The "Hypertension Approaches in the Elderly: a Lifestyle study" multicenter, randomized trial (HAEL Study): rationale and methodological protocol.

BACKGROUND: Hypertension is a clinical condition highly prevalent in the elderly, imposing great risks to cardiovascular diseases and loss of quality of life. Current guidelines emphasize the importance of nonpharmacological strategies as a first-line approach to lower blood pressure. Exercise is an efficient lifestyle tool that can benefit a myriad of health-related outcomes, including blood pressure control, in older adults. We herein report the protocol of the HAEL Study, which aims to evaluate the efficacy of a pragmatic combined exercise training compared with a health education program on ambulatory blood pressure and other health-related outcomes in older individuals. METHODS: Randomized, single-blinded, multicenter, two-arm, parallel, superiority trial. A total of 184 subjects (92/center), ≥60 years of age, with no recent history of cardiovascular events, will be randomized on a 1:1 ratio to 12-week interventions consisting either of a combined exercise (aerobic and strength) training, three times per week, or an active-control group receiving health education intervention, once a week. Ambulatory (primary outcome) and office blood pressures, cardiorespiratory fitness and endothelial function, together with quality of life, functional fitness and autonomic control will be measured in before and after intervention. DISCUSSION: Our conceptual hypothesis is that combined training intervention will reduce ambulatory blood pressure in comparison with health education group. Using a superiority framework, analysis plan prespecifies an intention-to-treat approach, per protocol criteria, subgroups analysis, and handling of missing data. The trial is recruiting since September 2017. Finally, this study was designed to adhere to data sharing practices. TRIAL REGISTRATION: NCT03264443 . Registered on 29 August, 2017.

Neuromuscular adaptations to sixteen weeks of whole-body high-intensity interval training compared to ergometer-based interval and continuous training.

The neuromuscular adaptations between ergometer-based high-intensity interval training (HIIT-T; n = 15), whole-body high-intensity interval training (HIIT-WB; n = 12) and moderate-intensity continuous training (MICT; n = 14) were compared in forty-one healthy men randomized to 16 weeks of training (3x per week). Two-way repeated measures analysis of variance (ANOVA) showed countermovement (CMJ) and squat (SJ) jump height (HIIT-T: 8.5 ± 13.3%; 3.1 ± 9.7%, HIIT-WB: 6.4 ± 9.8%, 10.4 ± 16.1% and MICT: 2.2 ± 9.5%; 4.4 ± 12.1%, respectively), SJ peak power (HIIT-T: 1.7 ± 3.9%; HIIT-WB : 6.4 ± 7.9%; MICT: 0.5 ± 6.5%) and CMJ rate of force development (HIIT-T: 58.1 ± 50.5%; HIIT-WB: 36.9 ± 54.2%; MICT: 38.4 ± 64.3%) improved similarly in all training groups (all p < 0.05). CMJ peak power increased only after HIIT-T (4.3 ± 5.5%) and HIIT-WB (4.5 ± 5.2%), while no differences were observed in both the rectus femoris and vastus lateralis maximal electromyographic amplitude. Finally, marked improvements were also observed in the number of repetitions in the HIIT-WB protocol at the eighth week, with no further improvement at the sixteenth week. These data suggest that 16 weeks of HIIT-WB is capable to improve neuromuscular function to a similar extent as HIIT-T and MICT.

Energy expenditure and EPOC between water-based high-intensity interval training and moderate-intensity continuous training sessions in healthy women.

The present study compared the energy expenditure (EE) during and after two water aerobics protocols, high-intensity interval training (HIIT) and moderate continuous training (CONT). A crossover randomized design was employed comprising 11 healthy young women. HIIT consisted of eight 20s bouts at 130% of the cadence associated with the maximal oxygen consumption (measured in the aquatic environment) with 10s passive rest. CONT corresponded to 30 min at a heart rate equivalent to 90-95% of the second ventilatory threshold. EE was measured during and 30 min before and after the protocols and excess post-exercise oxygen consumption (EPOC) was calculated. Total EE during session was higher in CONT (227.62 ± 31.69 kcal) compared to HIIT (39.91 ± 4.24 kcal), while EE per minute was greater in HIIT (9.98 ± 1.06 kcal) than in CONT (7.58 ± 1.07 kcal). Post-exercise EE (64.48 ± 3.50 vs. 63.65 ± 10.39 kcal) and EPOC (22.53 ± 4.98 vs.22.10 ± 8.00 kcal) were not different between HIIT and CONT, respectively. Additionally, oxygen uptake had already returned to baseline fifteen minutes post-exercise. These suggest that a water aerobics CONT session results in post-exercise EE and EPOC comparable to HIIT despite the latter supramaximal nature. Still, CONT results in higher total EE.

Acute effects of high-intensity interval training and moderate-intensity continuous training sessions on cardiorespiratory parameters in healthy young men.

