[Sports in Luxembourg. The role of heart healthy sports].

30 years of organized ambulatory heart sport in Luxembourg Promoter of health sports. For more than 30 years both mortality and morbidity due to coronary artery disease (CAD) are significantly decreasing (> 70%) in the western world. This achievement is due to multiple interventions in the direct treatment of CAD and, especially, in fighting its risk factors: smoking, high blood pressure, hypercholesterolemia and physical inactivity. In 1984 the first ambulatory heart sport group (phase 3 of cardiac reeducation) was founded in Luxembourg City, followed in 1991 by a section in Esch/Alzette and in 2002 by a 3ème section in Ettelbrück. These phase 3 cardiac sport groups (= chronic phase) are organized by some committed patients working on a voluntary basis and performing a professional job. Paradoxically these phase 3 groups preceded the phases 1 and 2 (= "in hospital" and subacute) of cardiac rehabilitation. However, in a parallel way ambulatory phase 2 physical activity (PA) was started in the main hospitals in Luxembourg City (Centrum), Esch/Alzette (South) and Ettelbrück ( North). In 2002 a cornerstone study by Myers et al proved that physical fitness is the most determinant of survival both for healthy people and for cardiac patients: The better the fitness, quantified in METs, the better the prognosis and this fact is the basis for the application of sports therapy in cardiac and most other patients. An important epidemiological study published in 2012 by Lee et al in Lancet analyzed the effects of physical inactivity (PI) all over the world: 4 important diseases were studied: CAD, breast cancer, colon cancer and type 2 diabetes. The effects of PI are most pronounced in colon cancer followed by diabetes 2, breast cancer and then CAD. As a mean about 9% of all deaths -5.9 million in 57 million deaths/year worldwide- are caused by PI and for Luxembourg 12.9%. This cornerstone study can serve as rationale for physical therapy (PT) intervention in oncology, diabetes and CAD. It is noteworthy that the basic RF are more or less the same for the chronic diseases investigated in this study. Since the beginning of the new century PT has become an integral part of the strategies for cancer prevention and treatment. This option has been studied thoroughly first in breast cancer, later also in colon, prostate, and bronchial cancers etc. In primary prevention regular medium intensity training decreases the incidence of cancers by about 20-30%. For patients with proven cancers the application of PA as treatment option is more complicated compared to patients with cardiac problems since cancer patients often have to undergo surgery, then chemo- and/or irradiation therapy. All these interventions and their side effects have to be considered before applying PA. Above the physical alterations most cancer patients have to face anxiety and depression problems. PT improves the outcome between 15-25% and plays an important role in improving the psychological problems of the cancer patients. Since 10 years several oncologists in Luxembourg became interested in PA as a therapeutic option for their patients. They contacted the cardiologists and physiotherapists in charge of cardiac reeducation and progressively programs for PA in oncology were launched also in Luxembourg. Meanwhile several groups of cancer patients offer regular PT programs. In 2014 a stock concerning the different health sport activities in Luxembourg was taken by a young researcher of the Luxembourg Institute of health (LIH). 11 different associations are active; the most important and best organized are the cardiac sports groups, but there are also several oncologic, neurologic and orthopedic sports groups. A target for the coming years is to confer a robust infrastructure to all these associations following the model used by the cardiac groups. For the next year all these groups should be integrated into the Federation of Health Sports of the national Olympic Committee.