Improving the neuromuscular fitness of patients with type 2 diabetes by aquatic exercise training - The Diabetes and Aquatic Training Study (DATS 3): a randomized controlled trial.

BACKGROUND: To compare the effects of aquatic aerobic and combined training on neuromuscular outcomes in patients with type 2 diabetes. METHODS: Patients with type 2 diabetes were randomized to an aerobic aquatic training (AERO), a combined aquatic training (COMBI) or a procedure control (CON) three weekly for 15 weeks. The sessions were 50 minutes long. Maximal strength and muscle endurance were assessed by the 1RM and maximum repetitions at 60% 1RM tests, respectively, in knee extension and elbow flexion exercises. Timed up and go test, testosterone, cortisol and testosterone:cortisol ratio also were evaluated. RESULTS: Participants had 59.0±8.2 years, 51% women. All groups increased (P<0.001) the maximal knee extension strength (Mean Difference: AERO: 21.1 kg; COMBI: 14.6 kg; CON: 4.4 kg), while only COMBI group increased (P<0.001) the maximal elbow flexion strength (Mean Difference: 2.6 kg). Muscle endurance in both exercises were increased in all groups. The Timed Up and Go test at the usual and maximal speed decreased in all groups. Testosterone were not modified in present study, while cortisol and testosterone:cortisol were improved in COMBI group. CONCLUSIONS: Aquatic training, especially combined aquatic training, improve the neuromuscular fitness of patients with type 2 diabetes.

Effects of Aquatic Exercise on Muscle Strength in Young and Elderly Adults: A Systematic Review and Meta-Analysis of Randomized Trials.

ABSTRACT: Prado, AKG, Reichert, T, Conceição, MO, Delevatti, RS, Kanitz, AC, and Kruel, LFM. Effects of aquatic exercise on muscle strength in young and elderly adults: a systematic review and meta-analysis of randomized trials. J Strength Cond Res 36(5): 1468-1483, 2022-The effects of training in an aquatic environment on muscular strength are still contradictory in the literature. The aim was to conduct a systematic review and meta-analysis of randomized studies about muscle strength responses after a program of aquatic exercise. A systematic review followed the Cochrane and PRISMA recommendations. The search was performed between December 2015 and January 2016. There were no language restrictions, and PubMed, SCOPUS, Scielo, Cochrane, and PEDro databases were consulted. An analysis of eligibility of the studies was performed by 2 independent authors. The data extraction followed standard criteria, and an evaluation of methodological quality was performed. The statistical analysis was conducted in the Review Manager 5.1 software. The statistical heterogeneity was assessed by means of Cochran's Q test and by the inconsistency test (I2). The search found 2,563 articles, 27 were included, totaling a total n of 1,006 subjects. The analysis of the risk of bias demonstrated a lack of clarity of the randomization process, allocation concealment, blinding assessment, intention to treat analysis, and calculation of the sample in 70% or more of the studies analyzed. Meta-analysis demonstrated a significant increase in handgrip strength, in isometric peak torque (PT) of knee unilateral extension and flexion, and isokinetic PT (60°·s-1) of knee unilateral extension. Sensitivity analyses demonstrated that the positive effects of training in an aquatic environment may be dependent on factors such as age, velocity of movement, and use of device. Land-based and aquatic exercises seem to lead to similar muscle strength gains. Aquatic exercise should be recommended as a strategy to improve muscle strength, but new studies with better methodological quality should be conducted.

Clustering of Physical Activity and Sedentary Behavior Associated With Body Composition in Brazilian Older Adults.

This study described the clustering patterns of moderate to vigorous physical activity and sedentary time (ST) according to handgrip strength and investigated the association between identified clusters of fat and lean mass in older adults from southern Brazil. Objective measures were used for moderate to vigorous physical activity, ST, and body composition outcomes. Two-step cluster and linear regression analyses were conducted according to handgrip strength. Three clusters were identified: all-day sitters, sitters, and active sitters. The prevalence of clusters in the low-strength group was 58.2%, 22.8%, and 19.0%, respectively, while the prevalence of clusters in the high-strength group was 42.1%, 34.8%, and 23.1%, respectively. All-day sitters had 2.6% more fat mass than active sitters with low strength. High levels of ST characterized all cluster profiles; low strength, lack of moderate to vigorous physical activity, and high ST levels among older adults may indicate a subpopulation at a greater risk of overweight and obesity-related diseases.

