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.

Determinants of Dual-task Gait Speed in Older Adults with and without Parkinson's Disease.

Mobility difficulties for people with Parkinson's disease (PwPD) are more pronounced when they perform a simultaneous cognitive task while walking. Although it is known that neurodegeneration results in widespread motor and brain impairments, few studies have comprehensively examined possible physical and mental determinants of dual task walking in PwPD. In this cross-sectional study, we aimed to investigate if and how muscle strength (sit-to-stand 30-sec test), cognition (mini-mental state examination) and functionality (timed up and go test) affect walking performance (10-meter walking test) with and without arithmetic dual task from older adults with and without Parkinson's disease. Walking speed was reduced by 16% and 11% with arithmetic dual task for PwPD (from 1.07±0.28 to 0.91±0.29 m.s-1, p<0.001) and older adults (from 1.32±0.28 to 1.16±0.26 m.s-1, p=0.002) compared to essential walking. The cognitive state was similar among the groups, but it was only associated with the dual-task walking speed in PwPD. In PwPD, lower limb strength was the better predictor of speed, whereas mobility was more related to it in older adults. Therefore, future exercise interventions aiming to improve walking in PwPD should consider these findings to maximize their effectiveness.

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.

Effect of the execution order from concurrent exercise session on blood pressure responses in hypertensive older men

Abstract Aim: To compare blood pressure (BP) responses among the different orders of execution of concurrent exercise (CE) sessions in controlled hypertensive older men. Methods: Fifteen older men (64 ± 5 years) participated in three randomized crossover sessions: control session (C), CE in aerobic-resistance order (AR), and resistance-aerobic order (RA). The CE was performed for 1 h, in which 30 min were for the resistance exercise with 5 exercises at 70% of 1RM and 30 min for the aerobic exercise on a treadmill with intensity corresponding to the first ventilatory threshold. Clinical systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) were measured at rest and over 2 h and 24 h after the session. For analysis, the Generalized Estimating Equations (GEE) test was used with Bonferroni's complimentary test (α = 0.05). Results: The SBP decreased by 30 min after AR, while after RA we obtained reductions during 1 h after a session concerning rest. Between sessions, we found lower values in both CE compared to the C at 30 min, 45 min, and 90 min. In the RA there was a lower pressure in relation to the C at minute 60. The DBP reduced 30 min after the AR regarding the pre-session, however with no difference between sessions. The MBP was lower in relation to 30 min rest after AR. Among sessions, a pressure drop was observed in the AR compared to the C at 30 min and 45 min. Conclusion: We can conclude that the CE was effective in generating post-exercise hypotension regardless of the order in controlled hypertensive older men.

The execution order of the concurrent training and its effects on static and dynamic balance, and muscle strength of elderly people

Abstract Aim: Assess the effect of the performance order in the Concurrent Training (CT), Aerobic-Strength (AS), and Strength-Aerobic (SA), in the static balance, dynamic balance, and muscle strength in elderly people. Methods: The study involved 38 elderly people (men and women) aged 60 to 75 years old, divided into SA (n = 19) and AS (n = 19). Within 12 weeks, the aerobic training consisted of walking with intensity prescribed by the Borg's Rating of Perceived Exertion (6-20) and the strength training consisted of six exercises, with intensity controlled by Repetition Maximum training zones. Static balance (plantar pressure center area and displacement in bipedal support with eyes closed and open), dynamic balance (Timed Up and Go and Tandem Gait), and maximum dynamic strength of knee extension and bench press have been evaluated. For data analysis, Generalized Estimating Equations with Bonferroni's complimentary test have been used (α = 0.05). Results: For static and dynamic balance there hasn't been an effect on the 12 weeks of combined training, regardless of the performance order. Both groups maintained the balance variables within the intervention period. When it comes to strength, there has been a noticeable improvement in lower limbs (SA: 16%; AS: 11%; p < 0,001) and upper (SA: 22.0%; AS: 8.7%; p < 0.001), without any differences between the groups. Conclusion: So there is no difference between the order of performance of the CT in the variables of static and dynamic balance and strength of upper and lower limbs. Furthermore, after training, there have been significant improvements in the variables of strength and maintenance of static and dynamic balance.

