 2Institut za reumatologiju, Beograd, Srbija

Zdravo starenje je proces razvijanja i odr-žavanja funkcionalnih sposobnosti koje

omogućavaju dobrobit starijih osoba sta-rijih od 65 godina (slika 1). Najčešći pore-mećaji vezani za ishranu, neuhranjenost i sarkopenična gojaznost (slika 2), zahteva-ju posebnu obradu nutritivnog statusa i primenu zičke aktivnosti.

Fiziološka anoreksija starenja (linearno smanjen unosa hrane) dovodi starije oso-be u visok rizik od neuhranjenosti zbog nedostatka proteina i energije (i pored re-dovne ishrane). Klinički dokazi ukazuju na to da kombinacija zičke neaktivnosti i hi-pokalorične ishrane može brzo dovesti do nedostatka proteina i energije i uticati na smanjnje bezmasne telesne mase (LBM).

Sarkopenija je sindrom koji se karakteri-še gubitkom mase i čvrstoće u mišićima i zamene mišića mastima (sarkopenična gojaznost). Najvažnija determinanta sar-kopenije je smanjenje zičke aktivnosti rezistentnog tipa. Primarna sarkopenija je direktno rezultat samog starenja, dok sekundarna sarkopenija može biti rezultat zičke neaktivnosti, bolesti i / ili nedosta-taka hranjivih materija.

Fizička aktivnost se smanjuje tokom zi-ološkog starenja. Kod starijih ljudi često postoji neaktivnost mišića i smanjen unos energije (neuhranjenost, podhranjenost, anoreksija), manje od potrošnje energije, i time gubitak skeletnih mišića. Ubrzanje gu-bitka mase kroz promenu kinetike proteina celog tela dovodi do povećane incidencije komplikacija sa lošim kliničkim ishodom.

Pošto je metabolizam proteina manje e -kasan u starenju, predloženo je da stariji povećaju unos proteina kako bi sprečili pad LBM i mišićno-skeletnog tkiva. Takođe, spe-ci čni efekti neaktivnosti uključuju smanje-ni metabolizam proteina skeletnih mišića, smanjenu iskoristljivost aminokiselina, što dovodi do disfunkcije mišića i atro je.

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Naje kasnije preventivne mere protiv funkcionalnog pada kod starijih se odnose na održavanje energetskog balansa, ade-kvatnom unosu proteina, suplmentaciji vitamina D, intenzivnim vežbama snage i posebnim suplementima koji sadrže esen-cijalne amino kiseline (EEA) / leucin.

Zahtevi proteina po kilogramu na dan se ne menjaju sa godinama tokom života od-raslih, ali smanjena energetska potrošnja sedentarnih starijih osoba znači da je od-nos proteina i energije viši nego kod mla-đe populacije. Najprikladniji odgovor na ovo je povećanje zičke aktivnosti, potro-šnje energije i posledično povećane koli-čine proteina, odnosno hrane obogaćene belančevinama.

Stopu sinteze proteina kod starijih je ma-nja nego kod mlađe populacije. Stariji su

manje sposobni da povrate gubitak LBM zbog zičke neaktivnosti. Preporučeni dnevni unos (RDA) proteina od 0,8 g/kg na dan izgleda da nije dovoljan da starije osobe održe ravnotežu azota. Prosečan zahtev za unos proteina je 0,94 g/kg na dan. Snaga mišića se može povećati sa unosom proteina preko 0,8 g/kg na dan, prosečno 1,0-1,2 g/kg na dan (40% manji gubitak mišićne mase), ali ne više od 1,5 g/kg na dan. Takođe, unošenje proteina ne bi trebalo da bude niže od 0,8 g/kg na dan za starije osobe. Potrošnja više od 45% energije u ishrani na račun proteina dovodi do mučnine i dijareje u roku od 3 dana i do smrti za nekoliko nedelja, što je stanje poznato kao “izgladnjivanje zeca”. Takođe, starijim osobama je potrebna veća potrošnja od 10-15 g/dan EAA da bi imali isti stepen sinteze mišićnih proteina

Gra kon 1: Telesna kompozicija u starenju.


kao i mlade osobe. Ovo ukazuje na to da intracelularna dostupnost amino kiselina može biti faktor koji diktira brzinu sinteze mišićnih proteina i utiče na racionalnost i mehanizam delovanja i potencijalni bla-gotvorni efekat proteinskih suplemenata.

Uzimanje hrane može sekundarno stimu-lisati sintezu mišićnih proteina zbog po-većanog oslobađanja insulina, jer insulin može direktno stimulisati sintezu mišićnih proteina i, u najmanju ruku, smanjiti razbi-janje proteina.

Naučni podaci ukazuju na to da je mišić e kasniji u korišćenju određene količine amino kiselina nakon vežbanja. Infuzija balansirane aminokiselinske mešavine na-kon vežbanja uzrokuje veliki porast sinteze neto proteina. Unos proteina tokom dana se maksimizira sinteza proteina posle veče-re. Takođe, poznato je da nedostatak vita-mina D utiče na funkcionalna ograničenja.

U zaključku: dijeta obogaćena proteinima u kombinaciji sa progresivnim treninzima

snage povećava LBM i mišićnu snagu. Sva-ka dijeta u kojoj je unos proteina ograniča-vajući, kod sedentarnih starijih osoba pred-stavlja najveći rizik od nedostatka proteina.

Iz tog razloga esencijalne aminokiseline i dodatak ugljenih hidratima u interakciji sa treningom snage smanjuju gubitak mišić-nih proteina u starenju.

Iz perspektive javnog zdravlja, razvoj pre-hrambenih proizvoda za određenu popu-lacionu grupu je veoma važan. Posebna inicijativa ima za cilj razvoj prehrambenih proizvoda koji održavaju i podržavaju nor-malne kognitivne funkcije u zdravom sta-renju i pomažu u smanjivanju cerebrova-skularnih rizika.

Stimulativni efekat aminokiselina nakon vežbanja ima direktan stimulativni efekat na brzinu sinteze mišićnih proteina i veći je od efekta kada se daje u mirovanju.

Ključne reči: starija populacija, neaktivnost mišića, metabolizam proteina, hipokalorič-na dijeta, bezmansa telesna masa (LBM).

Gra kon 2. Proces i posledice sarkopenije

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LITERATURA

Wilson MM, Morley JE. Aging and energy balance. J Appl Physiol 2003; 95:1728–36.

Ferrando AA, Lane HW, Stuart CA, Davis--Street J, Wolfe RR. Prolonged bed rest decreases skeletal muscle and whole body protein synthesis. Am J Physiol 1996; 270:E627–33.

Energy and protein requirements. Geneva, Switzerland: World Health Organization, 1985.

Paddon-Jones D, She�eld-Moore M, Ur-ban RJ, et al. Essential amino acid and carbohydrate supplementation ameliora-tes muscle protein loss in humans during 28 days bed rest. J Clin Endocrinol Metab 2004;89:4351–8.

WHO Global Strategy and Action Plan on Ageing and Health, 2016-2020.

