Profound medical examination includes a basic program:
1. Consultation by a sports medicine physician: life history taking; sports history taking; anthropometric examination; visual examination; functional tests; evaluation of the physical development; evaluation of the state of health; medical recommendations for correcting the training process; admittance to the training process and competitions; analysis of the obtained information with a unified individual conclusion for each athlete as well as for the whole team.
2. Consultations by specialists: cardiologist, therapist, surgeon, pediatrician (according to the age), traumatologist-orthopedist, neurologist, dentist, otorhinolaryngologist, ophthalmologist, gynecologist, dermatovenerologist, medical psychologist, urologist, endocrinologist (according to indications). If necessary, physicians of other specialties can be involved.
3. Functional diagnostic examinations:
Breast fluorography once a year;
Roentgen examination of different parts of the musculoskeletal apparatus (according to indications);
ECG at rest in standard derivations;
Computer spirography with investigation of volume and speed parameters of external respiration (including functional tests and diagnostic pharmacological tests);
USI of internal organs (liver, bile ducts, kidneys, pancreatic gland, spleen, prostate gland, pelvic organs and mammary glands, thyroid gland);
Ultrasound imaging of the heart (echocardiography, Doppler cardiography) at rest, after a load – according to indications;
USI of joints – according to indications;
Rheoecephalography, rheovasography, rheohepatography - according to indications;
Electroencephalography according to indications;
A set of methods for examining the neuromuscular apparatus – electrical neuromyoreflectography with magnetic stimulation (according to indications);
Testing of physical working capacity and tolerance to physical load with a gas analysis: cycloergometric test, treadmill test with submaximum (PWC 170) or maximum loads (until refusal);
Special stress tests according to the orientation of the training process and type of sports (they are determined based on preparation phases, specificity of sports).
4. Additional methods of examination for athletes of different types of sports:
audiometry - shooting, biathlon, modern pentathlon, boxing, high board diving, water polo, ski jumping, freestyle, bobsleigh, tobogganing;
vestibulometry – figure skating, gymnastics, trampoline, high board diving and ski jumping, freestyle, bobsleigh, tobogganing, yachting;
examination of fields of vision – team sports, clay target shooting, fencing, etc.;
examination of the ocular fundus and measurement of intraocular pressure – boxing, taekwondo, weightlifting, high board diving and ski jumping, athletes with heavy weight, as well as according to individual indicators of health;
coordination test – for athletes of team and complex coordination sports: evaluation of the ability to maintain individual strength parameters that are average for this sport in case of differently directed movement of the lower and upper extremities;
stress ergospirometric test: determination of the lactic acid trend with a direct method (except for the rapid assessment method and assessment of the lactate threshold according to oxygen and СО2 consumption curves) – for athletes of cyclic sports.
5. Laboratory investigations performed within profound medical examination for each athlete:
clinical urine analysis; complete blood count using an automatic analyzer with swab microscopy, calculation of thrombocytes and reticulocytes and determination of the erythrocyte sedimentation rate;
state of the immune system (lymphocyte subpopulation: CD3+ (CD4+, CD8+), CD16+, CD19+, IgM, IgA, IgG, IgE, phagocytosis); functional activity of the pituitary gland (somatotrophic hormone, prolactin, thyroid stimulating hormone, cortisol, testosterone);
state of the thyroid gland (free thyroxine, anti-TPO, glucose, Cross Laps); ionized calcium; magnesium; phosphorus; alkaline phosphatase;
iron; ALT; AST; total/direct bilirubin; urea; creatinine; total protein; albumin; myoglobin; serotonin; histamine; lactate; uric acid; lipase; GGT (gamma-glutamyl-transferase); CPK-MB (cardiac creatine phosphokinase) activity; CPK-MB (cardiac creatine phosphokinase) quantitative analysis; acid phosphatase; LDH (lactic dehydrogenase); cholesterol; HDL cholesterol ratio; LDL cholesterol ratio; VLDL cholesterol ratio; triglycerides; CPK;
anti-HIV 1/2; anti-chlamydia trachomatis IgA; anti-chlamydia trachomatis IgG; anti-HCV with a confirming test and further additional tests in case of a positive result of anti-HCV: HCV RNA, HCV genotype; syphilis antibodies (total antibodies); HbsAg – antigen with a confirming test and further additional tests in case of a positive result of Hbs: Hbe, anti-Hbe, anti-HBs, anti-Hbcor-IgM, HBV DNA; chlamydia trachomatis DNA (biological material: urethra/cervical canal epithelial scraping); gonorrhea DNA (biological material: urethra/cervical canal epithelial scraping); trichomoniasis DNA (biological material: urethra/cervical canal epithelial scraping);
blood group, Rh factor and Rh antibodies.