Water-based exercises in postmenopausal women: Vertical ground reaction force and oxygen uptake responses.

The purpose of the present study was to analyse vertical ground reaction force (Fz) and oxygen uptake (VO2) responses in six different water-based exercises performed at different cadences by postmenopausal women. Twelve postmenopausal women (57.3 ± 2.6 years, 158.1 ± 6.9 cm, 69.1 ± 10.9 kg) voluntarily took part in the study. Participants completed six sessions corresponding to maximal tests for each water-based exercise. Then, two sessions were performed for the experimental protocols, which comprised the performance of three exercises at three cadences (80, 100 and 120 b min-1), with Fz and VO2 measurements. Peak (Fzpeak) and impulse of Fz were determined. In addition, VO2 percentages relative to maximal VO2 (VO2max) values obtained in each maximal test were expressed as %VO2max. Data were analysed using two-way ANOVA with repeated measures (α = 0.05). As results, significant differences were found in Fzpeak and impulse between the water-based exercises, with similar VO2 and %VO2max values between them for each cadence. In addition, with the increasing cadence, Fzpeak (0.20-0.80 BW), VO2 (5.3-9.4 ml kg-1 min-1) and %VO2max (32.1-57.6%) values increased, while impulse (0.20-0.07 N.s/BW) values were reduced. Therefore, for a same physiological intensity, postmenopausal women experience different Fz loads during different water-based exercises.

Contributions of physical exercise to motor symptoms and the balance of people with Parkinson's Disease: a systematic review / Contribuciones del ejercicio físico para los síntomas motores y el equilibrio de las personas con Enfermedad de Parkinson: una revisión sistemática / Contribuições do exercício físico nos sintomas motores e no equílibrio de pessoas com Doença de Parkinson: uma revisão sistemática

OBJECTIVE: The aim of the study was to conduct a systematic review evaluating the effects of physical exercise on balance and motor symptoms of Parkinson's Disease. METHOD: The search was carried out on the PubMed, Scielo and PEDro databases. The articles were evaluated by two independent researchers, following the criteria: presenting a control group, having more than eight weeks of intervention, assessing motor symptoms (Unified Parkinson's Disease Rating Scale and Parkinson's Disease Questionnaire -39) and balance (Timed Up and Go and Berg Scale). RESULTS: The search resulted in 1377 articles, of which 11 were included in the study. The total number of participants was 925, in which 545 were allocated in the intervention groups and 380 in the control groups. The strength training and balance, performed alone or in combination, are highlighted in improvements related to balance. Exercise, regardless of type, improves motor symptoms. CONCLUSIONS: Thus, physical exercise has a positive effect on both balance and motor symptoms of Parkinson's Disease, strength and balance modalities stand out

OBJETIVO: El objetivo de este estudio fue conducir una revisión sistemática evaluando los efectos del ejercicio físico en el equilibrio y los síntomas motores de la Enfermedad de Parkinson. MÉTODO: Se realizó una búsqueda de artículos científicos en las siguientes bases: PubMed, Scielo y PEDro. Los artículos fueron evaluados por dos investigadores, siguiendo los criterios: presentar grupo control, contar con al menos ocho semanas de intervención, evaluar síntomas motores (Unified Parkinson's Disease Rating Scale y el Parkinson's Disease Questionnaire-39) y equilibrio (Timed Up and Go y Escala de Berg). RESULTADOS: Se revisaron un total de 1377 artículos, de estos, 11 fueron incluidos. El número total de participantes fue de 925, 545 en el grupo experimental y 380 en el grupo de control. Los entrenamientos de fuerza y de equilibrio, realizados juntos o separados, indujeron mejoras del equilibrio. El ejercicio, de cualquier tipo, mejora los síntomas motores. CONCLUSIONES: Así, el ejercicio físico tiene efecto positivo, tanto en el equilibrio como en los síntomas motores de la Enfermedad de Parkinson, destacándose el entrenamiento de fuerza y equilibrio

