For nearly a century it has been hypothesized, that repetitive head trauma can lead to adverse neurological and psychiatric conditions [1]. Still, it took the discovery of Chronic Traumatic Encephalopathy (CTE) in a player of the National Football League to bring widespread public and scientific attention to this important topic on the intersection of neurology, psychiatry and sports medicine [2,3].
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Suicidal ideation and behaviours are still a highly stigmatized and neglected health problems in athletes. The suicides of well-known athletes have repeatedly brought the subject of mental health problems of top athletes into the public discourse. However, there is still a lack in psychiatric and psychotherapeutic care in high-performance sports.
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lite athletes may use psychotropic substances for recreational reasons, (perceived) performance enhancement or self-medication. Causes can hereby overlap. In substance use, recreational consumption aiming primarily at psychotropic effects is distinguished from performance-enhancing use (doping).
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The Olympic Games tradition dates back to antiquity. And we learned the quote „mens sana in corpore sano est“ coming from that period. It became a paradigm in the western world, undermining any efforts of psychiatric relevance in high performance sports. With world renowned athletes himself as suffering from depression, things began to move; nowadays, sport psychiatry has moved from a theoretical option to an accepted necessity in elite sports [1].
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Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder which is characterized by symptoms of inattention, hyperactivity, and impulsivity. The estimated prevalence of ADHD in the general population is 7,2% in children, with persistence into adulthood of approximately 35%. [1,2]
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Physical inactivity is a known risk factor for stroke. The interaction between exercise and risk of stroke is complex. Physical activity has a beneficial effect on most risk factors for stroke, which may show reciprocal potentiation (e.g. obesity, sleep apnea, atrial fibrillation). Advice on physical activity is of importance in primary prevention of stroke. Hereby, type, amount and intensity of physical activity may be distinguished and adjusted according to comorbidities (e.g. in case of heart failure).
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There is a continuous increase in dementia partly due to increasing life-expectance. Currently there are no causal therapies for dementia, neither for dementias with vascular etiology nor for neurodegenerative dementias such as Alzheimer’s disease.
Main risk factors for the development of dementia are low physical activity, hypertonia and diabetes mellitus. Physical activity has shown to exert beneficial effects on cardiovascular and metabolic risk factors und is closely connected with cognitive disturbance and the development and the course of dementia.
Therefore, the implementation of physical activity in preventive and therapeutic strategies of dementia is recommended.
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After having a stroke the main challenges are reducing the risk of recurrent stroke, improving impaired brain function, quality of life, independence in activities of daily living and reintegration into the community. [1] Lesion-induced impairment of brain function also has, besides its effects on e.g. motor, sensory, visual and speech function, an influence on e.g. cognition and mood, all of which are determinants of post-stroke physical activity.
The evidence for a benefit of physical activity in secondary stroke prevention is increasing and treatment strategies aimed at factors which are limiting physical activity are more and more recognized.
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Gait impairments in simultaneous motor-cognitive tasks have been well documented in neurodegenerative disease populations, including Parkinson’s disease, and Alzheimer’s disease. The consequences of these gait impairments in patient populations include an increased fall risk, sedentariness, functional decreases, decreases in self-efficacy, and overall reduced quality of life. Therefore, improving gait performance in dual-task situations is becoming an important focus of rehabilitation for people with neurological disorders.
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Strategies to improve cognitive aging are highly needed. Among those, promotion of exercise and physical activity appears as one of the most attractive and beneficial intervention. Indeed, results from basic and clinical studies suggest that exercise and physical activity have positive effects on cognition in older persons without cognitive impairment, as well as in those with dementia. Despite inconsistent results, aerobic exercise appears to have the strongest potential to enhance cognition. However, even limited periods of walking (45 minutes, three times a week, over a 6-month period) have also been shown to enhance cognition, particularly executive functions.
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