Impact of exercise intervention-based changes on physical function biomarkers in older adults after hospital discharge: A systematic review with meta-analysis of randomized clinical trials.

BACKGROUND: This systematic review with meta-analysis aimed to compare the changes caused by exercise intervention with those provoked by usual care on physical function biomarkers in older adults immediately after hospital discharge. METHODS: Two independent authors performed a systematic search (PubMed, Scopus, Web of Science, and SciELO) of studies published from database inception until August 2021. Randomized clinical trials investigating the effects of an exercise intervention compared to usual care were included. The Cochrane Collaboration assessment tool was used to analyze the risk of bias. The comparisons included handgrip strength, the short physical performance battery scale, six-minute walking test, and 10-m gait speed. RESULTS: Overall, the exercise intervention led to significantly greater changes compared to usual care in physical function biomarkers [standard mean difference = 0.89, 95% CI = 0.39, 1.42; P = 0.001]. However, considering the very few studies investigating each variable separately, our sub-analysis did not reveal a significant effect of the exercise intervention on handgrip strength, the short physical performance battery, six minutes walking test, and 10-m gait speed. CONCLUSIONS: This systematic review with meta-analysis of randomized clinical trials suggests that exercise intervention induce greater physical function biomarker alterations in older adults after hospitalization than usual care including physical activity guidance. Future trials comparing the effects of these intervention groups on physical function biomarkers in this population are needed to confirm our results.

Functional high-intensity interval training is not equivalent when compared to combined training for blood pressure improvements in postmenopausal women: a randomized controlled trial.

INTRODUCTION: Low-volume functional high-intensity interval training (F-HIIT) improves cardiorespiratory fitness, body composition, and physical function similarly to combined training (CT, gold standard protocol), however no previous studies have compared the F-HIIT equivalence with CT in reducing blood pressure in older people, particularly in postmenopausal women (PW). Therefore, the aim of this study (trial registration: NCT03200639) was designed to test whether F-HIIT of low volume is an equivalent strategy to CT for improving blood pressure (BP) in PW. MATERIAL AND METHOD: Forty-nine PW were divided into two groups: F-HIIT and CT. The F-HIIT protocol was composed of 10 sets of 60 seconds of high-intensity exercises interspersed with 60 seconds of low-intensity exercises for recovery. The CT protocol was composed of 30 minutes of moderate-intensity walking, followed by five total body resistance exercises. Both protocols were performed 3-times-a-week for 12 weeks. The BP from rest condition (before exercise) was measured before and after 12 weeks of intervention in both groups, using an automatic blood pressure monitor. The boundaries values for equivalence for systolic and diastolic BP was set at 5.14 and 2.92 mmHg, respectively. RESULTS: There was only a significant reduction (P < .05) in systolic BP in CT group from baseline (-3.2 (95% CI, -6.2 to -0.2) mmHg). The difference of systolic BP between F-HIIT and CT was 5.8 (95% CI, 1.3-10.4) mmHg, showing non-equivalence (inferiority) for F-HIIT. CONCLUSION: Thus, these results suggest that low-volume F-HIIT protocol is not an equivalent strategy when compared to CT for BP improvements in PW.

Comparative effects of high-intensity interval training with combined training on physical function markers in obese postmenopausal women: a randomized controlled trial.

OBJECTIVES: This study compared the effects of high-intensity interval training (HIIT) with effects of combined training (CT) on physical function, body composition, and muscle strength in obese postmenopausal women (PW) (trial registration: NCT03200639). METHODS: PW were randomized to CT (n = 12) and HIIT (n = 12). The CT group performed 30 minutes of moderate walking at 70% of maximum heart rate (MHR) and five resistance exercises at 70% of one repetition maximum (1RM) for 12 weeks. The HIIT group performed 10 sets of vigorous exercises (30 seconds (s) of stair climbing and 30 s of body weight squats) at >80% MHR interspersed by a light walk (recovery period at 60% MHR). RESULTS: Both groups reduced body fat percentage (0.5%), chair stand (3 s) and increased leg lean mass (0.3 kg). Only the CT, however, increased muscle strength (29%) and fast walking speed (5%) compared with HIIT. The fast walking speed changes were partially explained by the muscle strength changes (36%, r = 0.60, P = 0.027) in the CT group. CONCLUSIONS: These results suggest that HIIT is an alternative time-efficient protocol for improving chair stand and body composition when compared with CT, whereas only CT is an efficient protocol for improving muscular strength and fast walking speed in obese PW. Thus, CT must be prioritized when the increase of muscular strength and fast walking speed are the goals of training. : Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A443.

