Aquatic Aerobic and Combined Training in Management of Type 2 Diabetes: The Diabetes and Aquatic Training Study (DATS): A Randomized Clinical Trial.

BACKGROUND: To compare the effects of aquatic aerobic and combined (aerobic more resistance) training on glycemic control and other cardiometabolic outcomes in patients with type 2 diabetes. METHODS: Patients were randomized to an aquatic aerobic training (AERO, n = 19; 57.5 [7.4] y; 9 [47%] women), or an aquatic combined training (COMBI, n = 19; 60.9 [7.4] y; 10 [53%] women), or an aquatic active procedure control (n = 19; 58.6 [9.7] y; 10 [53%] women) in 3 weekly sessions (50 min each), during 15 weeks. Glycated hemoglobin was the primary outcome, whereas insulin resistance markers, lipid profile, systemic inflammation, renin concentration, blood pressure, physical activity levels, and sitting time were secondary outcomes. RESULTS: Glycated hemoglobin was reduced in all groups (P = .021), although changes were more marked in AERO (-0.36%) and COMBI (-0.44%) than in active control (-0.26%) group. Lipid profile was similarly modified in all groups. Diastolic blood pressure and renin concentration were also reduced in all groups; however, renin showed more marked reductions in AERO (-17.7 uIU/mL) and COMBI (-15.1 uIU/mL) than in active control (0.2 uIU/mL) group. Fasting insulin, triglycerides, C-reactive protein, systolic blood pressure, walking time, and sitting time on weekends were not modified. CONCLUSION: AERO and COMBI presented similar effect to improve glycemic control and some cardiometabolic risk factors in patients with type 2 diabetes.

Pilates training improves aerobic capacity, but not lipid or lipoprotein levels in elderly women with dyslipidemia: A controlled trial.

INTRODUCTION: The aim of the present study was to verify the effects of a Pilates training on total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), glucose and C-reactive protein (CRP) levels, as well as on functionality of postmenopausal women with dyslipidemia. METHOD: This randomized study involved 35 sedentary women with dyslipidemia, aged between 60 and 75 years. One group participated in a Pilates exercises training with two to four weekly sessions during 10 weeks (Pilates group, n = 20) and the other group did not perform any intervention (control group, n = 6). Biochemical analyses and functionality parameters were measured before and after the 10 weeks. RESULTS: No significant differences were observed in TC, TG, LDL and HDL for both groups. Regarding glucose and CRP levels, significant reductions were observed in both groups after the intervention period. In functional parameters, both groups significantly increased their 30-s chair stand test values. On the other hand, only the Pilates group presented significant increments in the 6-min walk test (p < 0.05). CONCLUSION: Pilates training did not change lipid or lipoprotein levels, but improved cardiorespiratory fitness of elderly women with dyslipidemia.

Aquatic Training in Upright Position as an Alternative to Improve Blood Pressure in Adults and Elderly: A Systematic Review and Meta-Analysis.

BACKGROUND: Meta-analyses have shown that land training (LT) reduces blood pressure; however, it is not known whether aquatic training (AT) promotes this same effect. OBJECTIVE: The aim was to conduct a meta-analysis on the effects of AT on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults and elderly and compare them to those of LT and no training [control group (CG)]. DATA SOURCES: Embase, PubMed, Cochrane and Scopus were searched up to May 2017. STUDY ELIGIBILITY CRITERIA: Studies that evaluated the effect of upright AT (i.e., AT performed in upright position) on the blood pressure of adult individuals and the elderly who did not present with cardiovascular disease (other than hypertension) were included. DATA ANALYSIS: Two independent reviewers screened search results, performed data extraction and assessed risk of bias. Random effect was used, and the effect size (ES) was calculated by using the standardized mean difference with a 95% confidence interval. RESULTS: AT promoted a reduction in SBP (ES - 1.47; 95% CI - 2.23 to - 0.70; p < 0.01) compared to CG. This effect is maintained with training progression (ES - 1.52; 95% CI - 2.70 to - 0.33; p = 0.01) and no progression (ES - 1.43; 95% CI - 2.64 to - 0.23; p = 0.02). These effects were significant only in hypertensive (ES - 2.20; 95% CI - 2.72 to - 1.68; p < 0.01), and not in pre-hypertensive individuals. AT promoted a decrease in DBP (- 0.92; 95% CI - 1.27 to - 0.57; p < 0.01) after training with progression (- 0.81; 95% CI - 1.62 to - 0.001; p = 0.04) and no progression (- 1.01; 95% CI - 1.40 to - 0.62; p < 0.01) in pre-hypertensive (- 1.12; 95% CI - 1.53 to - 0.70; p < 0.01) and hypertensive patients (- 0.69; 95% CI - 1.31 to - 0.06; p = 0.03). AT promoted similar reductions in SBP compared to LT; however, reduction of DBP in hypertensive patients was lower (1.82; 95% CI 0.84 to 2.79; p < 0.01). CONCLUSION: AT promotes blood pressure reduction in adults and elderly. The reduction in SBP in those performing AT is similar to those performing LT, but reduction of DBP is lower in the AT group compared to that in the LT group. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42016049716.