PHYSICAL ACTIVITY AND NUTRITION IN AGEING AND INDEPENDENT LIVING Simovska Vera1, Vidin Mila2

1University MIT Skopje, Faculty for environmental resource management, Study for food safety, Skopje, Republic of Macedonia, 2Institute of Rheumatology, Belgrade, Serbia

Healthy ageing is the process of developing and maintaining the functional ability that enables well-being in older adults over 65 years (Fig. 1). The most frequent nutrition-related disorders are malnutrition and sarcopenic obesity (Fig. 2) with own etiology requiring a speci c nutrition and physical activity treatment.

-The physiologic anorexia of ageing (a linear decline in food intake) puts older adults at high risk for developing

protein-energy malnutrition (under nutrition). Clinical evidence indicates that

a combination of physical inactivity and hypo caloric nutrition may rapidly lead to protein-energy malnutrition, and a�ect regulation of lean body mass (LBM).

-Sarcopenia is a syndrome characterised by age-related loss of skeletal muscle mass and strength, and fat replaced muscle (sarcopenic obesity). The main determinant of sarcopenia appears to be the decline in resistance-type physical activities. Primary sarcopenia directly results from ageing itself, whereas secondary sarcopenia may result from physical inactivity, disease, and/or nutrient de ciencies.

Physical activity is reduced during physiologic aging. Older adults often combine muscle inactivity with a reduced energy intake (malnutrition, under nutriution, anorexia) that is below their

energy expenditure, and thus they lose skeletal muscle and fat mass. Accelerating

the loss through changes in whole-body protein kinetics leads to increased incidence of complications with a poor clinical outcome.

Because protein metabolism is less e�cient with increasing age, it has been suggested that older adults may need to increase their protein intake to prevent LBM and to prevent musculoskeletal conditions. Also, the speci c e�ects of inactivity on physiologic functions include decreased turnover of skeletal muscle proteins and impaired dietary amino acid utilization, which lead to muscle dysfunction and atrophy.


The most e�ective preventive measures against functional decline in older adults are focusing on energy balance, adequate protein intake, vitamin D-supplementation, intensive e�orts with resistance exercise and speci cally designed supplements containing essential amino acids (EEAs)/Leucine.

Protein requirements per kg per day do not change with age during adult life, but the low energy requirement of sedentary older adults means that the protein: energy ratio of their requirement is higher than for younger age groups. The most appropriate response to this is to encourage increased physical activity, energy expenditure and consequent increased food intake and protein enriched diet.

Protein needs of older adults have lower rates of protein synthesis than younger adults. The older adults are less able to recover LBM loss resulting from physical inactivity. Recommended dietary allowance (RDA) of 0.8 g/kg per day protein seems to be insu�cient for older adults to maintain nitrogen balance. The average requirement for protein intake is 0.94 g/kg per day. Muscle strength may be increased on a protein intake over 0.8 g/kg per day, average 1.0-1.2 g/kg per day (40% less loss of muscle mass), but not higher than 1.5 g/kg per day. Also, dietary intake of protein should not be lower than 0.8 g/kg per day for older adults. Consumption of more than about 45% of the dietary energy as protein led to nausea and diarrhea within 3 days and to death in a few weeks, a condition known as “rabbit

Fig-1: Body weight and composition in ageing.

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starvation”. Also, older adults need higher consumption of 10-15g/day EAAs to have the same degree of stimulation of muscle protein synthesis as their younger people. This close relation suggests that the intracellular availability of amino acids may be a factor that dictates the rate of muscle protein synthesis and therefore provides both a rationale and a mechanism of action for a potential bene cial e�ect of protein supplements.

Food intake can stimulate muscle protein synthesis secondary to an increased insulin release, because insulin can directly stimulate muscle protein synthesis and, to at least some extent, decrease protein breakdown.

Scienti c data indicate that muscle is more e�cient at utilizing a given amount of amino acid after resistance exercise. The infusion of a balanced amino acid mixture after exercise causes a large increase in net protein synthesis. Protein intake over the day to maximize protein synthesis is after dinner. Also, it’s known that vitamin D de ciency a�ected functional limitation.

In conclusion: Protein enriched diet combined with progressive resistant training enhances LBM and muscle strength. For any diet in which protein intake is likely to be limiting, sedentary older adults are the population group most at risk from protein de ciency.

From that reason, essential amino acid and carbohydrate supplementation in the interaction with the resistant exercise make improvement to muscle protein loss in ageing.

From public health perspectives, the development of population-targeted food products is high important. Particular initiative aims to develop dietary products that maintain and support the normal cognitive function in healthy aging and to help reduce cerebrovascular risks.

Stimulatory e�ect of amino acids after exercise has a direct stimulatory e�ect on the rate of muscle protein synthesis and it’s greater than the e�ect when given at rest.

Key words: older adults, muscle inactivity, protein metabolism, hypo caloric diet, lean body mass (LBM).

Fig-2. Ageing - Process and Consequences related to Sarcopenia


References:

Wilson MM, Morley JE. Aging and energy balance. J Appl Physiol 2003; 95:1728–36.

Ferrando AA, Lane HW, Stuart CA, Davis-Street J, Wolfe RR. Prolonged bed rest decreases skeletal muscle and whole body protein synthesis. Am J Physiol 1996; 270:E627–33.

Energy and protein requirements. Geneva, Switzerland: World Health Organization, 1985.

Paddon-Jones D, She�eld-Moore M, Urban RJ, et al. Essential amino acid and carbohydrate supplementation ameliorates muscle protein loss in humans during 28 days bed rest. J Clin Endocrinol Metab 2004;89:4351–8.

WHO Global Strategy and Action Plan on Ageing and Health, 2016-2020.

32 . ZASTUPLJENOST BENIGNIH EKG PROMENA KOD MLADIH SPORTISTA SA TERITORIJE VOJVODINE U ODNOSU NA PRIPADNOST DOMINANTNO AEROBNIM ILI ANAEROBNIM SPORTOVIMAAndrić Lana1, Karan Vedrana2, Bogdan Maja2, Slavić Dani-jel2, Rakovac Aleksandra2, Radulović Nikola3, Klašnja Alek-sandar2 1Dom zdravlja Bečej, Služba za zdravstvenu zaštitu dece i žena, Odeljenje za zdravstvenu zaštitu školske dece, 2Univerzitet u Novom Sadu, Medicinski fakultet Novi Sad, Katedra za �ziologiju, 3Univerzitet u Novom Sadu, Fakultet sporta i �zičkog vaspitanja

UVOD: Poslednjih godina akcenat posto-ji na analizi elektrokardiografskih (EKG) zapisa kod sportista, u svrsi preciznijeg

razgraničenja normalnih od abnormalnih nalaza. Kriterijumi za EKG interpretaciju su unapređeni i sadrže detaljne preporu-ke o čestim i ziološkim entitetima, kao i o onim koje je neophodno dalje dijagno-stički ispitati.

Cilj ovog istraživanja bio je da ispita zastu-pljenost benignih EKG promena u odnosu na bavljenje pretežno aerobnim, odnosno, anaerobnim sportovima.

METODOLOGIJA: U istraživanje je uključe-no 77 mladih sportista iz više grana sporta, razvrstanih u dve grupe na osnovu domi-nantnih metaboličkih zahteva sporta. Za analizu EKG-a korišćen je metod vizuelne inspekcije, rukovodeći se Internacional-nim kriterijumom.