Muscular Strength Adaptations and Hormonal Responses After Two Different Multiple-Set Protocols of Resistance Training in Postmenopausal Women.

Nunes, PRP, Barcelos, LC, Oliveira, AA, Furlanetto, R, Martins, FM, Resende, EAMR, and Orsatti, FL. Muscular strength adaptations and hormonal responses after two different multiple-set protocols of resistance training in postmenopausal women. J Strength Cond Res 33(5): 1276-1285, 2019-We studied the effects of 2 different resistance training (RT) multiple-set protocols (3 and 6 sets) on muscle strength and basal hormones concentrations in postmenopausal women (PW). Postmenopausal women were randomly allocated into 3 groups: control (CT, n = 12), low RT volume (LV = 3 sets for each exercise, n = 10), and high RT volume (HV = 6 sets for each exercise, n = 12). The LV and HV groups performed 8 exercises of a total body RT protocol 3 times a week, at 70% of 1 repetition maximum (1RM) for 16 weeks. Muscle strength and basal hormone concentrations were measured before and after RT. Our findings show that 3 sets or 6 sets at 70% of 1RM protocol increased muscular strength similarly after 16 weeks (sum of all exercises, LV: 37.7% and HV: 34.1% vs. CT: 2.1%, p < 0.001). Moreover, the RT volume does not affect basal levels of testosterone (TT) (LV: 0.02%, HV: -0.12%, and CT: 0.006%, p = 0.233), cortisol (C) (LV: 72.4%, HV: 36.8%, and CT: 16.8%, p = 0.892), insulin-like growth factor-1 (LV: 6.7%, HV: 7.3%, and CT: 4.1%, p = 0.802), dehydroepiandrosterone sulfate (LV: 0.1%, HV: -4.5%, and CT: -6.7%, p = 0.885), and TT:C ratio (LV: -0.9%, HV: -1.6%, and CT: -0.4%, p = 0.429). Our results suggest that 3 sets and 6 sets at 70% of 1RM seem to promote similar muscle strength gain. Thus, 3-set RT is a time efficient protocol for strength gain after 16 weeks in PW.

Effect of high-intensity interval training on body composition and inflammatory markers in obese postmenopausal women: a randomized controlled trial.

OBJECTIVES: This study tested whether high-intensity interval training is a time-efficient strategy for improving visceral adiposity tissue and inflammatory markers in obese postmenopausal women when compared with combined training. Moreover, we tested whether change in visceral adiposity tissue is associated with alterations in these inflammatory markers. METHODS: Postmenopausal women were randomized in two groups: combined training (n = 13) and high-intensity interval training (n = 13). The combined training group performed 60 minutes of walking at 70% of maximum heart rate and resistance exercises at 70% of one repetition maximum. The high-intensity interval training group performed 28 minutes of high-intensity exercises (> 80% of maximum heart rate). Both groups trained three times a week for 12 weeks. Body composition and inflammatory markers were analyzed with dual-energy x-ray absorptiometry scanning and enzyme-linked immunosorbent assay, respectively. RESULTS: All groups reduced body fat percentage (P = 0.026), visceral adiposity tissue (P = 0.027), leptin (P = 0.043), and increased interleukin (IL)-1 receptor antagonist (P < 0.01). The high-intensity interval training group reduced visceral adiposity tissue (P = 0.021) in a greater magnitude and increased interleukin-6 (P = 0.037) level when compared with the combined training group. Moreover, the visceral adiposity tissue changes explained the changes in IL-6 (56%; P = 0.002) only in the high-intensity interval training group. CONCLUSIONS: These results suggest that high-intensity interval training is a time-efficient strategy for improving visceral adiposity tissue and inflammatory markers in obese postmenopausal women. Moreover, we observed that serum cytokine changes, at least in part, depend on visceral adiposity tissue alterations.