PURPOSE: The aim of the present study was to compare the energy expenditure (EE) during and after two treadmill protocols, high-intensity interval training (HIIT) and moderate continuous training (CONT), in young adult men. METHODS: The sample was comprised by 26 physically active men aged between 18 and 35 years engaged in aerobic training programs. They were divided into two groups: HIIT (n = 14) which performed eight 20 s bouts at 130% of the velocity associated with the maximal oxygen consumption on a treadmill with 10 s of passive rest, or CONT (n = 12) which performed 30 min running on a treadmill at a submaximal velocity equivalent to 90-95% of the heart rate associated with the anaerobic threshold. Data related to oxygen consumption ([Formula: see text]) and EE were measured during the protocols and the excess post-exercise oxygen consumption (EPOC) was calculated for both sessions. RESULTS: No difference was found between groups for mean [Formula: see text] (HIIT: 2.84 ± 0.46 L min-1; CONT: 2.72 ± 0.43 L min-1) and EE per minute (HIIT: 14.36 ± 2.34 kcal min-1; CONT: 13.21 ± 2.08 kcal min-1) during protocols. Regarding total EE during session, CONT resulted in higher values compared to HIIT (390.45 ± 65.15; 55.20 ± 9.33 kcal, respectively). However, post-exercise EE and EPOC values were higher after HIIT (69.31 ± 10.88; 26.27 ± 2.28 kcal, respectively) compared to CONT (55.99 ± 10.20; 13.43 ± 10.45 kcal, respectively). CONCLUSION: These data suggest that supramaximal HIIT has a higher impact on EE and EPOC in the early phase of recovery when compared to CONT.

Caffeine Supplementation Effects on Concurrent Training Performance in Resistance-Trained Men: A Double-Blind Placebo-Controlled Crossover Study.

Purpose: The aim of the present study was to investigate the effects of acute caffeine supplementation on the performance during a session of resistance training alone (RT) or in combination with aerobic training (i.e. concurrent training; CT). Method: Fourteen resistance-trained men (23.1 ± 4.2 years) were recruited and performed both RT and CT under three different conditions: control (CONT), placebo (PLA), and caffeine (CAF; 6 mg.kg-1) for a total of six experimental conditions. Results: Both total and per set number of repetitions, and total volume load were lower during CT as compared to RT, irrespective of the supplementation condition (all p < .001), whereas a supplementation main effect was observed for the total number of repetitions (p = .001), the number of repetitions in the first (p = .002) and second sets (p = .001), and total volume load (p = .001). RPE values were higher after the CT sessions than after the RT sessions (p < .001), whereas no differences were observed between supplementation conditions (p = .865). Conclusions: Caffeine supplementation was not sufficient to minimize the acute interference effect on strength performance in a CT session when compared to RT alone. In contrast, caffeine improved strength performance during the first set of both CT and RT, while maintaining a similar RPE between the supplementation conditions. However, the overall effect was small.

Effects of a remotely supervised physical training program combined with cognitive training for older individuals at increased risk of clinical-functional vulnerability: study protocol for a randomized clinical trial.

BACKGROUND: Despite the robust body of evidence for the benefits of home-based physical exercise, there is still a paucity of data on the benefits of home-based cognitive training for older adults, especially in those at increased risk of clinical-functional vulnerability. As such, the present study aims to compare the chronic effects of a telehealth-delivered physical training intervention alone or combined with a cognitive training program in older adults at increased clinical-functional vulnerability risk. METHODS: A randomized clinical trial will be conducted including 62 sedentary older individuals classified as at increased risk of clinical-functional vulnerability based on their Clinical-Functional Vulnerability Index score. Participants will be randomly allocated in a 1:1 ratio to one of two groups, an intervention group including physical training combined with cognitive training, or an active control group including physical training alone. Both groups will receive home-based supervised training remotely for 12 weeks and will be assessed for the primary and secondary outcomes of the study before and after the training period. Primary outcomes include cognitive function and dynamic balance with a dual task. Secondary outcomes encompass physical, cognitive, and occupational performance, functional capacity, quality of life, and anxiety and depression symptoms, as well as hemodynamic measures. Data analysis will be performed by intention-to-treat and per protocol using mixed linear models and Bonferroni's post hoc (α = 0.05). DISCUSSION: Our conceptual hypothesis is that both groups will show improvements in the primary and secondary outcomes. Nevertheless, we expect physical combined with cognitive training to improve cognitive function, dual task, and occupational performance to a greater degree as compared to physical training alone. TRIAL REGISTRATION: NCT05309278. Registered on April 4, 2022.

Impact of Resistance Training Volume on Physical and Perceptual Outcomes of Breast Cancer Survivors Submitted to a Combined Training Program: A Randomized, Single-Blinded Study.