OBJETIVO: O objetivo do estudo foi conduzir uma revisão sistemática avaliando os efeitos do exercício físico no equilíbrio e nos sintomas motores da Doença de Parkinson. MÉTODO: Realizou-se a busca nas bases PubMed, Scielo e PEDro. Os artigos foram avaliados por dois investigadores independentes, seguindo os critérios: apresentar grupo controle, possuir mais de oito semanas de intervenção, avaliar sintomas motores (Unified Parkinson's Disease Rating Scale e Parkinson's Disease Questionnaire-39) e equilíbrio (Timed Up and Go e Escala de Berg). RESULTADOS: A busca resultou em 1377 artigos, destes, 11 foram incluídos no estudo. O total de participantes foi de 925, em que 545 alocados no grupo intervenção e 380 no grupo controle. Os exercícios de força e de equilíbrio, realizados de forma isolada ou combinada, se destacaram nas melhoras relacionadas ao equilíbrio. O exercício, independente da modalidade, melhora os sintomas motores. CONCLUSÕES: Assim, o exercício físico tem efeito positivo tanto no equilíbrio quanto nos sintomas motores da Doença de Parkinson, destaca-se as modalidades de força e equilíbrio

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.

Effects of 2 Models of Aquatic Exercise Training on Cardiorespiratory Responses of Patients With Type 2 Diabetes: The Diabetes and Aquatic Training Study-A Randomized Controlled Trial.

BACKGROUND: There are a lack of clinical trials with suitable methodological quality that compare aquatic exercise training types in type 2 diabetes (T2D) treatment. This study aimed to compare the effects of aerobic and combined aquatic training on cardiorespiratory outcomes in patients with T2D. METHODS: Untrained patients with T2D were randomized to receive an aerobic aquatic training, a combined aquatic training, or a procedure control in 3 weekly sessions for 15 weeks. The sessions were 50 minutes long. The intensities were from 85% to 100% of heart rate of anaerobic threshold and at maximal velocity for aerobic and resistance parts, respectively. Resting heart rate, peak oxygen uptake (VO2peak), and oxygen uptake corresponding to second ventilatory threshold and its relation with VO2peak were evaluated. RESULTS: Participants were 59.0 (8.2) years old and 51% women. Intervention groups increased in VO2peak (aerobic aquatic training group: 4.48 mL·kg-1·min-1, P = .004; combined aquatic training group: 5.27 mL·kg-1·min-1; P = .006) and oxygen uptake corresponding to second ventilatory threshold, whereas the control group presented an increase in oxygen uptake corresponding to second ventilatory threshold and minimal change in VO2peak. CONCLUSIONS: Aerobic and combined aquatic exercise interventions improve the cardiorespiratory fitness of patients with T2D.

Association of phase angle with sarcopenia and its components in physically active older women.

OBJECTIVE: The aim of the present study was to associate phase angle (PhA) with sarcopenia and its components in physically active older women. METHODS: A cross-sectional study was performed with 94 physically active older women. PhA and muscle mass were assessed by bioelectrical impedance. Muscle strength was measured by handgrip strength (HGS) and functional capacity was evaluated by 4-meter walk test. Sarcopenia was diagnosed according to the European Consensus on Definition and Diagnosis of Sarcopenia (2010). Participants were evaluated according to the PhA tercile. The individuals were divided into two groups: 1st vs. 2nd and 3rd terciles. The individuals in the first tercile were considered having low PhA (< 5.7º). RESULTS: Low PhA was not associated with sarcopenia (OR = 1.50 (0.520-4.319)), low muscle mass index (OR = 1.50 (0.520-4.319)), low HGS (OR = 3.15 (0.954-10.401)) and low walk speed (OR = 1.46 (0.384-5.534)). In addition, PhA had a weak correlation with walk speed (r = 0.24, p = 0.023) and walk speed was able to predict the PhA variations by 3.9%. CONCLUSION: PhA was not associated with sarcopenia and its components in physically active older women. Although PhA was correlated with walk speed, the biological meaning of this association is questionable, since the power of the prediction was low.