REZULTATI: Grupe se nisu razlikovale po pitanju prosečnih, minimalnih i maksi-malnih vrednosti srčane frekvencije, a homogene su bile u odnosu na učestalost sinusne bradikardije, sinusne aritmije, AV bloka I stepena, inkompletnog bloka de-sne grane (IBDG), QRS voltažnog kriteri-juma za hipertro ju leve komore (HLK) i benigne rane repolarizacije (BRR). Grupe su bile homogene i kada je analiziran broj EKG promena po pojedincu. Pozitivan QRS voltažni kriterijum za HLK javljao se najče-šće kod fudbalera, biciklista i triatlonaca, IBDG u fudbalu i košarci, a BRR u fudbalu i džudou. U obe grupe učestalost javljanja IBDG i BRR odgovara prijavljenim vredno-stima u postojećoj literaturi, dok su ostale promene zastupljene u manjoj meri.

ZAKLJUČAK: Naši rezultati pokazuju da nema razlike u zastupljenosti benignih EKG promena između sportista koji se bave dominantno aerobnim i dominantno anaerobnim sportovima.

Ključne reči: sport, ziološki EKG, skrining

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BENIGN ECG CHANGES IN YOUNG ATHLETES FROM VOJVODINA IN RELATION TO ENGAGEMENT IN DOMINANTLY AEROBIC OR ANAEROBIC SPORTSAndrić Lana1, Karan Vedrana2, Bogdan Maja2, Slavić Danijel2, Rakovac Aleksandra2, Radulović Nikola3, Klašnja Aleksandar2 1Health Center Becej, Department of Women and Children’s Health Care, Section for School Children’s Health Care, 2University of Novi Sad, Faculty of Medicine Novi Sad, Department of Physiology, 3University of Novi Sad, Faculty of Sport and Physical Education

INTRODUCTION: In recent years the analysis of electrocardiographic (ECG) ndings in athletes has been highlighted in order to precisely demarcate normal from abnormal ECGs. ECG interpretation criteria have been upgraded and contain thorough recommendations about frequent and physiological entities, as well as of ones that require further diagnostics.

The goal of this research was to inspect the existence of benign ECG changes in regard to participation in dominantly aerobic and anaerobic sports, respectively.

METHODOLOGY: Seventy seven young athletes from multiple sport branches participated in this research. They were divided in two groups according to dominant metabolic needs of sport. Visual inspection method was used for ECG analysis, following the International criteria.

RESULTS: There were no di�erences between groups in average, minimal and maximal heart rate. Groups were homogenous in relation to occurrence of sinus bradycardia, sinus arrhythmia, rst degree AV block, incomplete right bundle branch block (IRBBB), QRS voltage criteria for left ventricular hypertrophy (LVH) and

benign early repolarization (BER). The groups were also homogenous when the frequency of changes in an individual was inspected. Positive QRS voltage criteria for LVH was mostly seen in soccer, cycling and triathlon; IRBBB in soccer and basketball and BER in soccer and judo. In both groups the rate of IRBBB and BER ndings matches the one from literature data, while other changes were present in lesser extent.

CONCLUSION: Our results show the lack of di�erences in benign ECG changes between athletes participating in dominantly aerobic and anaerobic sports, respectively.

Key words: sport, physiologic ECG, screening

33. UPOTREBA DODATAKA ISHRANI MEĐU REKREATIVNIM SPORTISTIMAMirjana Đermanović1,2, Lj.Bojanić1,2 1 Institut za javno zdravstvo, Banja Luka, 2 Medicinski fakultet - Studijski program Farmacija, Univerzitet u Banjoj Luci

Uvod: Sportisti su prema podacima istraži-vanja najveći potrošači dodataka ishrani. Upotreba dodataka ishrani danas je sasta-vni dio strategije za postizanje što boljih sportskih rezultata. Odluka o korištenju ovih proizvoda donosi se uglavnom uz konsulta-ciju sa trenerom ili instruktorom, a mnogo rjeđe u donošenje ovih odluka uključeni su i zdravstveni radnici, ljekari ili farmaceuti.

Metodologija: Pomoću ankete provede-no je istraživanje o tome koji su najčešće korišteni dodaci ishrani kod rekreativnih sportista. Anketu je popunilo 50 ispitani-ka. Anketa je bila anonimna, a sadržavala je pitanja zatvorenog i otvorenog tipa.

Rezultati: Podaci prikupljeni anketiran-jem prikazuju najčešće korištene dodatke ishrani među rekreativnim sportistima. Rezultati pokazuju da je od 50 ispitanika


82% koristilo bar jedan dodatak ishrani. Od toga, najčešće upotrebljavani su pro-teinski preparati (54%), zatim sportski na-pici, gelovi, barovi (20%), multivitaminski proizvodi (12%), kreatin (7%), sagorjevači masti (2%), antioksidansi (2%), te neki dru-gi dodaci ishrani (3%).

Zaključak: Veliki broj sportista upotreblja-va dodatke ishrani. Upotreba dodataka ishrani je konstantno u porastu, kako kod profesionalnih, tako i kod rekreativnih sportista. S obzirom na navedeno, izuzet-no je značajno da njihova upotreba bude racionalna i bezbijedna. Osim pozitivnih efekata moguća je i pojava neželjenih dejstava koja mogu štetno da djeluju na zdravlje sportista. Sve ukazuje za potrebu dodatne edukacije sportista od strane me-dicinskih radnika sa ciljem pravilne a rma-cije ergogenih efekata dodataka ishrani. Svakako ne treba zanemariti ni individu-alizaciju potreba za suplementacijom kod ove grupe ispitanika.

Ključne riječi: dodaci ishrani, sportisti, upotreba

USE OF FOOD SUPPLEMENTS AMONG RECREATIONAL ATHLETESMirjana Đermanović1,2, Lj.Bojanić1,2

1 Public Health Institute of the Republic of Srpska, Banja Luka, 2 Department for Pharmacy, Medical faculty, University in Banja Luka

Introduction: According to research, athletes are the biggest consumers of food supplements. The use of food supplements today is an integral part of the strategy for achieving the best possible sports results. The decision to use these products is made mainly by consulting to a trainer or instructor, but healthcare workers, doctors or pharmacists are rarely involved in making these decisions.

Methodology: A questionnaire on the most commonly used food supplements was lled out by recreational athletes. The survey was conducted among 50 respondents and it was anonymous and contained questions of closed and open type.

Results: Collected data show the most frequently used food supplements among recreational athletes. The results show that 82% respondents used at least one food supplement. Of this, most commonly used are protein products (54%), then sports drinks, gels, bars (20%), multivitamin products (12%), creatine (7%), fat burners (2%), antioxidants (2%) , and some other food supplements (3%).

Conclusion: A large number of athletes use food supplements. The use of food supplements is constantly increasing, both for professional and recreational athletes. In view of this, it is extremely important that its use is rational and safe. Apart from positive e�ects, it is possible to have side e�ects that can adversely a�ect the health of athletes. Everything points to the need for additional education of athletes by medical workers in order to properly a�rm the ergogenic e�ects of food supplements. Certainly, it is not necessary to neglect the individualization of the need for supplements in this group of consumers.