Short-term water-based aerobic training promotes improvements in aerobic conditioning parameters of mature women.

Aging is accompanied by a decrease in aerobic capacity. Therefore, physical training has been recommended to soften the effects of advancement age. The aim of this study was to assess the effects of a short-term water-based aerobic training on resting heart rate (HRrest), heart rate corresponding to anaerobic threshold (HRAT), peak heart rate (HRpeak), percentage value of HRAT in relation to HRpeak and test duration (TD) of mature women. Twenty-two women (65.91 ± 4.83 years) were submitted to a five-week water-based interval aerobic training. Aerobic capacity parameters were evaluated through an aquatic incremental test. After training, there was an increase in TD (16%) and HRAT percentage in relation to HRpeak (4.68%), and a reduction of HRrest (9%). It is concluded that a water-based aerobic interval training prescribed through HRAT of only five weeks is able to promote improvements in aerobic capacity of mature women.

Glycemic reductions following water- and land-based exercise in patients with type 2 diabetes mellitus.

PURPOSE: To assess the acute glucose responses to the first sessions of three mesocycles of water- and land-based aerobic exercise. METHODS: The water-based exercise group (WBE, n = 14; 54.1 ± 9.1 years) performed deep water walking and/or running, while the land-based exercise group (LBE, n = 11; 60.1 ± 7.3 years) performed walking and/or running on athletic track. In the first mesocycle, patients trained at 85-90% of their anaerobic threshold (AT) for 35 min, progressing to 90-95% of the AT in the second mesocycle, and 95-100% of the AT in the last mesocycle. Capillary glucose was assessed before and immediately after the first session of each mesocycle. RESULTS: There was glycemic reduction (p < 0.001) in all sessions, with relative reductions of 19%, 29% and 24% for the WBE and 24%, 29% and 27% for the LBE in the mesocycles 1, 2 and 3, respectively. There were no found differences between groups and between mesocycles. CONCLUSIONS: The acute response of blood glucose to aerobic training between 85 and 100% of the heart rate of AT is effective and independent of the environment in which it is performed. Clinical trial reg. no. NCT01956357, clinicaltrials.gov.

Imersão em água fria para o manejo da hipertermia severa / Cold water immersion to the control of exertional heat illness

A incapacidade de dissipar o calor gerado pela atividade muscular prejudica o desempenho e aumenta a predisposição a lesões do organismo. A hipertermia severa induzida pelo esforço físico (HTE) prejudica a saúde e está associada à morbidade e mortalidade de indivíduos em diferentes atividades ocupacionais e atléticas. Estudos sobre a eficiência de métodos de resfriamento corporal têm recomendado a imersão em água fria para o tratamento da HTE. Sua utilização nos minutos iniciais pós-hipertemia parece a melhor recomendação por reduzir o tempo no qual a temperatura central permanece elevada. A manutenção de infraestrutura necessária para a realização desse procedimento deve ser considerada em atividades físicas e condições ambientais nas quais os indivíduos estão mais suscetíveis ao acometimento da HTE. As taxas de resfriamento observadas através da imersão em água a diferentes temperaturas podem servir de referência para o controle da duração do procedimento. Esta revisão analisa a recomendação da imersão em água fria como procedimento de resfriamento corporal para o manejo da HTE.