BACKGROUND: To determine the effect of resistance training volume on physical and perceptual outcomes of breast cancer survivors submitted to a combined training program. DESIGN: Randomized single-blinded study. METHODS: Nineteen breast cancer survivor women were randomized to a single-set (SS) or a multiple-set (MS) group. Both groups completed an 8-week combined training intervention in which the SS and MS groups performed 1 and 3 sets per resistance exercise, respectively. The following outcomes were assessed preintervention and postintervention: maximal knee extension dynamic strength (1-repetition maximum), quadriceps muscle thickness, peak oxygen uptake, time to exhaustion, cancer-related fatigue, and quality of life. RESULTS: Both interventions increased knee extension 1-repetition maximum (SS: 29.8% [37.5%]; MS: 19.3% [11.8%]), quadriceps muscle thickness (9.4% [4.1%]; 8.9% [5.9%]), and quality of life (4.3% [6.3%]; 7.9% [9.0%]), with no difference between the groups. However, only MS improved cancer-related fatigue (-2.1% [1.7%]) and time to exhaustion (21.3% [14.9%]), whereas peak oxygen uptake remained unchanged in both groups. CONCLUSIONS: Cancer-related fatigue and time to exhaustion, improved only in the MS group after the intervention. On the other hand, similar knee extension 1-repetition maximum, quadriceps muscle thickness, and quality of life improvements were observed in breast cancer survivors irrespective of the resistance training volume performed.

Short-Term Effects of Land-Based Versus Water-Based Resistance Training Protocols on Post-Exercise Hypotension in Normotensive Men: A Crossover Study.

Considering that water immersion may acutely reduce blood pressure (BP) and that exercise may elicit positive post-exercise hypotension (PEH) responses, we aimed to analyze the presence of PEH in normotensive individuals and compare its magnitude between two resistance training sessions performed in aquatic or land environments. Ten physically active men (23.2 ± 3.1 years) performed the two training protocols in a randomized, counterbalanced fashion. BP measurements were performed for 30 min (at 5 min intervals) both prior to (resting) and after each of the protocols. No differences were observed between protocols at baseline (p > 0.05). Only the water-based resistance training protocol resulted in a systolic BP reduction from 10 to 20 min post-exercise (all p < 0.05) compared to baseline. Compared to the land-based session, systolic BP was lower in the water-based protocol from 10 to 25 min post-exercise (all p < 0.05). On the other hand, diastolic BP showed a similar PEH effect between water and land-based protocols for the entire 30 min post-session period (all p < 0.001). Our results suggest that water-based resistance training holds the potential as a nonpharmacological strategy to lower BP levels following exercise.

Relationship between Oxygen Uptake, Heart Rate, and Perceived Effort in an Aquatic Incremental Test in Older Women.

Different parameters can be used to control the intensity of aerobic exercises, a choice that should consider the population and exercise environment targeted. Therefore, our study aimed to verify the relationship between oxygen uptake (VO2), heart rate (HR), rating of perceived exertion (RPE), and cadence during an aquatic incremental test in older women. Nine older women (64.3 ± 4.4 years) engaged in a water-based aerobic training performed an aquatic incremental test using the stationary running exercise (cadence increases of 15 b·min-1 every 2 min) until participants' volitional exhaustion. VO2, HR, and RPE data were measured, and the percentage of peak VO2 (%VO2peak) and percentage of maximal HR (%HRmax) were calculated. Linear and polynomial regression analyses were performed (α = 0.05). Polynomial regressions revealed the best adjustments for all analyses. Data showed a significant relationship (p < 0.001) between %VO2peak and %HRmax (r = 0.921), %VO2peak and RPE (r = 0.870), and %HRmax and RPE (r = 0.878). Likewise, significant relationships between cadence (p < 0.001) and %VO2peak (r = 0.873), %HRmax (r = 0.874), and RPE (r = 0.910) were also observed. In summary, the physiological, subjective, and mechanical variables investigated were highly associated during an aquatic incremental test to exhaustion in older women. Therefore, these different parameters can be employed to adequately prescribe water-based programs according to preference and availability.

Water-based continuous and interval training in older women: Cardiorespiratory and neuromuscular outcomes (WATER study).

The purpose of this study was to investigate the effects of two water-based aerobic programs on cardiorespiratory and neuromuscular outcomes in older women. Forty-one women (60 to 75 years old) volunteered to participate in the study. Participants were randomized into a water-based continuous (CTG; n = 21; 63.9 ± 2.5 years) or an interval (ITG; n = 20; 64.8 ± 3.6 years) aerobic training group. Both training programs were performed for 12 weeks (45-min sessions twice a week), with exercise intensity based on rating of perceived exertion (Borg's RPE 6-20 Scale). Pre and post training assessments of cardiorespiratory and neuromuscular outcomes were performed. Data analyses were conducted using Generalized Estimating Equations and Bonferroni post-hoc test (α = 0.05). After the intervention, the CTG and the ITG displayed similar improvements in time to exhaustion (8% vs. 11%), peak oxygen uptake (9% vs. 7%), maximal dynamic knee extension strength (5% vs. 6%), dynamic muscular endurance of knee extensors (10% vs. 11%), maximal vastus lateralis electromyographic signal amplitude (13% vs. 35%), as well as an increase in muscle thickness (5% vs. 6%) and decrease in muscle echo intensity (-2% vs. -3%) of the quadriceps femoris. In conclusion, older women benefited from water-based exercise training prescribed based on participants' RPE, with both the interval and the continuous training programs resulting in similar increases in the cardiorespiratory and neuromuscular parameters.