Water-Based Training Programs Improve Functional Capacity, Cognitive and Hemodynamic Outcomes? The ACTIVE Randomized Clinical Trial.

Purpose: To compare the effects of 16 weeks of aerobic training (AT) to 8 weeks of AT followed by 8 weeks of combined training (CT), as well as to a control group (CG), on the functional, cognitive and hemodynamic responses of older women exercising in the aquatic environment. Materials and Methods: The study is a three-armed parallel randomized controlled clinical trial. For this, 52 older women were first randomized in an aerobic training (AT; n = 35) or control group (CG; n = 17). After 8 weeks of intervention, participants from AT group were again randomized into another 8-week period of either AT (n = 17) or combined training (CT; n = 18). AT was performed at the percentage of the heart rate corresponding to the anaerobic threshold, resistance training was performed with sets at maximal effort and the control group performed low-intensity therapeutic exercises in water. All outcomes were assessed before (week 0) and after the intervention (week 17). In addition, some outcomes were also investigated in the middle timepoint (week 9). Generalized Estimating Equations (GEE) and Bonferroni post-hoc tests (α = 0.05) were used to compare timepoints and groups. Results: All groups similarly improved functional capacity (3-11%) and blood pressure (-4 to -10%), whereas cognitive function was not modified for any group. Conclusion: Water-based training programs and therapeutic exercises (i.e., CG) improve functional capacity and blood pressure responses in older women. Clinical Trials NCT03892278.

Effect of High-Intensity Interval Treadmill Exercise on Subsequent Lower and Upper Limb Strength Performance.

Purpose: The aim of this study was to analyze the acute effect of a treadmill high-intensity interval protocol on subsequent upper body and lower body strength exercise performance. Method: Sixteen young men had their maximal aerobic capacity and one-repetition maximum (1RM) determined and underwent four randomized conditions: a half-squat control session; a bench press control session; a treadmill interval protocol followed by a half-squat experimental session; and a treadmill interval protocol followed by a bench press experimental session. During the control sessions, four sets to failure for each exercise were performed at 80% of 1RM. In the experimental sessions, participants performed eight sprints of 40 s at 100% velocity of maximal oxygen uptake with 20 s of passive interval between them, followed by the same strength exercise protocol of the control sessions. The number of repetitions during each protocol and participants' heart rate (HR),and blood lactate concentration ([lac]) were compared pre and post protocols and exercises. Results: Fewer repetitions were completed in the experimental session compared to the control sessions (p < .001). Moreover, the reduction in number of repetitions performed was more evident in half-squat compared to bench press (p = .018). HR was higher at the end of sessions with the interval protocol for both exercises (p < .001). The [lac] was higher at the end of session with the interval protocol for half-squat (p = .003). Conclusions: These findings suggest that previous high-intensity interval running may impair subsequent strength exercise performance, but the magnitude of the negative effect is greater in the lower limbs.

Exercise intervention does not reduce the likelihood of VO2max underestimation in older adults with hypertension.

The present study aimed to investigate whether training status would influence the capacity of a verification phase (VER) to confirm maximal oxygen uptake (VO2max) of a previous graded exercise test (GXT) in individuals with hypertension. Twelve older adults with hypertension (8 women) were recruited. Using a within-subject design, participants performed a treadmill GXT to exhaustion followed by a multistage VER both before and after a 12-wkcombined exercise training programme. Individual VO2max, respiratory exchange ratio (RER), maximal heart rate (HRmax), and rating of perceived exertion (RPE) were measured during both GXT and VER tests. Absolute and relative VO2max values were higher in VER than in GXT at baseline, but only absolute VO2max differed between bouts post-intervention (all p < 0.05). Individual VO2max comparisons revealed that 75% of the participants (9/12) achieved a VO2max value that was ≥3% during VER both before (range: +4.9% to +21%) and after the intervention (range: +3.4% to +18.8%), whereas 91.7% (11/12) of the tests would have been validated as a maximal effort if the classic criteria were employed. A 12-wk combined training intervention could not improve the capacity of older adults with hypertension to achieve VO2max during a GXT, as assessed by VER.

Cardiorespiratory Parameters Comparison Between Incremental Protocols Performed in Aquatic and Land Environments by Healthy Individuals: A Systematic Review and Meta-Analysis.

