Extreme sleep fragmentation for 11 consecutive days and nights does not significantly alter total sleep time, and sleep stage distribution, during the continuous alpine downhill skiing world record

Introduction: Extreme levels of sleep deprivation, fragmentation and management, are major problems in many sportive disciplines, ultramarathons, polar or extreme altitude expeditions, and in space operations. Material and methods: Polysomnographic (PSG) data was continuously recorded (total sleep time and sleep stage distribution) in a 34-year-old male whilst performing the new world record in long-term downhill skiing. He napped only during the short ski lift rides for 11 days and nights. Results: After an initial period of complete sleep deprivation for 24 hours, total sleep time and the total times of non-REM and REM achieved during the lift rides returned to standard values on the second day. PSG data revealed an average sleep time per 24 hours of 6 hours and 6 minutes. During daylight sleep was rarely registered. The subject experienced only two minor falls without injury and immediately resumed skiing. Conclusion: In a healthy, trained, elite male athlete, sleep fragmentation over 11 consecutive days did not significantly impair the sleep, motor or cognitive skills required to perform a continuous downhill skiing world record after an initial adaptation phase.

Planning for Sustainable Development of Tourism in the Tatra National Park Buffer Zone Using the MCDA Approach

This study aims to develop practice guidelines for the preparation of local regulations promoting sustainable tourism planning for the area located at the entrance to the Tatra National Park, Poland. Included in the study was a set of tourism activities put forward by the local community. These activities were divided into two priorities: sustainable tourist activities (hiking and walking, cycling, horseback riding) and investments that would have an environmental impact (downhill skiing, recreational infrastructure, commerce, catering). The analysis criteria covered the tourist attractiveness of the area and its suitability for a given activity (benefit), as well as requirements concerning the protection of nature, topographical relief, landscape, and traditional land use (cost). These criteria were evaluated using the Analytic Hierarchy Process (AHP) and summarized using the Weighted Linear Combination (WLC). The results showed the high attractiveness of the area for both priorities. However, due to the area's unique nature, investments having an environmental impact must be limited to the vicinity of the existing built-up areas. The use of MCDA supports decision-making at the local scale, significantly enhances the transparency of the results, and facilitates communication with local communities. The comparison with the current local law provisions showed the shortcomings of the methods used to date when preparing planning instruments.

Downhill skiing following total knee arthroplasty: a survey of Alberta orthopedic surgeons

Background: In older adults facing knee arthroplasty, the ability to resume downhill skiing postoperatively is unclear. This study aimed to determine the perspectives of Alberta orthopedic surgeons and senior residents regarding downhill skiing after total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA). Methods: In May 2019, a Web-based survey was sent through the Alberta Orthopaedic Society to poll orthopedic surgeons performing arthroplasty and senior orthopedic residents (postgraduate year 4 or 5) in Alberta regarding the permissibility of downhill skiing after TKA or UKA. The survey also elicited information regarding under which conditions or restrictions, if any, surgeons would allow patients to return to downhill skiing, whether these recommendations were evidence based, and whether surgeons had seen complications from downhill skiing in their patients who had undergone knee arthroplasty. Results: Of the 41 respondents, 21 (51%) were full-time fellowship-trained orthopedic surgeons, 15 (37%) were specialists with some arthroplasty in their practice, and 5 (12%) were orthopedic residents. Ten of 40 respondents (25%) would allow unrestricted downhill skiing after TKA, and 1 (2%) would not allow any skiing at all. The remaining 29 (72%) indicated that they might allow downhill skiing under specific conditions, with the top 3 being limitations on speed and intensity (29 [71%]), return of full range of motion and strength in the operative knee (26 [63%]), and years of downhill ski experience (23 [56%]). Fourteen respondents (34%) would allow unrestricted downhill skiing after UKA, and 27 (66%) would allow skiing with the same top 3 conditions as for TKA. Thirty-two respondents (78%) reported that their decisions were not evidence based, and 35 (85%) had never seen complications from downhill skiing after TKA or UKA. Conclusion: Alberta orthopedic surgeons and senior residents are cautious regarding skiing after knee arthroplasty. The majority reported that their restrictions were not evidence based, which indicates the need for further investigation to develop an approach for surgeons to consistently and safely address return to downhill skiing after TKA or UKA.

The human factor in alpine skiing and snowboarding accidents

Introduction: Hundreds of millions of people practice winter sports worldwide. Alpine skiing and snowboarding are associated with a possible risk of injury. There are at least three important factors that can affect safety in wilderness activities (environmental factors, technical factors and human factors). Awareness of human factors would allow us to reduce the risk in winter sports. Material and method: The objective of this study is to find out, through a self-explanatory cross-sectional personal survey, what and how human factors are involved in alpine skiing and snowboarding accidents. Results: 219 surveys were carried out of a total of 3,911 patients attended at the different health care points. The highest percentage of respondents related their accident to distraction or complacency, both in 72.2% of the respondents. Other factors that were pointed out by more than 50% were; lack of knowledge (60.4%), lack of following the norms (58.5%), fatigue (57.5%), lack of situational awareness (57%) and stress with (53.8% of the respondents). Conclusions: By identifying these most frequent human factors during downhill skiing and snowboarding, actions can be taken to prevent or contain human error.