Adding Soy Protein to Milk Enhances the Effect of Resistance Training on Muscle Strength in Postmenopausal Women.

Resistance training (RT) and high-quality protein ingestion improves muscle mass (MM) and strength (MS). However, no study has evaluated the effect of ingesting milk plus soy protein (SOY) on MM and MS in postmenopausal women (PW). Thus, the aim of this study was to evaluate the effects of adding SOY to milk on MM and MS after 16 weeks of RT. Thirty-two PW were randomized and allocated into two groups: placebo and RT (PL+RT, n = 16) and SOY and RT (SOY+RT, n = 16). The SOY+RT received 25 g of SOY while the PL+RT received 25 g of maltodextrin (placebo). All supplements were given in the form of a chocolate-flavored powder added to 200 mL of milk. The RT protocol consisted of eight total body exercises at 70% of one repetition maximum (1RM), three sets of 8-12 repetitions, 2-3 times/week. No differences were found in the baseline measures between groups (age, menopause status, anthropometric and nutrition patterns), except for protein intake, which was higher in the SOY+RT. Both groups increased the MM (bioimpedance) showing no difference between groups (PL+RT = 1.5 kg; SOY+RT = 1.1 kg). For MS, the SOY+RT showed a larger (p < .05) increase in 1RM of bench press (PL+RT = 6.7 kg; SOY+RT = 12.5 kg), knee extension (PL+RT = 3.7 kg; SOY+RT = 6.7 kg), total load (PL+RT = 15.1 kg; SOY+RT = 24.2 kg), and the total load exercises/MM (PL+RT = 0.3 kg; SOY+RT = 0.9 kg). These results suggest that adding SOY to milk combined with 16 weeks of RT resulted in more significant increases in MS in PW.

Effect of resistance training volume on walking speed performance in postmenopausal women: A randomized controlled trial.

Low muscle strength and high abdominal fatness play an important role in fast and usual walking speeds decrement in postmenopausal women (PW). Low-volume resistance training (RT) improves muscle strength. However, high-volume RT has shown to improve muscle strength and abdominal fatness in PW. Thus, high-volume RT would elicit greater improvement in fast and usual walking speeds than low-volume RT. OBJECTIVE: To confirm whether the high-volume RT is better than the low-volume RT, we performed a randomized controlled trial (clinical trial registration: RBR-8SBBVP) study to investigated the effects of two different RT volumes (three sets vs. six sets) on fast and usual walking speed performances (fast: one-mile walk test and usual: four-meter walk), muscle strength (1RM test), and abdominal fatness (WC - waist circumference; WC/W waist circumference-to-weight ratio; WHtR - waist-to-height ratio; ABSI - A body shape index; BRI - body roundness index; CI - conicity index) in PW. METHODS: Thirty-three PW were randomized (simple randomization) in three groups: control group (CT - no exercise), low-volume RT (LV) and high-volume RT (HV). The RT consisted of eight total body exercises at 70% of one repetition maximum for 16weeks performed three times a week. RESULTS: The fast walking speed (6.1% [CI 95% 2.3-9.9]), WC (-4.1% [CI 95% -6.9 to -1.4]), WHtR (-4.2% [CI 95% -7.0 to -1.4]) and BRI (-10.3% [CI 95% -17.3 to -3.4]) improved in the HV when compared to the LV and CT. The WC/W (-3.7% [CI 95% -6.5 to -0.93]), ABSI (-3.8% [CI 95% -6.5 to -1.2]) and CI (-3.9% [CI 95% -6.6 to -1.3]) improved in the HV when compared to the CT. Muscle strength improved similarly in trained groups (LV: 49.1% [CI 95% 42.5-55.6] and HV: 43.7% [CI 95% 33.0-54.5]) when compared with the CT. No differences were observed in usual walking speed. CONCLUSION: Our results suggest that high-volume RT (six sets) at 70% of 1RM is necessary to promote an improved fast walking speed performance and abdominal fatness in PW.