Effectiveness of exercise and health education interventions in Brazilian primary health care

Abstract AIM This study examined the effectiveness of two different behavioral change interventions to improve Physical Activity (PA) and to reduce Sedentary Behavior (SB) in a primary health care setting. METHODS This quasi-experimental study recruited and enrolled 31 users of a primary health care unit of the Brazilian Unified Health System aged 18 or more. Participants were allocated into two groups: Physical Exercise Group combined with Health Education (EHE) and Health Education Group (HE). The EHE group participated in 60 minutes of exercise, twice a week, and 20 minutes of counseling. The HE group participated in 40 minutes of counseling, once a week. Both programs were conducted for over 18 weeks. PA levels were self-reported (IPAQ) and PA and SB were objectively (accelerometer) assessed before and after the intervention period. Data were analyzed using intention-to-treat analysis with generalized estimating equations adopting p<0.05 for significance. Also, the individual PA and SB deltas were computed. Improvements in PA and SB were observed for both interventions (p<0.05). RESULTS Both groups increased the minutes of weekly leisure PA (p=0.006), time spent in light (p=0.003), and moderated-to-vigorous (p=0.042) PA and decreased the amount of SB, with a significant decrease in the HE group (p=0.010). Delta analyses further demonstrated the effectiveness of the interventions to increase PA in other domains (i.e., transportation, household) and maintenance of occupational PA. CONCLUSION Behavioral change interventions in the primary health care context involving exercise and counseling seem to be effective in improving PA and SB in adults.

Lazer, atividade física e comportamento sedentário de idosos participantes de um grupo de aconselhamento / Leisure Time, Physical Activity and Sedentary Behavior of participants in a counseling group

O processo de envelhecimento no mundo torna-se cada vez maior. Na tentativa de se conseguir estimular o idoso a ter um estilo de vida mais saudável, algumas iniciativas em relação à educação para a saúde, lazer e motivação para a prática regular de atividade física já estão em curso, como intervenções físicas em conjunto a intervenções informativas. O objetivo do presente estudo é analisar a efetividade de intervenções informativas, por meio de grupos de aconselhamento, nos aspectos comportamentais relacionados à atividade física, comportamento sedentário e lazer em idosos. A população estudada nesta pesquisa foi de idosos participantes do Programa AFRID (Atividades Físicas e Recreativas para Terceira Idade), sendo a amostra composta por 14 idosos. O projeto foi desenvolvido em um período de 8 semanas, no qual os idosos foram avaliados pré e pós intervenção informativa. Os instrumentos utilizados no presente estudo foram Anamnese, Questionário Internacional de Atividade Física (IPAQ) versão longa, Questionário LASA-SBQ para medida do comportamento sedentário em idosos, EPL ­ Escala de Práticas no Lazer adaptada e grupo focal. Os resultados encontrados destacam que as intervenções realizadas melhoraram significativamente os dados do comportamento sedentário e mostraram uma tendência de melhora para os níveis de atividade física e envolvimento em atividades de lazer Físico/Esportivas e Intelectuais. A análise qualitativa apresentou que as intervenções informativas foram relevantes para a percepção da melhora dos aspectos comportamentais, como um significativo meio para a mudança de hábitos de vida, no qual os idosos puderam apresentar suas reflexões, anseios e sugestões sobre a importância do grupo de aconselhamento em sua saúde e qualidade de vida....(AU)

In an attempt to stimulate the elderly to have a healthier lifestyle, some initiatives in Public Policies are already in progress, such as physical activities interventions with informative interventions. The aim of this study was to analyse the effectiveness of a counseling interventions in the behavioral aspects related to physical activity, sedentary behavior and leisure time in the elderly. The population in this study was the elderly participants in the AFRID Program (Atividades Físicas e Recreativas para Terceira Idade), and the sample was composed of 14 elderly people. This project was developed in 16 weeks, and the subjects were assessed pre and post counseling intervention. The instruments used in the present study were: Anamnesis, International Physical Activity Questionnaire (IPAQ) long version, LASA-SBQ Questionnaire to measure sedentary behavior in older adults, EPL - Adapted Leisure Practice Scale and focal group. The results show that the interventions improved sedentary behavior data and indicated a tendency to improve physical activity levels and involvement in leisure activities, especially in Physical/Sport and Intellectuals.The qualitative analysis revealed that the informative interventions were relevant for the perception of the improvement of the behavioral aspects as a significative device for change of habits and lifestyle. In counseling, this population was able to present their reflections, wishesand suggestions on the importance of the group of counseling and continuity of this....(AU)

Effects of Different Models of Water-Based Resistance Training on Muscular Function of Older Women.

