OVERVIEW

The teaching unit focuses on the main endocrine and metabolic disorders in relation to the planning, adaptation and monitoring of preventive and adapted physical activity. The module is part of the Master’s degree programme and provides students with the tools required to understand how endocrine disorders may affect physical efficiency, body composition, exercise tolerance and exercise safety across the different stages of life.

Particular attention is devoted to conditions associated with sedentary behaviour and lifestyle, such as diabetes, obesity, osteoporosis and sarcopenia, as well as to endocrine disorders that may benefit from an appropriately adapted exercise programme. Through examples and case-based learning, the criteria for identifying goals, precautions, monitoring parameters and conditions requiring medical assessment will be discussed.

The teaching unit is aimed at developing competencies that graduates can apply in collaboration with physicians and the other professionals involved in patient care.v

AIMS AND CONTENT

LEARNING OUTCOMES

The teaching unit aims to provide advanced scientific knowledge of the interactions among the endocrine system, metabolism and physical exercise, applying such knowledge to prevention, maintenance of physical efficiency and adaptation of physical activity in individuals who are at risk of, or affected by, endocrine and metabolic disorders.

The aim of the module is to develop the ability to use essential clinical and functional data in order to contribute to the planning and evaluation of individualised exercise interventions, identifying the main risk factors, exercise limitations and situations requiring modification of the programme or further medical assessment.

AIMS AND LEARNING OUTCOMES

By the end of the teaching unit, students will be able to:

• relate the main endocrine and metabolic pathophysiological mechanisms to changes in physical efficiency and exercise response;

• analyse the available clinical and functional information, without making a diagnosis, in order to identify the goals and limitations of an exercise programme;

• design physical activity programmes that are consistent with the clinical condition, age, functional capacity and preventive or adaptive goals;

• adapt the frequency, intensity, duration and type of exercise according to the disorder, complications, treatment and individual response;

• select simple indicators to monitor the effectiveness and safety of the exercise intervention;

• recognise warning signs and symptoms and distinguish conditions that can be managed within the exercise setting from those requiring medical assessment;

• understand the role of body composition, energy availability, sleep and lifestyle in endocrine and metabolic health;

• apply the acquired knowledge to the discussion of cases involving diabetes, obesity, osteoporosis, sarcopenia and other stable endocrine disorders;

• communicate and collaborate appropriately with physicians, dietitians, physiotherapists and other healthcare professionals.

PREREQUISITES

Knowledge of anatomy, physiology, biochemistry, general pathology and exercise physiology acquired during the degree programme is required. Basic knowledge of the principles of functional assessment, exercise planning and physical activity monitoring is also useful.

TEACHING METHODS

The teaching unit consists of 16 hours of face-to-face lectures. Theoretical content will be integrated with case-based learning, guided discussion of practical situations and analysis of essential clinical and functional data, such as current treatment, blood glucose, glycated haemoglobin, body composition and the main risk indicators.

Teaching activities will focus on defining the goals of the exercise intervention, identifying precautions, selecting monitoring parameters and providing a rationale for the proposed exercise adaptations. Teaching materials and any relevant consensus documents or guidelines will be made available on AulaWeb.

Students with a certified specific learning disorder, disability or other special educational needs are invited to contact the School representative and the lecturer at the beginning of the teaching period in order to agree on appropriate teaching and examination arrangements. These arrangements will take individual learning needs into account, while maintaining the learning outcomes of the teaching unit, and may include compensatory or dispensatory measures recognised by the relevant University services.

SYLLABUS/CONTENT

• Endocrinology applied to physical activity: acute endocrine responses to exercise, chronic adaptations and factors affecting exercise tolerance.

• Preliminary assessment of individuals with endocrine and metabolic disorders: essential clinical information, current treatment, complications, functional capacity, risk factors and general criteria for medical referral.

• Type 1 and type 2 diabetes mellitus: benefits and risks of exercise, glucose monitoring, interactions with treatment, and prevention and management of hypoglycaemia during and after physical activity.

• Obesity and regulation of energy balance: body composition, adipose tissue distribution, sarcopenia and definition of the goals of the exercise intervention.

• Medications for diabetes and obesity: main practical implications for exercise and monitoring of the response.

• Bone metabolism, osteoporosis and frailty: risk assessment, goals of physical activity, precautions and main contraindications.

• Sarcopenia and endocrine ageing: effects on strength, muscle mass, balance and functional independence.

• Thyroid disorders: effects on heart rate, thermoregulation, fatigue and exercise capacity.

• Adrenal disorders and alterations of the hypothalamic-pituitary-adrenal axis: response to physical stress, muscle function and cardiovascular risk.

• Hypogonadism and menopause: implications for body composition, bone health, muscle function and exercise planning.

• Growth hormone deficiency and excess: main functional and cardiovascular consequences relevant to physical activity.

• Low energy availability, the female athlete triad and RED-S: endocrine, metabolic, bone and reproductive consequences, and recognition of warning signs.

• Case-based learning: identification of goals, risk analysis, exercise adaptation and selection of monitoring indicators.

RECOMMENDED READING/BIBLIOGRAPHY

Recommended textbook:

Endocrinologia ed attività motorie, Lenzi, Lombardi, Martino, Trimarchi, Elsevier.

Additional materials, guidelines, consensus documents and scientific articles selected by the lecturer will be made available on AulaWeb.

TEACHERS AND EXAM BOARD

Exam Board

MARA BOSCHETTI (President)

SABRINA PAOLINO (President)

GIOVANNI PASSALACQUA (President)

ANNA MARIA RICCIO (President)

GIAN MARCO ROSA (President)

ROCCO VERGALLO (President)

GIAMPAOLO BRICHETTO (President and Coordinator of Integrated Course)

LESSONS

LESSONS START

Lectures are held in Genoa during the first semester, according to the timetable published online on the EasyAcademy portal.

Class schedule

The timetable for this course is available here: Portale EasyAcademy

EXAMS

EXAM DESCRIPTION

The examination consists of an in-person oral interview as part of the examination for the integrated course in Internal Medicine Disorders.

The oral examination covers the topics included in the syllabus and includes discussion of a simple practical situation. Students may be asked to identify the main endocrine and metabolic issues, determine the information required, define goals and precautions, propose adaptations to physical activity and indicate appropriate monitoring parameters.

ASSESSMENT METHODS

The assessment is designed to verify the achievement of the expected learning outcomes in terms of knowledge, ability to apply knowledge and independent judgement.

To pass the examination, students must demonstrate knowledge of the fundamental concepts and the ability to relate the endocrine or metabolic condition to its possible implications for physical activity. The final assessment will take into account accuracy and clarity of presentation, the use of appropriate terminology, the ability to analyse the case critically, the relevance of the proposed adaptations and monitoring strategies, and the recognition of professional boundaries and criteria for medical referral.

The ability to integrate knowledge and to justify the proposed choices independently and coherently will be considered deserving of the highest marks.

FURTHER INFORMATION

The Endocrinology teaching unit must be taken and passed together with the other teaching units included in the integrated course in Internal Medicine Disorders. Attendance is governed by the regulations of the degree programme.