Water-based Exercise Training Research Articles

The effects of water-based circuit exercise training on vascular function in people with coronary heart disease.

Impaired endothelial function in people with coronary heart disease (CHD) is associated with increased mortality. Water immersion can increase peripheral artery shear stress which may provide an additional stimulus to the endothelium during exercise. This study compared the effects of water-based circuit exercise training (WEX) and gym-based circuit exercise training (GEX) on vascular function in people with stable CHD. Participants were randomised to 12 weeks of WEX (n=20), GEX (n=20) or a control group (usual activities; n=12). Endothelium-dependent flow-mediated dilation (FMD) and glyceryl trinitrate-mediated dilation (GTN) of the brachial artery were assessed pre- and post-intervention. FMD increased following WEX [4.0% (3.0-5.1%) to 5.3% (4.1-6.5%); p=0.016], but was unchanged following GEX [4.9% (3.8-5.9%) to 5.0% (3.8-6.1%); p=0.822]. There were no between-group differences in the change in FMD and no significant changes in GTN-mediated dilation percentage. Triglycerides decreased following GEX [1.2 mmol.L-1 (1.0-1.4 mmol.L-1) to 1.0 mmol.L-1 (0.8-1.3 mmol.L-1); p=0.022], but there were no further differences in lipid profiles. WEX improved endothelial function of the brachial artery in people with stable CHD, suggesting that WEX is an effective alternative to gym-based exercise in people living with CHD, which may specifically address vascular health.

Effect of Water-Based vs. Land-Based Exercise Intervention (postCOVIDkids) on Exercise Capacity, Fatigue, and Quality of Life in Children with Post COVID-19 Condition: A Randomized Controlled Trial.

Evidence suggests that COVID-19 can cause lasting health consequences called post-COVID-19 condition. We conducted a three-group, randomized controlled trial for children aged 10-12 years with post COVID-19 condition. Participants were randomized to AQUA, LAND, or CONTROL groups. The AQUA and LAND training sessions were conducted twice a week for eight weeks. The primary outcomes were exercise capacity, measured using the modified Balke treadmill protocol, and fatigue, measured using the Cumulative Fatigue Symptoms Questionnaire (CFSQ). The secondary outcome was health-related quality of life (HRQoL), measured with the Pediatric Quality of Life Inventory (PedsQL) for children and parents. A total of 74 of the 86 children completed the intervention and attended the post-intervention assessment. The absolute maximal oxygen uptake (VO2max) values increased after both AQUA (p = 0.001) and LAND (p = 0.004) interventions. No significant differences were found in the degree of total fatigue and individual fatigue symptoms. A significant improvement was found in the PedsQL reported by the parents in the LAND group. In conclusion, the applied eight-week water-based and land-based exercise training programs improved exercise capacity in children aged 10-12 years old with post COVID-19 condition. The parents of the children in the training groups also noted an improvement in HRQoL.

The Effect of Aquatic Exercise Training on Heart Rate Variability in Patients with Coronary Artery Disease.

(1) Background: Aquatic exercise training is a relatively understudied exercise modality in patients with CAD; with the present study, we sought to compare the impact of short-term 14-day water- and land-based exercise training on heart rate variability (HRV). (2) Methods: We randomized 90 patients after a recent CAD event (myocardial infarction and/or revascularization within 2 months prior to inclusion) to either (i) water-based or (ii) land-based exercise training (14 days, two 30 min sessions daily), or (iii) controls. Before and after the intervention period, all participants underwent 20 min 12-channel high-resolution ECG recordings with off-line HRV analysis, including conventional linear time- and frequency-domain analysis (using the Welch method for fast-Fourier transformation), and preselected non-linear analysis (Poincaré plot-derived parameters, sample entropy, and the short-term scaling exponent α1 obtained by detrended fluctuation analysis). (3) Results: Eighty-nine patients completed the study (mean age 60 ± 8 years; 20 % women). We did not detect significant differences in baseline- or age-adjusted end-of-study HRV parameters, but aquatic exercise training was associated with a significant increase in the linear LF/HF parameter (from 2.6 [1.2–4.0] to 3.0 [2.1–5.5], p = 0.046) and the non-linear α1 parameter (from 1.2 [1.1–1.4] to 1.3 [1.2–1.5], p = 0.043). (4) Conclusions: Our results have shown that a short-term 14-day aquatic exercise training program improves selected HRV parameters, suggesting this mode of exercise is safe and may be beneficial in patients with CAD.

Beneficial Effect of Water-Based Exercise Training on Exercise Capacity in COPD Patients-a Pilot Study.