BACKGROUND: Physical properties of water cause physiological changes in the immersed human body compared with the land environment. Understanding the magnitude of cardiorespiratory alterations might ensure adequate intensity control during aquatic exercise programs. OBJECTIVE: We aimed to compare the oxygen uptake (VO2), heart rate (HR), and rating of perceived exertion (RPE) parameters during aquatic and land incremental tests. METHODS: Four databases (PubMed, LILACS, EMBASE, and SPORTDiscus) were searched in September 2020. Eligibility criteria included studies in a crossover design comparing aquatic and land incremental tests for healthy individuals with at least one of the following parameters: VO2 (maximal, VO2max; anaerobic threshold, VO2AT), HR (HRmax; HRAT), and RPE (RPEmax; RPEAT). The random-effects meta-analysis included mean difference and 95% confidence interval for VO2 and HR or standardized mean difference for RPE. The Joanna Briggs Institute Critical Appraisal tool was adapted to assess methodological quality. RESULTS: Twenty-eight studies were eligible and included in the meta-analysis. Aquatic protocols showed lower values compared with land for VO2max (- 7.07 mL.kg-1.min-1; - 8.43 to - 5.70; n = 502), VO2AT (- 6.19 mL.kg-1.min-1; - 7.66 to - 4.73; n = 145), HRmax (- 11.71 bpm; - 13.84 to - 9.58; n = 503), and HRAT (- 15.29 bpm; - 19.05 to - 11.53; n = 145). RPEmax (0.01; - 0.16 to 0.18; n = 299) and RPEAT (- 0.67; - 1.35 to 0.02; n = 55) values were similar between aquatic and land protocols. CONCLUSIONS: Our study reinforces the specificity of the environment during incremental tests for prescribing exercises based on physiological parameters as VO2 and HR parameters presented lower values in aquatic protocols than land protocols. Conversely, RPE seems an interchangeable measure of exercise intensity, with similar values during the protocols in both environments. Substantial levels of heterogeneity were present for the VO2max and HRmax meta-analyses, and as such, results should be interpreted with attention. PROTOCOL REGISTRATION: This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020212508).

High-velocity resistance training mitigates physiological and functional impairments in middle-aged and older adults with and without mobility-limitation.

The aim of the present study was to compare the neuromuscular, morphological, and functional responses to a high-velocity resistance training (HVRT) program between three cohorts: middle-aged adults (40-55 years, n = 18), healthy older adults (> 60 years, n = 18), and mobility-limited older adults (n = 8). Participants were tested before and after a 4-week control period and then assigned to a 12-week HVRT intervention. Investigated outcomes included ultrasound-derived muscle thickness and quality, maximal dynamic strength (1RM), maximal voluntary isometric contraction (MVIC), and muscle activation (sEMG), as well as muscle power and functional performance. After the intervention, quadriceps muscle thickness, 1RM, and sEMG improved in all three groups (all p < 0.05), whereas muscle quality improved only in middle-aged and older participants (p ≤ 0.001), and MVIC only in middle-aged and mobility-limited older adults (p < 0.05). With a few exceptions, peak power improved in all groups from 30-90% 1RM (p < 0.05) both when tested relative to pre-training or post-training 1RM workloads (all p < 0.05). Both mobility-limited older adults and older adults improved their short physical performance battery score (p < 0.05). Chair stand, stair climb, maximal gait speed, and timed up-and-go performance, on the other hand, improved in all three groups (p < 0.05), but no change was observed for habitual gait speed and 6-min walk test performance. Overall, our results demonstrate that a HVRT intervention can build a stronger foundation in middle-aged individuals so that they can better deal with age-related impairments at the same time that it can mitigate already present physiological and functional impairments in older adults with and without mobility-limitation.

Quality of life responses after combined and aerobic water-based training programs in older women: a randomized clinical trial (ACTIVE Study).

BACKGROUND: Quality of life (QoL) is an important health index for older adults. AIM: The aim of this study was to compare the effects of 16 weeks of aerobic training to 8 weeks of aerobic followed by 8 weeks of combined (i.e., resistance and aerobic exercises) training, as well as to a control group on the QoL of older women exercising in the aquatic environment. METHODS: 52 older women were first randomized to either aerobic training (n = 35) or a control group (n = 17). After 8 weeks of intervention, participants initially assigned to the aerobic training group were again randomized to either 8 additional weeks of aerobic (n = 17) or combined training (n = 18). Aerobic training was performed at the heart rate percentage associated with the anaerobic threshold, while resistance training sets were performed at maximal effort. The control group performed low-intensity water-based therapeutic exercises. QoL was assessed before (week 0) and after the intervention (week 17) using the WHOQOL-BREEF and WHOQOL-OLD questionnaires. Generalized Estimating Equations (GEE) and Bonferroni post hoc tests (α = 0.05) were used to compare time points and groups. RESULTS: QoL improved significantly only in the training groups after the 16-week training intervention, whereas it remained unchanged in the control group. In addition, autonomy, environment, and present, past and future activities domains were more impacted after combined training. CONCLUSION: QoL improved only in the water-based training groups, and the addition of resistance exercises to the training program resulted in additional benefits to autonomy, environment, and past, present, and future activities domains. TRIAL REGISTRATION: Clinical Trials NCT03892278.