PURPOSE: To compare the effects of three water-based resistance trainings on neuromuscular parameters of older women. METHOD: Thirty-six women were randomized to groups: simple set of 30 seconds (1 × 30 s, 66.41 ± 4.71 years, n = 12), multiple sets of 10 seconds (3 × 10 s, 66.50 ± 4.74 years, n = 11), and simple set of 10 seconds (1 × 10 s, 65.23 ± 3.93 years, n = 13). Maximal isometric strength concomitantly with neuromuscular activity during extension and flexion knee was evaluated. In the same exercises, rate of force development at different time intervals was measured. Finally, functional capacity was assessed. RESULTS: All trainings promoted similar improvements in the rate of force develpment of extension (effect size RFD 50 ms: 1 × 30 s .49, 3 × 10 s .67, 1 × 10 s .65; ES RFD 100 ms: 1 × 30 s .76, 3 × 10 s .80, 1 × 10 s .63; ES RFD 250 ms: 1 × 30 s .31, 3 × 10 s .49, 1 × 10 s .37) and flexion knee (ES RFD 50 ms: 1 × 30 s .59, 3 × 10 s .31, 1 × 10 s .48; ES RFD 100 ms: 1 × 30 s .41, 3 × 10 s .44, 1 × 10 s .42; ES RFD 250 ms: 1 × 30 s .57, 3 × 10 s .36, 1 × 10 s .43; ES RFD maximal: 1 × 30 s .63, 3 × 10 s .23, 1 × 10 s .26), however only the 3 × 10 s group improved the performance in the 8-foot up-and-go test (ES 3 × 10 s: .93, 1 × 30: .39, 1 × 10 s: .23). There was a maintenance of the isometric force and neuromuscular activity, except for the activity of the rectus femoris that showed an increase after training in all groups (ES 3 × 10 s: .04, 1 × 30: .36, 1 × 10 s: .50). CONCLUSION: Water-based resistance training using simple or multiple sets promotes the same gains in rapid strength, however only multiple sets induced improvement on functional capacity.

Effects of Nordic walking training on quality of life, balance and functional mobility in elderly: A randomized clinical trial.

PURPOSE: There is physiological and biomechanical evidence suggesting a possible advantage of using poles in walking training programs. The purpose of this proof-of-concept study was to test the hypothesis that untrained elderly training Nordic walking for eight weeks will show higher improvements on the functional mobility, quality of life and postural balance than that training without poles; more likely to occur in self-selected walking speed (primary outcome), and the locomotor rehabilitation index than the quality of life, the static balance and the dynamic stability. It was a two-arm randomized sample- and load-controlled study. METHODS: Thirty-three untrained older people were randomly assigned into Nordic walking (n = 16, age: 64.6±4.1 years old) and free walking (n = 17, age: 68.6±3.9 years old) training groups. RESULTS: Improvements in the self-selected walking speed (primary outcome, p = 0.011, ES = 0.42 95%CI -0.31 to 1.16), locomotor rehabilitation index (p = 0.013, ES = 0.36; (95%CI -0.39 to 1.10), quality of life (p<0.05), static balance (p<0.05) and dynamic variability (p<0.05) were found in both groups. CONCLUSIONS: The hypothesis was not supported, our findings indicated that after 8 weeks, the Nordic walking training did not result in greater improvements than free walking training for the primary outcome (self-selected walking speed) and most of the secondary outcomes (including locomotor rehabilitation index, static balance, dynamic stability, and psychological and social participation domains of quality of life). TRIAL REGISTRATION: ClinicalTrials.gov NCT03096964.

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.

