Associate Professor, PhD L.V. Safonov
All-Russian Research Institute of Physical Culture and Sport, Moscow

Keywords: venous circulation deficiency in lower limbs, flight, elite athletes.

Introduction. Venous circulation deficiency in the lower limbs and its most common cause - varicosity of lower limb veins - are the most common peripheral vascular diseases among one-third of the world's population, which is a major medical and social problem. In most cases, chronic disorders of venous blood circulation in the lower limbs develop in people under 35, when they are most physically active, being one of the reasons of their temporary, and, most often, total disability [4]. Steadily growing incidence of this pathology, its clinical features, increasing incidence of disease de-compensation and its complications largely determine the deterioration of the quality of life of those with venous circulation deficiency in the lower limbs [1]. The key factor determining the development of chronic venous circulation deficiency in the lower limbs is hereditary connective tissue dysplasia [2, 10]. However, the high incidence rate in recent years is due to the increasing influence of the precipitating factors, being an integral part of man’s sports activity, such as continuous orthostatic posture, especially when related to high-intensity physical loads, increased intra-abdominal pressure, venous hypertension, water and electrolyte imbalance, hypervolemia, increased body mass index, etc. [9, 7]. The growing number of people with the symptom-free and compensated forms of venous circulation deficiency in the lower limbs results in the increase of the disease complications, the most formidable of which are venous thrombosis and thromboembolism, the number of which in recent years has increased and become more closely connected with flights [3, 8]. The incidence of pulmonary embolism due to long-range air travels is growing steadily: if in the 90s of the last century they registered only 0.5-1.5 cases per 1 million passengers [5], the latest studies of interdependence between longhaul flights and frequency of thromboembolic events have shown that, out of 2000 analyzed episodes of venous thrombosis of the lower limbs, 233 developed in those flying for more than 4 hours for the past two months [6]. There is a lack of specialized literature devoted to the study of hemorheological changes in venous circulation in athletes who often have longhaul flights, which is the objective of our study.

Methods and structure of the study. For the purpose of this study, we examined 100 male athletes (mean age - 24.8 ± 5.5 years, sports qualification - CMS to MSIC) engaged in speed-strength, cyclic and complex coordination sports, including athletes free of vascular pathologies, athletes diagnosed with functional (CEAP clinical class 0) and chronic disorders of venous blood circulation in the lower limbs (CEAP clinical class 1-2).

We analyzed the hemorheological rates (studying the APTT dynamics using the RENAM reagent and blood viscosity using the viscosimeter ANTARES VKA-0801), as well as the bio-impedance rates (Ohmniscan, France), which enabled us to make quantitative evaluation of the venous outflow disorders, lower limb swelling. The significant differences in the study rates were determined using the Student t-criterion for related and unrelated samples at significance level р<0.05.

Results and discussion. At the first stage, we studied the correlation between the functional and chronic venous circulation deficiency in the lower limbs and the hemorheological indices, bio-impedance and blood clotting ability rates in athletes specializing in different sports (Table 1).

Table 1. Indices of bio-impedance, rheological properties of blood and clotting system in athletes engaged in speed-strength and cyclic sport disciplines depending on the presence or absence of venous circulation deficiency in the lower limbs (M ± m).

No significant differences were detected within the same group, made of the athletes with the signs of venous circulation deficiency in lower limbs and those free of vascular pathologies. However, certain differences were detected between the groups of athletes specializing in speed-strength and cyclic sports. Thus, the athletes mainly developing their strength abilities were registered to have increased blood viscosity and reduced APTT, whereas in the athletes mainly developing endurance, both blood viscosity and APTT were reduced.

The next stage involved the analysis of the effects of different flight time on the dynamics of changes in the bio-impedance and hemorheological rates in athletes specializing in speed-strength and cyclic sports. The results are represented in Table 2.

Table 2. Effects of flight time on dynamics of bio-impedance, rheological properties of blood, clotting system in athletes specializing in speed-strength and cyclic sports, М±m

The research results testify to the negative effect of longhaul air travel on the rheological properties of blood, its clotting ability, and venous circulation in the lower limbs of athletes from the studied sport disciplines. With increasing flight time over 400 hours, the negative variations of the studied parameters become statistically significant, while the flights up to 4 hours long caused no statistically significant changes in the rheological properties of the blood, its clotting ability and venous circulation in the lower limbs.

Conclusion. The study of the hemorheological and bio-impedance rates in athletes specializing in speed-strength and cyclic sports diagnosed with venous circulation deficiency in the lower limbs and those free of vascular pathologies has not revealed any statistical significant differences in the study rates, which, in view of the absence of the clear clinical picture and available methods of screening diagnostics, results in the underestimation of the importance of diagnosing of venous circulation deficiency in the lower limbs in elite athletes. Negative variations of the lower-limb hemorheological and bio-impedance rates directly correlate with the flight time and have no correlation with the degree of venous circulation deficiency in the lower limbs, lasting in both the athletes diagnosed with the disorders of venous blood circulation in the lower limbs and those free of vascular pathologies. The flights up to 4 hours long did not cause any meaningful health impairments in the athletes from the studied sports, but the athletes diagnosed with functional or chronic lower-limb venous blood circulation disorders were found to have more expressed negative variations of the study rates. With the increase of the flight time lasting longer than 4 hours negative variation of the study rates correlated with the flight time, moreover, the detected variations were more expressed in the athletes diagnosed with functional or chronic lower-limb venous blood circulation disorders. The study finding urges a set of reasonable therapeutic and preventive actions be taken to counter de-compensations of venous blood circulation in the lower limbs.

References

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Corresponding author: sessia@mail.ru

Abstract

The article analyzes the effects of classified jet lags on the lower-limb hemorheological and venous hemodynamic rates in the athletes specializing in speed-strength and cyclic sport disciplines, the athletes classified into those free of vascular pathologies and the diagnosed with functional or chronic disorders of venous blood circulation in the lower limbs. Tests of the hemorheological and bio-impedance rates in the athletes specializing in speed-strength and cyclic sport disciplines and diagnosed with venous blood circulation versus the healthy ones found no statistically significant differences in the rates. Negative variation of the lower-limb hemorheological and bio-impedance rates were found to directly correlate with the flight time and have no correlation with the degree of venous circulation deficiency in the lower limbs. The flights up to 4 hours long were found to cause no significant health impairments as verified by the study data albeit the athletes diagnosed with functional or chronic lower-limb venous blood circulation disorders showed more expressed negative variations of the study rates. The flights longer than 4 hours were found to cause no significant health impairments as verified by the study data; albeit the detected variations were more expressed in the athletes diagnosed with functional or chronic lower-limb venous blood circulation disorders. The study finding urges a set of reasonable therapeutic and preventive actions be taken to counter de-compensations of venous blood circulation in the lower limbs.