Sudden Cardiac Death Risk in Downhill Skiers and Mountain Hikers and Specific Prevention Strategies

Sudden cardiac death (SCD) still represents an unanticipated and catastrophic event eliciting from cardiac causes. SCD is the leading cause of non-traumatic deaths during downhill skiing and mountain hiking, related to the fact that these sports are very popular among elderly people. Annually, more than 40 million downhill skiers and mountain hikers/climbers visit mountainous regions of the Alps, including an increasing number of individuals with pre-existing chronic diseases. Data sets from two previously published case-control studies have been used to draw comparisons between the SCD risk of skiers and hikers. Data of interest included demographic variables, cardiovascular risk factors, medical history, physical activity, and additional symptoms and circumstances of sudden death for cases. To establish a potential connection between the SCD risk and sport-specific physical strain, data on cardiorespiratory responses to downhill skiing and mountain hiking, assessed in middle-aged men and women, have been included. It was demonstrated that previous myocardial infarction (MI) (odds ratio; 95% CI: 92.8; 22.8–379.1; p < 0.001) and systemic hypertension (9.0; 4.0–20.6; p < 0.001) were predominant risk factors for SCD in skiers, but previous MI (10.9; 3.8–30.9; p < 0.001) and metabolic disorders like hypercholesterolemia (3.4; 2.2–5.2; p < 0.001) and diabetes (7.4; 1.6–34.3; p < 0.001) in hikers. More weekly high-intensity exercise was protective in skiers (0.17; 0.04–0.74; p = 0.02), while larger amounts of mountain sports activities per year were protective in hikers (0.23; 0.1–0.4; <0.001). In conclusion, previous MI history represents the most important risk factor for SCD in recreational skiers and hikers as well, and adaptation to high-intensity exercise is especially important to prevent SCD in skiers. Moreover, the presented differences in risk factor patterns for SCDs and discussed requirements for physical fitness in skiers and hikers will help physicians to provide specifically targeted advice.

Pedagogical multilevel system and scheme for managing the quality of training results for athletes in the training of instructors-methodologists in alpine skiing in Russia

Currently, there are about 200 ski resorts in Russia from Smolensk to Chukotka, which are located both in the low mountains (GC "Tyagacheva", "Sarochany", etc.), and in the middle mountains ("Abzakovo", "Bannoe Lake", etc. ) and highlands (regions of the Elbrus region, Dombay, Krasnaya Polyana, etc.). More than six million Russians go downhill skiing and snowboarding every year. Over the years, the quality of sports equipment and track equipment has changed significantly, which has led to an increase in speeds, an increase in injuries and a change in teaching methods. Currently, a large number of people die and are seriously injured at ski resorts every year due to the low quality of training in safe skiing, lack of control over the work of instructors, and the irresponsible attitude of the holders of ski resorts to the safety of providing services on the ski slopes.

Sudden cardiac death during mountain sports activities

Sudden cardiac death (SCD) is an unanticipated and dramatic event resulting from cardiac causes. First reports on SCDs during mountain sports activities date back to the 1970s and 1980s of the last century. Relatively large datasets have been collected in Austria from 1985 onwards initiating systematic recordings and analyses of risk factors and triggers of SCDs during mountain sports activities. The results presented in this publication are derived from a literature search on reported SCDs that occurred during selected mountaineering activities with particular regard to study findings based on data collected in Austria. We found a relatively low SCD risk during mountaineering activities, amounting to about 1 SCD per 1 million activity days when hiking, trekking or ski touring, which is even lower during downhill skiing but higher in competitive cross-country skiing. The risk is much higher in men than in women and increases sharply above the age of 34. Main risk factors include prior myocardial infarction, coronary artery disease, arterial hypertension, hypercholesterolaemia and diabetes mellitus type 2, but regular and sport-specific activities turned out to be important protective factors. Unaccustomed physical exertion, in particular on the first days in the mountains (altitude), prolonged activities without rest and insufficient energy and fluid intake represent important SCD triggers. Besides considering these potential triggers during mountaineering activities, sports medical examination, appropriate pharmacological therapy of risk factors and physical preparation represent preventive key elements. Key Words: Exercise, Mountains, Cardiovascular, Risk, Triggers, Prevention

Extreme sports performance for more than a week with severely fractured sleep

Purpose Severely fractured sleep is mostly portrayed negatively, but investigations in extreme sports show that humans can maintain performance with a minimum of sleep. With two cases of long-lasting extreme sports performances, we demonstrate that severely fragmented sleep does not necessarily lead to a deterioration of physical and cognitive performance. Methods We performed continuous polysomnography on a 34 year-old skier for 11 days and nights during a world record attempt in long-term downhill skiing and monitored a 32 year-old cyclist during the Race Across America for 8.5 days via sleep and activity logs. Results The skier slept fractured fashion in 15–16 naps with a daily average of 6 h consisting of 77% in sleep stage 1 and 2, 11% in stage 3, and 13% in stage REM. The cyclist slept a total of 7 h and 52 min in 8.5 days, split up into 11 short naps and 6 sleep periods. The average duration of napping was 8.8 min and of sleep 64.2 min. Conclusions These two cases demonstrate that outstanding performances are possible with severely fractured sleep and/or sleep deprivation. In well-trained athletes, breaking new recordsis possible despite extreme sleep habits.