Keywords: food supplements, athletes, use

34. KVALITET DODATAKA ISHRANI NAMIJENJENIH SPORTISTIMA Mirjana Đermanović1,2 Lj. Bojanić1,2

1 Institut za javno zdravstvo, Banja Luka, 2 Medicinski fakultet, Studijski program Farmacija, Univerzitet u Banjoj Luci

Uvod: Dodaci ishrani su namirnice koje do-punjuju normalnu ishranu i predstavljaju

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koncentrovane izvore vitamina, minerala ili drugih supstanci sa hranljivim ili ziolo-škim efektom, pojedinačno ili u kombina-ciji, a u prometu su u doziranim oblicima, dizajnirani da se uzimaju u odmjerenim pojedinačnim količinama (kapsule, table-te, kesice praška, ampule tečnosti, i dr). Spisak svih ziološki aktivnih sastojaka mora biti praćen informacijom o njihovom sadržaju izraženom na 100 g ili 100 ml pro-izvoda kao i na jedan preporučen obrok ili jednu preporučenu dozu kada je odgova-rajuće. Analiza kvaliteta dodataka ishrani je važna s obzirom na rasprostranjenost njihove upotrebe u današnje vrijeme. Cilj je bio je da se utvrdi kvalitet dodataka is-hrani, određivanjem sadržaja proteina u ispitivanim uzorcima i poređenjem sa de-klarisanim vrijednostima.

Metodologija: Analizirano je 20 dodataka ishrani na bazi protein namijenjenih spor-tistima. Određivanje makronutrijenata u ovom slučaju sadržaja proteina vršeno je metodom BAS ISO 1871:2012. Sva odre-đivanja rađena su u duplikatu, a korišteni reagensi su bili p.a. čistoće. Nakon toga dobijene vrijednosti su poređene sa po-dacima koji su bili navedeni na deklaraciji ispitivanih uzoraka.

Rezultati: Deklarisani sadržaj proteina u ispitivanim uzorcima bio je u rasponu od 80% do 100%. Hemijskom metodom sa-držaj proteina koji je određen metodom BAS ISO 1871:2012 kretao se u opsegu od 67% do 98%. Dobijeni rezultati ukazuju na zadovoljavajući kvalitet većine ispitanih proizvoda. Odstupanja sadržaja proteina bila su u skladu sa mjernom nesigurno-šću metode, koja je određena korištenjem Nord testa, kao i dozvoljenim odstupanji-ma od deklarisanih vrijednosti. Tri uzorka imala su sadržaj proteina daleko niži od deklarisanog, što upućuje na problem sa kvalitetom ovih proizvoda.

Zaključak: Dodaci ishrani su proizvodi koji su lako dostupni, izdaju se i proda-ju bez ljekarskog recepta, tako da njiho-va upotreba konstantno raste kod nas, ali i u čitavom svijetu. Kontrola kvaliteta ovih proizvoda vrlo često je prepuštena odgovornosti proizvođača i često sastav proizvoda koji je deklarisan ne odgovara sastavu samog proizvoda. Veliki broj spor-tista koristi dodatke ishrani i upravo iz tog razloga potrebno je vršiti kontrolu njiho-vog kvaliteta. Osim toga da deklarisani sa-stav treba odgovarati i stvarno prisutnom sastavu proizvoda s ciljem pružanja ade-kvatnih informacija potrošačima, potreb-no je vršiti i kontrolu prisustva nedozvo-ljenih supstanci (npr.doping agensi), a sve sa ciljem da upotreba dodataka ishrani u populaciji sportista bude racionalna, bez-bijedna i kontrolisana.

Ključne riječi: dodaci ishrani, sportisti, de-klarisanje, proteini

QUALITY OF FOOD SUPPLEMENTS INTENDED FOR ATHLETESMirjana Đermanović1,2, Lj.Bojanić1,2

1 Public Health Institute of the Republic of Srpska, Banja Luka, 2 Department for Pharmacy, Medical faculty, University in Banja Luka

Introduction: Food supplements are products intended for supplementation of normal nutrition and represent concentrated sources of vitamins, minerals or other substances with a nutritional or physiological e�ect, individually or in combination, and are marketed in dosage forms, designed to be taken in measured individual amounts (capsules, tablets, powder bags, liquid ampoules, etc). A list of all physiologically active ingredients must be declared together with the information on their content expressed per 100 g or 100 ml of the product as


well as one recommended meal or one recommended dose when appropriate. The quality of food supplements is important considering the prevalence of their use. The aim was to determine the quality of food supplements, determining the protein content of the samples tested and compare it with the declared values.

Methodology: 20 food supplements based on proteins intended for athletes were analyzed. Determination of protein content was performed using the method BAS ISO 1871: 2012. All determinations were made in duplicate, and the used reagents were p.a. cleanliness. Subsequently, the obtained values are compared with the declaration of tested samples.

Results: The declared protein content ranged from 80% to 100%. Determined protein content ranged from 67% to 98%. The obtained results indicate the satisfactory quality of the tested products. Deviation of determined protein content was in accordance with the measurement of uncertainty of the method, which was determined using the Nord test, and allowed deviations for declared values. The three samples had protein content much lower than the declared value, which indicates the problem with the quality of these products. Conclusion: Food supplements are products that are easily accessible, issued and sold without a prescription, so its use is constantly increasing in our country, as well as elsewhere in the world. The quality control of these products is often left to the manufacturers’ responsibility and often the declared composition does not correspond to the the product itself. A large number of athletes use food supplements, and for this reason it is necessary to control their quality. Apart from the fact that the declared composition should correspond

to the real product composition in order to provide an adequate information to consumers, which was the aim of this study, it is necessary to control the presence of unauthorized substances (eg, doping agents), all with the aim of rational, safe and controlled use of food supplements among the athlete population.

Keywords: food supplements, athletes, declaration, proteins

35. UTICAJ GVOŽĐA NA OKSIDACIONI STRES I ANTIOKSIDANTNU AKTIVNOST VITAMINA C U AKUTNOM FIZIČKOM OPTEREĆENJULjiljana M. Popović, Nebojša R Mitić 1 Institut za Pato�ziologiju,Univerzitet u Prištini, Medicinski fakultet ( K.Mitrovica), Srbija

Uvod. Suplementacija vitaminom C pred-stavlja moćno sredstvo u borbi protiv de-lovanja slobodnih radikala. Međutim on, pod određenim uslovima, može biti i izra-zito jak prooksidans čije se prooksidantno dejstvo bazira na recikliranju jona metala sa promenljivom valensom do oblika po-godnog da katalizuje Fenton-ovu i Haber--Weissov-ovu reakciju. U tom kontekstu su posebno značajni joni gvožđa čiji ne-dostatak predstavlja najčešći mikronutri-jentni de cit kod sportista. Ovo stanje di-rektno utiče na sportske performanse pa suplementaciju preparatima gvožđa čini poželjnom, a nisu retke ni zloupotrebe.