Aerobic and combined water-based trainings in older women: effects on strength and cardiorespiratory outcomes.

BACKGROUND: The aim of the present study was to investigate the muscular and cardiorespiratory adaptations of two water-based training programs in older women. METHODS: Volunteers were divided between a water-based aerobic training (WBA; N.=13), water-based combined training (WBC; N.=11) or an active control group (CG; N.=9) and those assigned to WBA and WBC exercised twice a week for 12 weeks. All outcomes of interest were assessed prior and after the intervention. The data were analyzed using Generalized Estimating Equations (GEE), and Bonferroni post-hoc test (α=0.05). Aerobic training was performed at the percentage of the heart rate corresponding to the anaerobic threshold and resistance training during WBC was performed with sets at maximal effort. RESULTS: Improvements were observed for the maximal knee extension dynamic strength (1RM) and oxygen uptake (VO2) corresponding to the second ventilatory threshold for both WBA and WBC (1RM: 16±12% vs. 15±16%; VO2: 20±24% vs. 23±13%, respectively), whereas VO2 peak improved in all three groups (WBA: 23±21%; WBC: 18±9%; CG: 7±16%). No increase was found for horizontal chest press 1RM (P>0.05). CONCLUSIONS: These results suggest that WBA, WBC and CG are effective to improve cardiorespiratory fitness, however, only water-based training programs (WBA and WBC) appear capable of improving the maximal strength of the lower limbs.

High-intensity interval running impairs subsequent upper limb strength performance.

BACKGROUND: This study compared the effect of treadmill running on subsequent upper limb exercise performance in young men. METHODS: Seventeen young men (24.8±5.2 years) completed a: 1) bench press resistance exercise control session; 2) treadmill interval running protocol followed by the bench press session; and 3) treadmill continuous running protocol followed by the bench press session. Four sets of the bench press exercise were performed at 80% of 1RM up to volitional failure. In the interval protocol, eight sprints of 40s at 100% of the velocity of maximal oxygen uptake, with 20s of passive interval between them were performed, whereas in the continuous protocol 30-min of treadmill running at 90% of the heart rate corresponding to second ventilatory threshold was performed. The number of maximal repetitions completed in each set and condition was recorded and compared using a two-way repeated measures ANOVA. RESULTS: The interval protocol (18.7±4.9 repetitions) resulted in a reduction in the number of bench press repetitions compared to the control protocol (21.4±5.4 repetitions) (P=0.002); whereas continuous running did not affect the bench press performance (20.6±4.4 repetitions). The total number of repetitions reduced from set to set in all protocols (P<0.001). CONCLUSIONS: The results evidenced an impairment in the upper limb strength performance after high intensity interval, but not moderate intensity continuous running, which has implication for concurrent training planning and prescription.

Maximal Oxygen Uptake Is Underestimated during Incremental Testing in Hypertensive Older Adults: Findings from the HAEL Study.

PURPOSE: The present cross-sectional study aimed to investigate whether a maximal oxygen uptake (V˙O2max) verification phase (VER) could improve the accuracy of a previous graded exercise test (GXT) to assess individual V˙O2max in hypertensive individuals. METHODS: Thirty-three older adults with hypertension (24 women) taking part in the Hypertension Approaches in the Elderly Study (NCT03264443) were recruited. Briefly, after performing a treadmill GXT to exhaustion, participants rested for 10 min and underwent a multistage VER to confirm GXT results. Individual V˙O2max, RER, maximal heart rate (HRmax), and RPE were measured during both GXT and VER tests. Mean values were compared between bouts using paired sample t-tests, and V˙O2max was also compared between GXT and VER on an individual basis. RESULTS: Testing was well tolerated by all participants. Both absolute (P = 0.011) and relative (P = 0.014) V˙O2max values were higher in VER than that in GXT. RER (P < 0.001) and RPE (P = 0.002) were lower in VER, whereas HRmax (P = 0.286) was not different between the two trials. Individual V˙O2max comparisons revealed that 54.6% of the participants (18/33) achieved a V˙O2max value that was ≥3% during VER (mean = 13.5%, range = +3% to +22.1%, ES = 0.062), whereas 87.9% (29/33) of the tests would have been validated as a maximal effort if the classic criteria were used (i.e., V̇O2 plateau or at least two secondary criteria). CONCLUSION: In sedentary older individuals with hypertension, GXT to exhaustion underestimated V˙O2max in more than half of tested participants, even when established, but criticized criteria were used to confirm whether a maximal effort was attained. Using VER after GXT is a quick approach to assist with the verification of an individual's V˙O2max.