The incapacity of dissipating heat generated by muscular activity hampers performance and increases predisposition to physical injuries. Exertional heat illness (HTE) harms health and is associated with morbidity and mortality of individuals in different occupational and athletic activities. Studies on the efficiency of body cooling methods have recommended cold-water immersion for the treatment of HTE. Its use in the initial minutes of post-hyperthermia seems to be the best recommendation to reduce the time central temperature remains high. Maintenance of the infrastructure needed to perform this procedure should be considered in physical activities and environmental conditions in which the individuals are more prone to HTE. The cooling rates observed through water immersion in different water temperatures may serve as reference to the control of HTE procedure duration. This review analyses the recommendation of cold-water immersion as a body cooling procedure for management of HTE.

Efeitos de diferentes sessões de aquecimento no torque e amplitude articular de homens jovens / Effect of distinct warm up routines on torque production and range of motion in young males

Exercícios de flexibilidade são freqüentemente incluídos em sessões de aquecimento antes de exercíciosresistidos. No entanto, alguns autores sugerem que a prática de exercícios de alongamento podem afetarnegativamente performance de atividades que exijam força máxima. Sendo assim, o objetivo geral desseestudo foi verificar o impacto de três diferentes sessões de aquecimento na amplitude de movimento doquadril, pico de torque e trabalho total dos flexores do joelho direito. Dez homens treinados, sem histórico delesão neuromuscular, foram testados isocineticamente em três velocidades (60°/s, 90°/s e 120°/s) após trêsdiferentes sessões de aquecimento: 1) aquecimento geral (AG) no cicloergômetro; 2) aquecimento geral nocicloergômetro e alongamento estático (AE); 3) aquecimento geral no cicloergômetro e a técnica de facilitaçãoneuromuscular proprioceptiva hold-relax (FNP). A amplitude articular do quadril direito foi medido atravésde um goniômetro. As comparações foram feitas através de análise de variância com medidas repetidas eteste Post-Hoc de Bonferroni. (p < 0,05). Os resultados mostraram uma redução no pico de torque na sessãoFNP comparados aos da sessão AE na velocidade de 60°/s na fase concêntrica (AE: 150,8 + 21 Nm vs. FNP:140 + 22 Nm) e excêntrica (AE: 182,4 + 24,5 Nm vs. FNP: 168,5 + 27,8 Nm) e também menores quandocomparados ao dia de AG na velocidade de 120°/s (AG: 141,4 + 15,9 Nm vs. FNP: 129,2 + 18,4 Nm). Avariação do arco articular do quadril foi maior com o FNP (AE: 18,3 + 10,9 graus vs. FNP: 27,9 + 6,8 grauscomparado ao AE. Nós concluímos que a técnica FNP “hold-relax” pode influenciar de forma negativa osvalores de força voluntária máxima dos flexores de joelho, enquanto exercícios estáticos parecem não promoverefeito negativo. No entanto, para o aumento dos níveis de amplitude da articulação do quadril, a técnica FNP“hold-relax” parece ser a melhor opção.

Stretching exercises are commonly included in warm-up routines before resistance exercises. However, some authors suggest that stretching exercises may affect negatively activities that require maximalstrength. The purpose of this study was to verify the impact of three different warm-up sessions on hiprange of motion (ROM), peak torque and total work of right knee flexors of young adults. Ten trainedmen without neuromuscular injury were tested isocinetically at three velocities (60º/s, 90º/s and 120º/s) afterdifferent warm-up sessions: stationary bike (B), stationary bike and static stretch (S), stationary bike and hold-relax technique (FNP). The right hip ROM variation after warm-up sessions was obtained with agoniometer. Comparisons were made with analyses of variance (ANOVA) for repeated measures andpost-hoc Bonferroni (p < 0.05). Our results showed a peak torque reduction in FNP session at theconcentric phase, compared with S session at velocity 60º/s (S: 182.4 + 24.5 Nm vs. FNP: 168.5 + 27.8Nm) and B session at velocity 120º/s (B: 141.4 + 15.9 Nm vs. FNP: 129.2 + 18.4 Nm). The FNP sessionpromoted a higher range of motion variation when compared with E session. (E: 18.3 + 10.9 degrees vs.FNP: 27.9 + 6.8 degrees). We concluded that FNP stretching exercises may promote a negative effect onmaximal force of knee flexors, while static stretching exercises promotes no negative effect. However, to increase the hip ROM , the hold-relax FNP technique seems to be a better choice.