TWO YEARS OF EXPERIENCE OF THE REGIONAL CENTER FOR SPORT IN YOUNG PEOPLE WITH HEART DISEASE: ANALYSIS OF CRITICAL ISSUES AND BARRIERS

The aim of our study was to identify the critical issues of our clinical–psychological–sports management program of young ex–athletes patients judged unfit for competitive sport following the diagnosis of heart diseases potentially at risk of sudden death. In these two years, 114 patients have been referred to our Center, with an average age of 28 years +– 17. Of these, 13 have decided not to join the program. 7 dropped out of the prescription program at follow–up. The most common critical issues are the following:

Difficulty in achieving a complete awareness of the pathology by the athlete and parents (if minor) Psychological problems related to diagnosis and unfitness (anxiety, anger, sense of isolation, depressive symptoms) Difficulty in accepting therapy when needed Patient adherence to prescription Failure to enjoy prescribed physical activity.

Difficulty in communicating the diagnosis and prognosis Difficulty in correctly determining training intensities (hrr, thresholds, lactate?) Influence of therapy schedule on training frequencies Difficulty in Monitoring the Prescribed Activity.

Difficulty in testing and monitoring all types of prescribable activities Resistance on the part of sports clubs to accept the return of these former athletes without the competitive certificate The identification of these "limits" has allowed us to adapt and modify the phases of the project in progress, reducing the number of non–adhesions and dropouts in the last year.

Prescribing exercise in athletes with conditions at risk of sudden death is a challenge for the future. In addition to a detailed knowledge of heart disease and a correct risk stratification, it is however essential to work on patient awareness and consider a series of psychological, motivational, logistical aspects aimed at optimizing the adherence of these ex–athletes, to prevent the prescription letter from translating into something unworkable, not understood, and therefore not followed.