Acute effect of bodyweight-based strength training on blood pressure of hypertensive older adults: A randomized crossover clinical trial.

Background: Strength Training (ST) reduces the cardiovascular risk of hypertensive elderly people; however, there is a need for efficient and low-cost ST programs that aim to reduce blood pressure (BP) in elderly people with adherence and affectivity in this population. Objective: Evaluate the acute effect on BP and satisfaction with the practice of bodyweight-based strength training (BWST) in hypertensive older adults. Methods: Participants performed a BWST session and a control session (CS). The BWST consisted of six exercises, with three sets of 30 seconds. In the CS, no activity was performed. BP was measured before and at 0, 10, 20, and 30 minutes post-session. Participants' satisfaction was assessed. Results: Eleven older adults (65.8 ± 4.6 years; 7 men) participated in the study. There was an increase (p = .028) in systolic BP immediately after BWST, returning to baseline values in the intervals 10, 20, and 30 post-section. In the CS there was an increase (p = .009) 30 minutes post-session compared to 20 minutes. Between sessions, a lower systolic BP was found in BWST (-6.54 ± 3.31; p = .048) 30 minutes post-sessions. For satisfaction, 82% of participants were "totally satisfied" with BWST. Conclusion: The SBP is lower 30 minutes after BWST session than control session, and BWST promoted a pleasant affective response in hypertensive older adults.

Glycemic Threshold as an Alternative Method to Identify the Anaerobic Threshold in Patients With Type 2 Diabetes.

Purpose: To analyze the agreement between the velocity, heart rate, and oxygen uptake values corresponding to second ventilatory threshold and glycemic threshold in patients with type 2 diabetes. Methods: Twenty-four untrained patients (55.1 ± 8.9 years) were evaluated. Three different parameters of training intensity corresponding to anaerobic threshold, one mechanical (velocity) and two physiological (heart rate and oxygen uptake) parameters, were identified by a classical method (second ventilatory threshold) and by an alternative method (glycemic threshold). To determine the threshold values, patients performed an incremental treadmill test, with an initial velocity of 3 km.h-1 for 3 min, that was then increased by 1 km.h-1 every 2 min. Comparisons between mean values and the degree of agreement between second ventilatory threshold and glycemic threshold were analyzed using the paired t-test and Bland-Altman test, respectively. Results: All patients performed the tests appropriately, and no adverse effects were recorded. Patients demonstrated similar mean velocity (p = 0.25), heart rate (p = 0.97) and oxygen uptake (p = 0.71) between the ventilatory threshold (6.4 ± 0.6 km.h-1, 130.1 ± 18.7 bpm, 15.2 ± 3.5 ml.kg.min-1) and the glycemic threshold (6.2 ± 0.9 km.h-1, 130.2 ± 12.8 bpm, 15.0 ± 3.8 ml.kg.min-1). Conclusion: The present study indicates an agreement between the glycemic and second ventilatory methods in determination of the anaerobic threshold of patients with type 2 diabetes; and thus, either method may be used for these patients.

Efeitos agudos dos exercícios de hidroginástica e minitrampolim sobre os níveis pressóricos e glicêmicos de adolescentes obesos / Acute effects of water based and mini-trampoline exercises on pressoric and glycaemic levels of obese adolescents