Anaerobic Threshold in a Water-Based Exercise: Agreement Between Heart Rate Deflection Point and Lactate Threshold Methods.

ABSTRACT: Alberton, CL, Andrade, LS, Pinheiro, RB, and Pinto, SS. Anaerobic threshold in a water-based exercise: agreement between heart rate deflection point and lactate threshold methods. J Strength Cond Res 35(9): 2472-2478, 2021-The purpose of this study was to compare and assess the agreement of the heart rate (HR) and rating of perceived exertion (RPE) corresponding to the anaerobic threshold (AT) between HR deflection point (HRDP) and lactate threshold (LT) methods during a water-based exercise in young men. Sixteen young men (24 ± 6 years) performed the experimental protocol, which comprised the performance of a maximal incremental test during the water-based stationary running exercise. The initial cadence corresponded to 90 b·min-1, with 10 b·min-1 increases every 3 minutes up to exhaustion. Heart rate was monitored every 30 seconds while blood lactate concentrations and RPE were measured at the end of each 3-minute bout. Anaerobic threshold was identified by HRDP and LT methods by experienced physiologists. Paired Student's t-test, Bland-Altman analysis, and Pearson correlation were used for data analysis (α = 0.05). As results, there was agreement between HRDP and LT methods for HR, while RPE presented significant higher values for the HRDP method, resulting in an absence of acceptable agreement between methods. In addition, strong relationships (p ≤ 0.001) were verified between methods of AT determination for HR (r = 0.786) and RPE (r = 0.916). Therefore, based on the agreement between HRDP and LT methods, the HR determined by HRDP may be a valid parameter used for the intensity prescription of water-based stationary running exercise in young men during water aerobics programs and may be considered more reliable than RPE.

HR, ̇V̇O2, and RPE Relationships in an Aquatic Incremental Maximum Test Performed by Young Women.

David, GB, Andrade, LS, Schaun, GZ, and Alberton, CL. HR, V̇O2, and RPE relationships in an aquatic incremental maximum test performed by young women. J Strength Cond Res 31(10): 2852-2858, 2017-The purpose of the study was to verify the relationship between oxygen uptake (V̇O2), heart rate (HR), rate of perceived exertion (RPE), and cadence (CAD) in an aquatic incremental maximum test performed during a water-based stationary running exercise. The study also verified the best adjustments for these relationships (linear or polynomial). Thirteen young college women (mean ± SD: 23.15 ± 1.72 years, 21.43 ± 2.09 body mass index) participated in the study. They performed an aquatic incremental maximum test during a water-based stationary running exercise. The experimental protocol started at an initial CAD of 80 b·min, and it was followed by increases of 10 b·min every minute until exhaustion. V̇O2, HR, and RPE were measured along the test. Linear and polynomial regression analysis were performed to determine the relationship among the percentage of peak V̇O2 (%V̇O2peak), percentage of maximal HR (%HRmax), RPE, and CAD to determine the best adjustment for each analysis (α = 0.05). The polynomial regression showed the best adjustments for all analysis. Data revealed a significant relationship (p < 0.001) between %V̇O2peak and %HRmax (r = 0.858), %HRmax and RPE (r = 0.823), and %V̇O2peak and RPE (r = 0.871). Regarding the relationship between these above-mentioned variables and CAD, all of them were significant (p < 0.001), with r = 0.848 for CAD and %HRmax, r = 0.877 for CAD and %V̇O2peak and r = 0.878 for CAD and RPE. It was concluded that all analyzed variables are associated and their relationships are in a polynomial quadratic form. Based on the findings, instructors may use the positive relationships between %V̇O2peak, %HRmax, and RPE to efficiently prescribe water-based training sessions.