Does Aerobic Exercise Impair Neuromuscular Function During Water-Based Resistance Exercises?

PURPOSE: The purpose of this study was to investigate the acute effects of water-based aerobic exercises on the performance of water-based resistance exercises by assessing kinematic parameters during protocols and neuromuscular responses after them. METHOD: Ten women performed 2 water-based protocols (i.e., resistance and concurrent water-based exercises) on separate days. We evaluated isometric force and electromyographic signal (sEMG) before and after protocols and analyzed kinematic parameters during a water-based resistance exercise. RESULTS: There was no significant difference between knee extension force production and sEMG from the vastus lateralis during the maximal voluntary contraction performed before and after the protocols. However, sEMG from the rectus femoris presented a significant difference between pretest and posttest measurements in both water-based protocols with greater values in the measurement after the end of the protocol (p = .046). The peak angular velocity of knee extension and mean angular velocity of knee extension and flexion showed similar values among the sets, with no difference between protocols. The peak angular velocity of knee flexion presented greater values in the water-based resistance exercises compared with the water-based concurrent protocol in the last set (p < .001). CONCLUSION: The main impairment induced by the water-based concurrent exercises was the lower peak angular velocity in the knee flexors compared with water-based resistance exercises alone.

Treinamento de força no meio aquático: uma revisão sobre os aspectos históricos, fi siológicos e metodológicos / Aquatic resistance training: a review about historical, physiological and metodological aspects

Exercitar-se na água é uma prática constatada há vários séculos, embora seja recente sua realização de forma sistemática e planejada. A literatura científi ca é ampla no estudo dos efeitos do treinamento aeróbico aquático, tendo investigado diferentes modalidades. Nas últimas décadas têm ganhado elevância os estudos que avaliam treinamentos aquáticos de caráter de força e sua melhora no sistema neuromuscular. Contudo estes trabalhos apresentam métodos de prescrição muito diferentes,dificultando sua comparação. Assim, o objetivo desta revisão é elucidar aspectos metodológicos para prescrição de exercícios de força no meio aquático. Este artigo tem caráter narrativo e para a localização e aquisição dos estudos foram consultadas as bases de dados eletrônicas SCOPUS, SCIELO e MEDLINE, realizando-se buscas de artigos publicados entre os anos 1980 e 2016, com os seguintes descritores: hidroginástica, treinamento de força aquático e corrida em piscina funda. Os resultados demonstraram que os primeiros estudos publicados mundialmente relacionados a este tema datam do início dos anos 2000. Estes seguiam métodos de treinamento que buscavam reproduzir o modelo aplicado no meio terrestre, ou seja, utilizando número de repetições e número de séries. Por outro lado, os estudos mais recentes têm proposto a utilização da velocidade máxima e o tempo de execução para enfatizar vias metabólicas específi cas (anaeróbica alática e anaeróbica lática) e promover níveis adequados de tensão mecânica (velocidade máxima) e estresse metabólico (tempo de execução). Assim, os trabalhos demonstram que o treinamento de força no meio aquático têm proporcionado resultados satisfatórios em variáveis neuromusculares e morfológicas. Ainda, a prescrição de um treinamento de força neste meio, visando a ênfase sobre vias metabólicas específi cas, utilizando o tempo de execução e a máxima velocidade, parece ser uma forma adequada de se alcançar objetivos relacionados ao treinamento de força....(AU)

Exercising in the water environment is a practice that has been observed for several centuries, although its realization in a systematic and planned manner is recent. The scientifi c literature is broad in the study of the eff ects of water-based aerobic training, having investigated diff erent modalities. In the last decades, studies that evaluate water-based resistance training and its improvement in the neuromuscular system have gained relevance. However, these studies present very diff erent prescription methods, making diffi cult to compare them. Thus, the purpose of this review is to elucidate methodological aspects for prescription of water-based resistance exercises. This manuscript is a narrative review and for location and acquisition of the studies the electronic databases SCOPUS, SCIELO and MEDLINE were searched, searching articles published between 1980 and 2016, with the following descriptors: water gymnastics, water--based resistance training and deep water running. The results showed that the fi rst published studies related to this topic date back to the early 2000s. These studies followed training methods that sought to reproduce the model applied in the land environment, that is, using number of repetitions and number of series. On the other hand, more recent studies have proposed the use of maximum velocity and time to execution to emphasize specifi c metabolic pathways (lactic and alactic anaerobic) and to promote adequate levels of mechanical stress (maximal velocity) and metabolic stress (time to execution). Thus, the studies demonstrate that water-based resistance training has provided satisfactory results in neuromuscular and morphological variables. Furthermore, prescribing strength training in this environment, aiming at emphasizing specificmetabolic pathways, using time to execution and maximum velocity, seems to be an appropriate way of achieving goals related to strength training....(AU)