Cilj. Cilj ovog istraživanja je bio da se u in vitro uslovima ispita uticaj gvožđa na ok-sidacioni stres i antioksidantnu aktivnost vitamina C u uslovima jednokratne inten-zivne zičke aktivnosti.

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Asc (μM/L)

DHA (μM/L)

A (μM/L)

DHA/A MDA (mM/L)

MDA ind (mM/L)

% ind MDA (%)

Pre suplementacije vitaminom C

Bazalne vrednosti 55,70 31,60 24,13 1,62 3,04 4,60 35

Nakon testa opterećenja 67,37 42,20 25,17 2,05 4,40 5,71 24,71

p p<0,0001 p=0,0014 p<0,0001 p=0,0006 p=0,0003

Nakon suplementacije vitaminom C

Bazalne vrednosti 98,57 57,80 40,77 1,68 2,12 3,19 35,33

Nakon testa opterećenja 114,97 72,63 42,33 2,07 2,78 4,09 33,39

p p<0,001 p=0,004 p<0,0001 p=0,0004 p=0,4

Materijal i Metodologija. 30 sedentarnih ispitanika je sprovodilo test opterećenja (Bruce-Treadmil protocol) pre i nakon suple-mentacije vitaminom C (2g dnevno per os, 14 dana). U svim fazama ispitivanja odre-đivani su parametri lipidne peroksidacije (MDA, MDA ind, %ind MDA) i status askor-

binske kiseline (askorbinska kiselina-Asc, askorbat-A, dehidroaskorbat-DHA i DHA/A). Indukovani MDA i %ind MDA predstavljaju pokazatelje uticaja gvožđa na proces lipidne peroksidacije (u in vitro uslovima).

Rezultati.

Zaključak. Rezultati ukazuju da u prisu-stvu soli gvožđa značajno raste vrednost indukovanog MDA i % ind MDA u svim fazama ispitivanja. Vrednost ovih para-metara je bila značajno veća nakon suple-mentacije vitaminom C, sugerišući njego-vo prooksidativno dejstvo u novonastalim uslovima (u kombinaciji sa gvožđem).

Ključne reči: askorbinska kiselina, gvožđe, oksidacioni stres, zička aktivnost

THE INFLUENCE OF IRON ON OXIDATIVE STRESS AND THE ANTIOXIDANT ACTIVITY OF VITAMIN C IN ACUTE EXERCISE

Ljiljana M. Popović1, Nebojša R Mitić1 1 Department of Pathophysiology, University of Pristina, Medical school (situated in K.Mitrovica), Serbia

Introduction. Vitamin C supplementation is a powerful tool against the action of free radicals. However, under certain circumstances, it can also be an extremely strong prooxidant whose protoxidant e�ect is based on the recycling of a metal ion with a variable valence to a form suitable for catalyzing Fenton and Haber-Weiss reaction. In this context, particularly important are iron ions whose absence is the most frequent micronutrient de ciency in athletes. This condition directly a�ects sports performance, making the iron supplementation desirable, but its abuse is also not rare.

Aim. The aim of this study was to investigate, in in-vitro conditions, the in�uence of iron on oxidative stress and the antioxidant activity of vitamin C under conditions of one-time intense physical activity.


Conclusion. The results indicate that, in the presence of iron salts, the value of induced MDA and %ind MDA in all stages of the study signi cantly increased. The values of these parameters were signi cantly higher after vitamin C supplementation, suggesting its prooxidative e�ect in new circumstances (in combination with iron).

Key words: ascorbic acid, iron, oxidative stress, physical activity

36. UTICAJ JEDNOKRATNOG INTENZIVNOG FIZIČKOG OPTEREĆENJA NA PROMENU ACIDOBAZNOG STATUSA I GASNIH ANALIZA Nebojša R Mitić, Ljiljana M. Popović1 Institut za Pato�ziologiju,Univerzitet u Prištini, Medicinski fakultet ( K.Mitrovica), Srbija

Uvod. Fizička sposobnost i kondicija spor-tista predstavljaju limitirajući faktor na nji-hovom putu ka uspehu, pa se kao logično nameće pitanje proučavanja parametara koji de nišu ta ograničenja. Količina do-stupnog kiseonika zavisi od zadovolja-vajuće kardio-respiratorne adaptacije i predstavlja osnovni ograničavajući fak-tor u generisanju energije. Mehanizmi koji dovode do nagle promene vrednosti parcijalnih pritisaka gasova i parametara acido-baznog statusa u arterijskoj krvi, tokom i nakon zičkog opterećenja, su kompleksni i predstavljaju važne činioce očuvanja homeostaze.

Cilj. Cilj ovog istraživanja bio je da se is-pita uticaj jednokratne intenzivne zičke aktivnosti na promenu parametara acido-baznog statusa i gasnih analiza kod neu-treniranih osoba.

Materijal i Metodologija. U ispitivanju je učestvovalo 30 sedentarnih ispitanika

Asc (μM/L)

DHA (μM/L)

A (μM/L)

DHA/A MDA (mM/L)

MDA ind (mM/L)

% ind MDA (%)

Before vitamin C supplementation

Basal values 55,70 31,60 24,13 1,62 3,04 4,60 35

After BTP 67,37 42,20 25,17 2,05 4,40 5,71 24,71

p p<0,0001 p=0,0014 p<0,0001 p=0,0006 p=0,0003

After vitamin C supplementation

Basal values 98,57 57,80 40,77 1,68 2,12 3,19 35,33

After BTP 114,97 72,63 42,33 2,07 2,78 4,09 33,39

p p<0,001 p=0,004 p<0,0001 p=0,0004 p=0,4

Material and Methodology. 30 sedentary subjects performed a Bruce-Treadmill protocol (BTP) before and after vitamin C supplementation (2 g daily per os, 14 days). The parameters of lipid peroxidation (MDA, MDA ind, %ind MDA) and ascorbic acid status (ascorbic acid-Asc, ascorbate-A,

dehydroascorbate-DHA and DHA/A) were determined at all stages of the study. The iron e�ects on the lipid peroxidation process (in in vitro conditions) were calculated by induced MDA and %ind MDA.

Results.

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kod kojih je jednokratno intenzivno zič-ko opterećenje sprovedeno u skladu sa Bruce-Treadmil protokolom. Iz uzoraka arterijske krvi, uzete pre i nakon testa op-terećenja, određivani su parametri acido-

baznog statusa (pH, HCO3, HCO3st, BE, BB) i parametri gasnih analiza (PaCO2, PaO2, O2sat, CO2tot).

Rezultati.

pH HCO3 (mM/L)

HCO3st (mM/L)

BE (mM/L)

BB (mM/L)

PaCO2 (mmHg)

PaO2 (mmHg)

O2sat CO2tot (mM/L)

B 7,41 24,78 24,58 0,79 47,96 40,01 83,69 95,87 25,97

O 7,33 18,53 19,23 -5,34 40,82 35,46 79,78 94,16 19,60

p p=0,0003 p<0,0001 p<0,001 p=0,0006 p<0,0001 p=0,0002 p=0,07 p=0,55 p<0,0001

B-Bazalna vrednost, O- Nakon testa opterećenja

Zaključak. Dobijeni rezultati ukazuju da jednokratna intenzivna zička aktivnost dovodi do pada vednosti pH u arterijskoj krvi i do nastanka acidoznog poreme-ćaja. Pad koncentracije HCO3, BB i porast BE ukazuju na metaboličku komponentu ovog poremećaja. Značajan pad PaCO2 u krvi nastaje kao rezultat kako kompenzan-torne hiperventilacije tako i uključivanja bikarbonatnog puferskog sistema u ko-rekciju acidobaznog poremećaja.