O número de crianças com excesso de peso está aumentando na sociedade, implicando no aparecimento precoce de diabetes tipo 2 e hipertensão. Para prevenir isso, o exercício físico de baixo impacto pode ser uma alternativa segura e eficaz, podendo ser realizado tanto em meio aquático como em meio terrestre. Assim, o presente estudo objetivou analisar o efeito do exercício aeróbico de baixo impacto, em diferentes meios (hidroginástica vs mini trampolim), sobre os níveis glicêmicos e pressóricos de adolescentes obesos. Trinta e dois adolescentes obesos (12,4±2,5 anos) foram alocados randomicamente no grupo hidroginástica (GH; n = 16) e no grupo minitrampolim (GMT; n = 16). Ambos os grupos realizaram uma sessão de exercícios com duração de 32 minutos, prescrita de forma intervalada, com intensidade de estímulo em índice de esforço percebido intenso e recuperação em índice de esforço percebido muito leve. Os desfechos de glicemia capilar e pressão arterial foram avaliados pré, pós e 30 minutos pós-exercício. Uma equação de estimativas generalizadas foi usada para analisar os níveis glicêmicos e pressóricos nos diferentes momentos e modalidades, adotando-se um nível de significância de 5%. Ambos os grupos apresentaram redução glicêmica apenas imediatamente após a sessão de exercício (GH: -7,4mg/dL, GMT: -4,5mg/dL; efeito tempo, p = 0,005). A pressão arterial diastólica foi reduzida em ambos os grupos cinco minutos pós-exercício (GH: - 4mmHg, GMT: 0mmHg; efeito tempo, p = 0,017), permanecendo assim 30 minutos pós-exercício (efeito tempo; p = 0,013), enquanto a pressão arterial sistólica foi reduzida somente 30 minutos pós-exercício (GH: -14mmHg, GMT: -1,5mmHg; efeito tempo, p < 0,001). Conclui-se que sessões sob minitrampolim e hidroginástica, de forma intervalada, podem diminuir de forma similar os níveis glicêmicos e pressóricos de adolescentes obesos....(AU)

The number of children that are overweight it has been increasing in society, resulting in early-onset type 2 diabetes and hypertension. To prevent this, the physical low-impact exercise can be a safe and effective alternative and can be performed both aquatic as terrestrial environment. Therefore, this study aimed to analyze the effect of aerobic exercise with low impact in different environment (water vs/ land) on glucose and blood pressure levels in obese adolescents. Thirty-two obese adolescents (12.4 ± 2.5 years; BMI: 33.1 ± 5.3 kg / m2) were randomly allocated in two aerobics group: water group (GH; n = 16) and mini-trampoline training (GMT; n = 16). Both groups performed an exercise session lasting 32 minutes of prescribed intervals and stimulus intensity perceived intense effort index and recovery in very light perceived. The outcomes of blood glucose and blood pressure were analyze before, after and 30 minutes after exercise. An equation of generalized estimates was use to analyze the blood sugar and blood pressure levels at different times and modalities, adopting the significance level of 5%. Both groups had reduced glycemic only immediately after the exercise session (GH: -7,4mg/dL, GMT: -4,5mg/dL; time effect, p = 0,005). The diastolic blood pressure was reduced both the five minutes post-exercise groups (GH: - 4mmHg, GMT: 0mmHg; time effect, p = 0.017) and remained at 30 minutes post-exercise (time effect, p = 0.013), while the systolic blood pressure was reduced just 30 minutes post-exercise (GH: -14mmHg, GMT: -1,5mmHg; time effect; p <0.001). We conclude that interval sessions with low impact exercise can decrease similarly glycemic and blood pressure of obese adolescents....(AU)

Glucose control can be similarly improved after aquatic or dry-land aerobic training in patients with type 2 diabetes: A randomized clinical trial.

OBJECTIVES: To compare the effects of two aerobic training methods in water and on dry-land on glycemic, lipid, inflammatory, hormonal, cardiorespiratory, and functional outcomes in patients with type 2 diabetes. DESIGN: Randomized clinical trial. METHODS: Thirty-five patients with type 2 diabetes were randomly assigned to aquatic aerobic training group (n=17) or dry-land aerobic training group (n=18). Exercise training interventions had duration of 12 weeks, performed in three weekly sessions (45min/session), with intensity progressing from 85% to 100% of heart rate of anaerobic threshold during interventions. All outcomes were evaluated at baseline and 12 weeks later. RESULTS: Patients were 56.7±7.9 years old. Decreases in glycated hemoglobin were observed in both groups (AT: -0.42±0.28%, DLT: -0.35±1.8%). Total cholesterol, high density lipoprotein, low density lipoprotein levels, plasma renin activity, angiotensin II concentrations, C-reactive protein, systolic blood pressure, resting heart rate, and timed up and go test performed at the usual speed also decreased in both groups in response to both interventions (p<0.05), without between-group differences. Both groups increased the ratio between oxygen uptake at the anaerobic threshold and oxygen uptake of peak (p=0.01). CONCLUSIONS: Aerobic training in an aquatic environment provides effects similar to aerobic training in a dry-land environment in patients with type 2 diabetes.