Water-based aerobic training improves strength parameters and cardiorespiratory outcomes in elderly women.

The aim of the present study was to compare the effects of water-based aerobic training and water-based resistance training on muscular strength and cardiorespiratory fitness in older women. Sixty-nine individuals were randomized into the following three groups: the water-based aerobic training (WA, n = 23) group, the water-based resistance training (WR, n = 23) group, and the control group (CG, n = 23). Participants were trained two times per week for 10 weeks. The trainings presented a linear periodization with an increase in the volume-intensity relation. Maximal dynamic muscular strength and the cardiorespiratory fitness were evaluated before the start of training and after 10 weeks of training. Only the WA group showed an increase in maximal oxygen consumption (13.8%) and oxygen consumption at the second ventilatory threshold (16.4%). Maximal dynamic strength of knee extensors improved in 10.6% of WA, 8.0% of WR, and 4.7% of CG participants, without any difference between the groups. Maximal dynamic strength of knee flexors was increased in 14.1% of WA and in 17.7% of WR participants; however, it remains unchanged in CG participants. No differences were observed in resting heart rate, peak heart rate, heart rate at the second ventilatory threshold and maximal dynamic strength of shoulder horizontal flexors. It was concluded that WA seems to be more efficient for improvement in cardiorespiratory responses, and both WA and WR were efficient for development of maximal dynamic strength of knee flexion and extension.

Low- and High-Volume Water-Based Resistance Training Induces Similar Strength and Functional Capacity Improvements in Older Women: A Randomized Study.

BACKGROUND: Water-based resistance training (WRT) has been indicated to promote strength gains in elderly population. However, no study has compared different training strategies to identify the most efficient one. The aim of this study was to compare the effects of 3 WRT strategies on the strength and functional capacity of older women. METHODS: In total, 36 women were randomly allocated to training groups: simple set of 30 seconds [1 × 30s; 66.41 (1.36) y; n = 12], multiple sets of 10 seconds [3 × 10s; 66.50 (1.43) y; n = 11], and simple set of 10 seconds [1 × 10s; 65.23 (1.09) y; n = 13]. Training lasted for 12 weeks. The maximal dynamic strength (in kilograms) and muscular endurance (number of repetitions) of knee extension, knee flexion, elbow flexion, and bench press, as well as functional capacity (number of repetitions), were evaluated. RESULTS: All types of training promoted similar gains in maximal dynamic strength of knee extension and flexion as well as elbow flexion. Only the 1 × 30s and 1 × 10s groups presented increments in bench press maximal strength. All 3 groups showed increases in muscular endurance in all exercises and functional capacity. CONCLUSIONS: WRT using long- or short-duration simple sets promotes the same gains in strength and functional capacity in older women as does WRT using multiple sets.

Quality of life and sleep quality are 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 models in water and on dry-land on quality of life, depressive symptoms and sleep quality 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 length was 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: In per protocol analysis, physical and psychological domains of quality of life improved in both groups (p<0.05) without between-group differences. Overall quality of life and sleep quality improved in both groups (p<0.05), without between-group differences in per protocol and intention to treat analysis. No changes on depressive symptoms were observed in both groups at follow-up. CONCLUSIONS: Aerobic training in an aquatic environment provides similar effects to aerobic training in a dry-land environment on quality of life, depressive symptoms and sleep quality in patients with type 2 diabetes. Clinical trial reg. no. NCT01956357, clinicaltrials.gov.