Ključne reči: acidobazni status, gasne analize, zička aktivnost

THE EFFECT OF ONE-TIME INTENSIVE PHYSICAL EXERCISE ON ACID-BASE STATUS AND BLOOD GAS ANALYSISNebojša R Mitić, Ljiljana M. Popović1 Department of Pathophysiology, University of Pristina, Medical school (situated in K.Mitrovica), Serbia

Introduction. The physical performance is limiting factors for athlete’s sport achievements, so extensive researches of parameters that de ne these constraints are necessary. The amount of available

oxygen delivery depends on adequate cardio-respiratory adaptation and this process is the basic limiting factor for energy production. Mechanisms involved in rapid change of gas partial pressures and parameters of the acid-base status in arterial blood, during and after physical exercise, are complex and directly a�ect the homeostasis processes.

Aim. The aim of this study was to examine the e�ect of one-time intense physical activity on the parameters of acid-base status and blood gas analyzes in untrained individuals.

Material and Methodology. The study involved 30 sedentary subjects. One-time intensive physical exercise was performed in accordance with the Bruce-Treadmill protocol. Parameters of the acid-base status (pH, HCO3, HCO3st, BE, BB) and parameters of blood gas analysis (PaCO2, PaO2, O2sat, CO2tot) were determined from arterial blood samples taken before and after the exercise test.


Conclusion. The obtained results indicate that one-time intense physical activity leads to the decrease of the pH value in the arterial blood and the acidosis disorder. The decrease in BB and HCO3 concentration and the increase of BE indicate the metabolic component of this disorder. A signi cant decrease in PaCO2 is the result of compensatory hyperventilation as well as the inclusion of the bicarbonate bu�er system in the correction of this acidosis disorder.

Key words: acid-base status, blood gas analysis, physical activity

37. POVREDE AHILOVE TETIVE KOD SPORTISTA-FIZIKALNI TRETMAN I LIJEČENJEVukosav Joksimović 1., Marija Joksimović 2,Slavko Tomić 3

1Opšta bolnica Berane,Crna Gora, 2Dom zdravlja Berane,Crna Gora, 3Institut za ortopediju Banjica, Beograd,Srbija

Uvod: Povrede Ahilove tetive predstavlja-ju jednu od najčešćih povreda mišićno--tetivnog aparata u sportu i to u indivi-dualnim: skijanje, gimnastika, tenis ali i u ekipnim: fudbal, košarka, rukomet. Češće su kod muškaraca nego kod žena u odno-su 3:1.Najčešće se javljaju u trećoj i četvtoj deceniji života, gdje važnu ulogu igraju starenje i degenerativne promjene, javlja-ju se kod mladjih sportista ali i rekreativa-

ca. Rupture su češće na strani suprotnoj od dominantne: desne kod ljevaka i obr-nuto.Obostrane rupture se vidjaju kod 25-30% slučajeva, mali broj ruptura nastaje direktnim dejstvom sile na tetivu,dok ve-ćina nastaje indirektnim djelovanjem sile.

Cilj rada: Želimo da istaknemo značaj zi-kalnog tretmana u liječenju povreda Ahi-love tetive kod sportista

Materijal i metode: Ispitivanje je sprove-deno u Službi zikalne medicine u Berana-ma u periodu 2010.-2017.godine.

Rezultati: U pomenutom periodu liječe-no je 18 pacijenata sa različitim stepenom oštećenja Ahi-love tetive. Sve povrede su nastale na sportskim terenima.Prosječna starost pacijenta bila je 31,2 godina. U od-nosu na pol 15 (83,33%)bilo je muškog,a 3(16,66%)ženskog pola.Nakon sprovede-nog hiruškog tretmana započeto je liječe-nje zičkim agensima: UZ 1W/cm2 5 minuta u seriji od 10 puta,Sonoforeza Diklofena 0,5 W/cm2 5 minuta u seriji od 10 puta,EF I KJ Novokaina 20 mi-nutau seriji od 10 puta-,manuelna masaža 15 minuta u seriji od 10 puta, Kineziterapija. Nakon ovako sprove-denog zikalnog tretmana otok je sasvim regredirao, nestala je palpatorna bolna osjetljivost u predjelu Ahilove tetive,a ta-kođe došlo je do punog oporavka u smislu obima pokretljivosti. Po završetku prve se-rije kod 8 (44,44%) došlo je do značajnog

Results.

pH HCO3 (mM/L)

HCO3st (mM/L)

BE (mM/L) BB (mM/L) PaCO2 (mmHg)

PaO2 (mmHg)

O2sat CO2tot (mM/L)

B 7,41 24,78 24,58 0,79 47,96 40,01 83,69 95,87 25,97

O 7,33 18,53 19,23 -5,34 40,82 35,46 79,78 94,16 19,60

p p=0,0003 p<0,0001 p<0,001 p=0,0006 p<0,0001 p=0,0002 p=0,07 p=0,55 p<0,0001

B-Basal value, O- After exercise test

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poboljšanja kod 7(38,88 %) bilo je potreb-no ponoviti još jednu seriju od 10 dana,kod 3 (16,66%) pacijenata i treću seriju.

Zaključak: Na osnovu postignutih rezultata zaključujemo da blagovremeno sprovede-na zikalna terapija u adekvatnim serijama-,nakon operativnog liječenja je metoda iz-bora u liječenju povreda Ahilove tetive kod sportistaSamo ovakvim načinom liječenja povrijedjeni se mogu i dalje baviti sport-skim aktivnostima.

Ključne riječi: zikalni tretman,Ahilova te-tiva,povrede,sportisti,bol…

THE INJURIES OF THE ACHILLES TENDON AT THE ATHLETES - THE PHYSICAL TREATMENT AND CURING Vukosav Joksimovic1, Marija Joksimovic2,Slavko Tomic3

1General Hospital in Berane,Montenegro, 2Health Centre in Berane,Montenegro, 3Institute for Orthopedics Banjica,Belgrade,Serbia

Introduction:the Achiles tendon injuries are one of the most common injuries of the musculosceletal apparatus the sport,in individual:skiing,gymnastic,tennis,but also in the team:footbal,basketball,handbal.They are more commom in men than in women in ratio of 3:1.Most often occurin in the third and fourth decade of life,where aging and degenerative changes play an important role,they appearin in young athletes as well as in recreational players.Ruptures are more often on the opposite side than the dominant;the left side of the left and vice versa.Obstructive rupture is seen in 25-30% of cases,a small number of ruptures is created by the direct e�ect of force on the tendon,while the majority is caused by the indirect e�ect of force.

Objective: We want to emphasize the importance of physical treatmen in the treatmen of Achilles tendon injury to athletes.

