Resistance Training and High-intensity Interval Training Improve Cardiometabolic Health in High Risk Older Adults: A Systematic Review and Meta-anaylsis.

Progressive resistance training (PRT) and high-intensity interval training (HIIT) improve cardiometabolic health in older adults. Whether combination PRT+HIIT (COMB) provides similar or additional benefit is less clear. This systematic review with meta-analysis of controlled trials examined effects of PRT, HIIT and COMB compared to non-exercise control in older adults with high cardiometabolic risk. Databases were searched until January 2021, with study quality assessed using the PEDro scale. Risk factor data was extracted and analysed using RevMan V.5.3. We analysed 422 participants from nine studies (7 PRT, n=149, 1 HIIT, n=10, 1 COMB, n=60; control n=203; mean age 68.1±1.4 years). Compared to control, exercise improved body mass index (mean difference (MD) -0.33 [-0.47, -0.20], p≤0.0001), body fat% (standardised mean difference (SMD) -0.71 [-1.34, -0.08], p=0.03), aerobic capacity (SMD 0.41 [0.05, 0.78], p=0.03), low-density lipoprotein (SMD -0.27 [-0.52, -0.01], p=0.04), and blood glucose (SMD -0.31 [-0.58, -0.05], p=0.02). Therefore, PRT, HIIT and COMB can improve cardiometabolic health in older adults with cardiometabolic risk. Further research is warranted, particularly in HIIT and COMB, to identify the optimal exercise prescription, if any, for improving older adults cardiometabolic health. (PROSPERO: CRD42019128527).

A survey evaluation comparing pain curriculum taught in Australian exercise physiology degrees to graduate perceptions of their preparedness and competency to treat people with chronic pain.

BACKGROUND AND AIMS: This cross-sectional study evaluated the nature of pain curriculum being taught in accredited exercise physiology degrees across Australian universities and its perceived usefulness for preparing exercise physiologists to treat people with chronic pain. MATERIALS & METHODS: Universities and graduates were asked about the nature and sufficiency of pain curriculum taught, with particular emphasis on competencies for physical therapists as outlined by the International Association for the Study of Pain. RESULTS: Ten universities and 101 graduates responded. Median (interquartile range) instruction time on pain curriculum was 12 (7.25-18.75) hours. Few universities (30%) were aware of the guidelines for physical therapy pain curricula, although most (70%) agreed their degrees contained adequate instruction on pain assessment and management. In contrast, 74% of graduates felt their degree did not adequately prepare them to treat people with chronic pain. Half the graduates (51%) were not aware of the guidelines for physical therapy pain curricula. DISCUSSION & CONCLUSION: There is a disconnect between perceptions of Australian universities and their graduates regarding the sufficiency of pain curriculum taught to student exercise physiologists. Benchmarking pain curriculum in Australian university programs against relevant international recommendations may enhance the suitability of pain curricula taught to exercise physiologists, thereby better preparing new graduates to treat people with pain.

The effectiveness and safety of isometric resistance training for adults with high blood pressure: a systematic review and meta-analysis.

High blood pressure (BP) is a global health challenge. Isometric resistance training (IRT) has demonstrated antihypertensive effects, but safety data are not available, thereby limiting its recommendation for clinical use. We conducted a systematic review of randomized controlled trials comparing IRT to controls in adults with elevated BP (systolic ≥130 mmHg/diastolic ≥85 mmHg). This review provides an update to office BP estimations and is the first to investigate 24-h ambulatory BP, central BP, and safety. Data were analyzed using a random-effects meta-analysis. We assessed the risk of bias with the Cochrane risk of bias tool and the quality of evidence with GRADE. Twenty-four trials were included (n = 1143; age = 56 ± 9 years, 56% female). IRT resulted in clinically meaningful reductions in office systolic (-6.97 mmHg, 95% CI -8.77 to -5.18, p < 0.0001) and office diastolic BP (-3.86 mmHg, 95% CI -5.31 to -2.41, p < 0.0001). Novel findings included reductions in central systolic (-7.48 mmHg, 95% CI -14.89 to -0.07, p = 0.035), central diastolic (-3.75 mmHg, 95% CI -6.38 to -1.12, p = 0.005), and 24-h diastolic (-2.39 mmHg, 95% CI -4.28 to -0.40, p = 0.02) but not 24-h systolic BP (-2.77 mmHg, 95% CI -6.80 to 1.25, p = 0.18). These results are very low/low certainty with high heterogeneity. There was no significant increase in the risk of IRT, risk ratio (1.12, 95% CI 0.47 to 2.68, p = 0.8), or the risk difference (1.02, 95% CI 1.00 to 1.03, p = 0.13). This means that there is one adverse event per 38,444 bouts of IRT. IRT appears safe and may cause clinically relevant reductions in BP (office, central BP, and 24-h diastolic). High-quality trials are required to improve confidence in these findings. PROSPERO (CRD42020201888); OSF ( https://doi.org/10.17605/OSF.IO/H58BZ ).

Aerobic fitness affects cortisol responses to concurrent challenges.

PURPOSE: Studies have demonstrated that a combination of mental and physical challenge can elicit exacerbated state anxiety, effort sense, and cortisol responses above that of a single stimulus. However, an analysis of the effects of aerobic fitness on the responses of cortisol to concurrent mental and physical stress between below average and above average fitness individuals has not been conducted. This study examined the effects of a combination of acute mental challenges and physical stress on psychological and cortisol responses between eight individuals of below average fitness (low fit (LF), VO2max = 36.58 ± 3.36 mL·kg(-1)·min(-1)) and eight individuals of above average fitness (high fit (HF), VO2max = 51.18 ± 2.09 mL·kg(-1)·min). METHODS: All participants completed two experimental conditions. An exercise-alone condition (EAC) consisted of cycling at 60% VO2max for 37 min, and a dual-challenge condition (DCC) included concurrent participation in a mental challenge for 20 min while cycling. RESULTS: The DCC resulted in increases in state anxiety (P = 0.018), perceived overall workload (P = 0.001), and exacerbated cortisol responses (P = 0.04). Furthermore, LF participants had a greater overall cortisol response in the DCC compared with the EAC (DCC = 346.83 ± 226.92; EAC = -267.46 ± 132.32; t7 = 2.49, P = 0.04), whereas HF participants demonstrated no difference between conditions (DCC = 38.91 ± 147.01; EAC = -324.60 ± 182.78; t7 = 1.68, P = 0.14). DISCUSSION: LF individuals seem to demonstrate unnecessary and unfavorable responses to the DCC compared with HF individuals, particularly concerning cortisol. The exacerbated cortisol responses in LF individuals have implications for harmful consequences such as increased risk of cardiovascular disease.