Material and methods;The study was conducted in the Physical Medicina Service in Berane in the period from 2010 to 2017.

Results: In the mentioned period,18 patients with varying degrees of damages to the Achilles tendon were treated.All injuries were caused in sports courts .The average age of the patient was 31.2 years. In relation to 15 (83.33%) men, and 3 (16.66%) of the female sex.After the surgical treatment,the treatment was initiated with phusical agents:UZ 1W/cm2 for 5 minutes in a series of 10 times,Sonoforeza Diclofen 0,5W/cm2 for 5 minutes in a series of 10 times,EF and KJ Novokain 20 minutes of series of 10 times,manual massage 15 minutes in a 10-fold series, Kinesiotherapy. After this physical treatmen, then island regaled completely, palpatory pain sensitivity disappeared in the Achilles tendon area, and there was also a full recovery in terms of mobility.After completing the rst series in 8(44.44%), there was a signi cant. Improvements, but at 7 (38.88%) patients had to repeat another 10-day series and at 3 (16.66%) patients and them third series.

Conclusion: Based on the a chieved results,we conclude that timely physical therapy in a dequate batches,after surgical treatment,is a method of choosing to treat Achilles tendon injuries to athletes .Only with this kind of treatment the injuried can continue to deal with sports activites.

Key words:physical treatment, Achilles tendon, injuries, pain.


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Murphy, K., Travers, P., Walport, M. and Janeway, C. (2008). Janeway’s immunobiology. New York: Garland Science.

Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, Morelli L, Canani RB, Flint HJ, Salminen S, Calder PC, Sanders ME. Expert consensus document. The International Scienti c Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014 11(8):506-14. doi: 10.1038/nrgastro.2014.66

38. ANALIZA KORIŠĆENJA LEKOVA I SUPLEMENATA U SPORTSKOM DRUŠTVU „CRVENA ZVEZDA”Nenad Dikić1, Marija Anđelković1, Igor Milojevic3, Stefan Berović2, Suzana Stojković2, Aleksandar Jakovljević2, Marija Bogdanović2, Vanja Todorovic2, Aleksandar Cincovic2, Stefan Vitkovic2, Isidora Ilić2, Aleksandar Petrović2, Ivana Popović2, Irena Jovanović2, Ana Milošević2, Marija Milaković2, Bozic Saska2, Marko Mitrovic2, Emilija Nastovic2, Andreja Nikolic2, Anđela Arsić2, Milica Aranđelović2, Emilija Prlincevic2

1Antidoping agencija Republike Srbije, 2Farmaceutski fakultet, Univerziteta u Beogradu, 3Sportsko društvo Crvena Zvezda

Sportska farmacija je relativno nova oblast u farmaciji, ali i u sportu, koja ima za cilj da omogući farmaceutima direktan anga-žman u sportu na svim nivoima. Samo su u nekim zemljama farmaceuti postali deo sport entourage, odnosno deo tima koji

prati sportistu. Sa idejom da proverimo mogućnosti u našem sportu postavili smo cilj da sagledamo korišćene suplemente i lekove u sportskom društvu Crvena Zve-zda. Analiza je obuhvatila indikacije, neže-ljene efekte, interakcije i bezbednost kori-šćenja, odnosno ukupnog menadžmenta lekova i suplemenata na treningu i tak-mičenju. Koristili smo metod anonimnog upitnika koji je popunio sportista svakog kluba sportskog društva Crvena Zvezda.

Rezultati

Dvadeset studenata je intervjuisalo 208 sportista iz 19 klubova sportskog društva “Crvena Zvezda”. Odnos muškaraca prema ženama je bio 71% prema 29%, dok je više od 50% bilo u uzrastnoj grupi od 18 do 23 godine. Oko 40% sportista ide u srednju škola, a isti procenat sportista je na fakul-tetu. Više od polovine pripada timskim sportovima (56,7%), dok oko 20% trenira borilačke sportove ili individualne spor-tove u najvećem procentu pet i više dana nedeljno (69,3%) odnosno do 2 h (53,6%) i preko 2 h (43,8%) na dan. Nešto više od 50% sportista uzima suplemente, a 20% le-kove. Blage neželjene efekte korišćenja le-kova i suplemenata prijavilo je od 3,8% do 7,3% sportista. Čak 86% sportista ne puši, dok je procenat koji ne konzumira alkohol znatno manji (46%). Iako je samo polovina sportista imalo priliku da pogleda Listu za-branjenih supstanci, samo jedan sportista ne bi želeo da ima mogućnost redovne konsultacije sa farmaceutom.

Diskusija

Rezultati pokazuju da je potencijalna uloga sportskog farmaceuta u velikom sportskom sistemu više nego značajna, ne samo u sagledavanje upotrebe lekova i suplementa, već i zbog savetovanja u vezi upotrebe medikamenata, neželjenih efe-

96


kata i interakcija, kao i edukacije stručnog tima. U radu će biti detaljno analizirani uzeti suplementi i lekovi.

Zaključak

Mesto sportsko farmaceuta još uvek nije de nisano, ali postoje velika potreba za njegovim radom. Verujemo da će sportisti imati priliku da shvate značaj sportskog farmaceuta i da će Srbija stati uz najrazvi-jenije sportske zemlje po ovom pitanju. Smatramo da ovakve inicijative treba da podrže najvažnije institucije sporta i obra-zovanja u zemlji.

ANALYSIS OF THE USE OF MEDICINES AND SUPPLEMENTS IN THE SPORTS SOCIETY RED STARNenad Dikić1, Marija Anđelković1, Igor Milojevic3, Stefan Berović2, Suzana Stojković2, Aleksandar Jakovljević2, Marija Bogdanović2, Vanja Todorovic2, Aleksandar Cincovic2, Stefan Vitkovic2, Isidora Ilić2, Aleksandar Petrović2, Ivana Popović2, Irena Jovanović2, Ana Milošević2, Marija Milaković2, Bozic Saska2, Marko Mitrovic2, Emilija Nastovic2, Andreja Nikolic2, Anđela Arsić2, Milica Aranđelović2, Emilija Prlincevic2

1Antidoping Agency of the Republic of Serbia, 2Faculty of Pharmacy, University of Belgrade, 3Sports Society Red Star

Sports pharmacy is a relatively new eld in pharmacy, but also in a sport that aims to provide direct engagement of pharmacists at all levels. Only in some countries pharmacists become part of a sports entourage, or a part of the team that follow an athlete. With the idea to check the possibilities in our sport, we set the goal to analyze the supplements and medicines in the Red Star sports society to monitor indications, side e�ects, interactions and safety, and overall management of medication in training and competition.

We used the method of an anonymous questionnaire lled by an athlete of every club of Red Star Sports Society.

Results

Twenty students ahve interviewed 208 athletes from 19 clubs of Red Star Sports Society. The ratio of men to women was 71% versus 29%, while the largest number of athletes was from almost 50% in the age group of 18 to 23 years. A similar percentage of athletes of about 40% is in high school and at faculty. More than a half belongs to team sports (56.7%), while around 20% train martial sports or individual sports in the highest percentage of ve or more days a week (69.3%) or up to 2 hours (53.6%) and over 2 h (43.8%) per day. Just over 50% of athletes take supplements and 20% drugs. Mild adverse e�ects have been reported from 3.8% of drugs to 7.3% of supplements of athletes. Even 86% of athletes do not smoke, while the percentage that does not consume alcohol is signi cantly lower (46%). Although only half of the athletes had the opportunity to look at the List of Prohibited Substances, only one athlete would not want to have the possibility of regular consultation with the pharmacist.

Discussion

The results show that the potential role of a sports pharmacist in a large sports system is more than signi cant, not only regarding of the use of drugs and supplements in sports, but also because of advising athletes about the use of medicines, side e�ects and interactions, as well as the education of sport entourage. In this paper, the supplements and drugs will be analyzed in details.


Conclusion

Role of a the sports pharmacist is still not de ned, but there is a great need for his work. We believe that athletes will have the opportunity to understand the importance

of a sports pharmacist and that our sport will stand alongside the most developed sports countries on this issue. We believe that such initiatives should support the most important institutions of sport and education in Serbia.

aPROGRAM I KNJIGA SAŽETAKA / PROGRAM AND ABSTRACT BOOK

REDOKS RAVNOTEŽA KOD PROFESIONALNIH SPORTISTKINJA: RAZLIKE UZROKOVANE VRSTOM SPORTASrejović Ivan1, Arsić Aleksandra2, Vucić Vesna2, Glibetić Ma-rija2, Popović Tamara2, Debeljak-Martačić Jasmina2, Čubrilo Dejan3, Ahmetović Zlatko3, Perić Dusan2, Borozan Sunčica4, Djurić Dragan5, Jeremić Nevena6, Jakovljević Vladimir1,7

1Katedra za Fiziologiju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Srbija2Centar izuzetne vrednosti u oblasti istraživanja ishrane i metabolizma, Institut za medicinska istraživanja, Univerzitet u Beogradu, Srbija3Fakultet za Sport i turizam, Univerzitet EDUCONS, Novi Sad, Srbija4Katedra za hemiju, Veterinarski fakultet, Univerzitet u Beogradu, Srbija5Institut za medicinsku �ziologiju “Rihard Burijan”, Medicinski fakultet, Univerzitet u Beogradu, Srbija6Odsek za farmaciju, Fakultet medicinskih nauka, Univerzitet u Kragujevcu, Srbija 7Katedra za Humanu Patologiju, Prvi Moskovski Državni Medicin-ski Univerzitet IM Sečenov, Ruska Federacija

Rezultati velikog broja epidemioloških is-traživanja ukazuju na činjenicu da redovno umereno vežbanje smanjuje rizik za nasta-janje kardiovaskularnih bolesti, uključuju-

ći hipertenziju, gojaznost i nivo lipida u krvi. Međutim, naporno vežbanje može da ima štetne efekte usled povećanja ok-sidacionog stresa. Cilj ovog istraživanja je bila analiza promena u redoks ravnoteži, analizom parametara oksidacionog stresa i aktivnosti antioksidacionih enzima, kod profesionalnih sportistkinja koje se bave vaterpolom i fudbalom, starosne dobi iz-među 20 i 23 godine. Četrnaest sedenter-nih osoba ženskog pola iste starosne dobi je takođe uključeno u istraživanje. Iz uzo-raka krvi su određivane vrednosti indeksa lipidne peroksidacije (MDA), ukupni anti-oksidacioni status (TAS), superoksid an-jon radikal (O2

-), vodonik peroksid (H2O2), redukovani glutation (GSH), oksidovani glutation (GSSG), nitriti, kao i aktivnost enzima superoksid dismutase (SOD), ka-talaze (CAT) i glutation peroksidaze (GPx). Nivoi MDA, TAS, GSSG i H2O2 su bili stati-stički značajno viši kod sportistkinja u odnosu na kontrolnu grupu. Sportistkinje koje se bave fudbalom sui male više vred-nosti O2

- u odnosu na druge dve grupe. Sa druge strane aktivnost SOD je bila više

Addendum

Prilikom preloma Knjige sažetaka napravili smo propust i izostavili rad kolege Ivana Sre-jovića. Uz izvinjenje njemu i celom timu iz Kragujevca zbog tehničkih uslova rad obja-vljujemo u prilogu na kraju knjige.

Prof. dr Nenad Dikić urednik

b


kod sportistkinja koje se bave vaterpolom u odnosu na druge dve grupe, aktivnost CAT je bila viša kod svih sportistkinja, dok se aktivnost GPx nije značajno razlikovala u grupama. U skladu sa tim prolongirana intezivna zička aktivnost značajno pove-ćava oksidacioni stress kod žena, što zavisi i od vrste sporta. Niže koncentracije O2

- i povišena aktivnost SOD kod sportistkinja koje se bave vaterpolom ukazuju na adap-tivni mehanizam antioksidacione zaštite koji je uslovljen vrstom zičke aktivnosti.

REDOX BALANCE IN ELITE FEMALE ATHLETES: DIFFERENCES BASED ON SPORT TYPESSrejovic Ivan1, Arsic Aleksandra2, Vucic Vesna2, Glibetic Marija2, Popovic Tamara2, Debeljak-Martacic Jasmina2, Cubrilo Dejan3, Ahmetovic Zlatko3, Peric Dusan2, Borozan Suncica4, Djuric Dragan5, Jeremic Nevena6, Jakovljevic Vladimir1,7

1Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia2Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia 3Faculty of Sport Science, University EDUCONS, Novi Sad, Serbia4Department of Chemistry, Faculty of Veterinary Medicine, University of Belgrade, Belgrade, Serbia5Institute of Medical Physiology “Richard Burian”, Medical faculty, University of Belgrade, Belgrade, Serbia6Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia7Department of Human Pathology, 1st Moscow State Medical University IM Sechenov, Russian Federation

The results numerous epidemiological studies have indicated that a regular moderate physical activity reduces risk factors for cardiovascular disease, including hypertension, obesity and blood lipid levels. However, strenuous exercise may have detrimental e�ects due to increased oxidative stress. The aim of the present study was to analyze changes

in redox balance throughout parameters of oxidative stress and activities of antioxidant enzymes in elite female water polo and football players aged between 20 and 23. Fourteen age-matched sedentary women were also included in the study. Blood sampling was performed to measure levels of lipid peroxidation (MDA), total antioxidant status (TAS), superoxide anion radical (O2

-), hydrogen peroxide (H2O2), reduced glutathione (GSH), oxidized glutathione (GSSG), nitrites, superoxide dismutase activity (SOD), catalase activity (CAT) and glutathione-peroxidase activity (GPx). Levels of MDA, TAS, GSSG and H2O2 were signi cantly higher in athletes than in the control women. Football players had higher levels of O2

- than the other two groups. Activity of SOD was higher in water polo players when compared with the football and control groups, CAT was increased in all athletes, while GPx did not di�er among groups. Therefore, prolonged intensive training markedly increases oxidative stress in women, which depends on the type of sport. Lower concentration of O2

- and increased activity of SOD in water polo players compared to football players suggest that mechanisms of adaptation of antioxidative defense are related to the type of exercise.

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