Background: Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable condition, characterized by persistent airflow limitation. Exercise training is a core component of pulmonary rehabilitation in people with COPD. Water-based exercise has been studied, but it remains unclear whether water-based exercise program leads to the improvement in respiratory function, muscle strength, balance ability, and exercise capacity. We aim to study the effect of an 8-week water-based exercise program on respiratory function, muscle strength, balance ability, and exercise capacity in people with COPD.Methods: Fourteen stable COPD participants (FEV1 56.8 ± 24.6%pred) were recruited and randomized into a water-based exercise or a land-based exercise group. Both groups were trained for 8 weeks, two sessions per week. Pulmonary function, respiratory muscle strength, peripheral muscle strength, balance ability, exercise capacity [6-min walking test (6MWT), incremental shuttle walk test (ISWT), and endurance shuttle walk test (ESWT)] were assessed at baseline and at the end of the program. ANCOVA was used to conduct between-group comparisons of outcomes after adjusting for pre-intervention values.Results: Baseline characteristics of participants were not significantly different between the two groups (p ≥ 0.05). After the 8-week training program, participants in the intervention group achieved larger gains in ESWT (Δ663.4 ± 279.5 vs. Δ45.4 ± 93.2 s, p = 0.001). In addition, maximal inspiratory pressure (MIP) was significantly increased more in the intervention group (Δ11.1 ± 7.8 vs. Δ1.1 ± 5.7 cmH2O, p = 0.026). However, no significant differences in pulmonary function, peripheral muscle strength, balance ability variables, 6MWD (p = 0.248), and ISWT (p = 0.506) were observed between the two groups.Conclusions: The water-based exercise program could be recommended to the COPD rehabilitation program for improving the endurance exercise capacity and inspiratory muscle strength.Clinical Trial Registration: www.thaiclinicaltrials.org, identifier: TCTR20210125005.

Tailored or adapted interventions for adults with chronic obstructive pulmonary disease and at least one other long-term condition: a mixed methods review.

Tailored or adapted interventions for adults with chronic obstructive pulmonary disease and at least one other long-term condition: a mixed methods review.

The effect of water-based rhythmic exercise training on glucose homeostasis and thyroid hormones in postmenopausal women with metabolic syndrome.

The present study aimed to explore the effect of water-based rhythmic exercise training on fasting blood sugar (FBS), homeostatic model assessment (HOMA), insulin, thyroid stimulating hormone (TSH), and T4 in postmenopausal women with metabolic syndrome. In this clinical trial, 31 postmenopausal woman with metabolic syndrome aged 69.16±2.02 years were randomly assigned to an experimental (n=16) and a control group (n=15). The training program was composed of 12 weeks of water-based rhythmic exercise training performed intermittently for 60min three times a week. Before and after training, blood was analyzed for glucose homeostasis, T4, and TSH. Data were subjected to analysis by paired t-test and covariance analysis at the p<0.05 level. The exercise training intervention reduced the FBS and insulin significantly (p=0.000). The growth hormone (GH) index was increased significantly only in the experimental group (p=0.037) whereas no significant variations occurred in the insulin-like growth factor-1 (p=0.712). It was also found that TSH and T4 change in the experimental group as compared to the pre-test. Water-based rhythmic exercise training may improve blood glucose homeostasis, TSH, and T4.

Effects Of Water-based Detraining/re-training On Muscular Fitness And Functional Capacity In Elderly People

The positive long-term effects of exercise training on health-related outcomes in elderly people as well as the negative effects of training interruption are well documented. Despite largely used, little is knowing about the effects of detraining/re-training in water-based exercise training. PURPOSE: To evaluate the effects of water-based detraining/re-training on low limb peak torque and functional capacity in an elderly population. METHODS: One hundred and eighty-nine older individuals (68±6yrs) from both genders (176 female and 13 male) engaged in water-based training (training period = 6±3yrs), had their lower limb peak torque (dynamometer), functional capacity (Time Up and Go test [TUG]; and 6-min walk test [6WT]) assessed before exercise training interruption (TI), after 12-weeks of interruption (DT) and after 12-weeks of re-training (RT) on water-based strength training (45minute per session twice a week). RESULTS: : Lower limb peak torque decreased from TI (12.83+3.86 kg/f) to DT (10.78+ 3.66) (p < 0.01), and was increased after RT (17.37 + 4.35 kg/f) (p < 0.01), achieving higher values compared to TI (p <0.01). No effects of detraining were observed for both 6WT or TUG (P>0.05), however re-training increases the performance on 6WT (425.94+ 65.30 m) and TUG (6.84+1.50 sec) compared to the TI (6WT= 390.00+ 55.47 m; TUG= 9.71+ 1.91 sec; p <0.01, for all). RESULTS: : Lower limb peak torque decreased from TI (12.83+3.86 kg/f) to DT (10.78+ 3.66) (p < 0.01), and was increased after RT (17.37 + 4.35 kg/f) (p < 0.01), achieving higher values compared to TI (p <0.01). No effects of detraining were observed for both 6WT or TUG (P>0.05), however re-training increases the performance on 6WT (425.94+ 65.30 m) and TUG (6.84+1.50 sec) compared to the TI (6WT= 390.00+ 55.47 m; TUG= 9.71+ 1.91 sec; p <0.01, for all). CONCLUSIONS: Detraining decreases muscle strength, but does not affect functional capacity. Water-based re-training induces additional improvements on muscle low limb peak torque and functional capacity in elderly people previously engaged in water-based training.

Water-based Exercise Training For Coronary Heart Disease

Exercise training is an important component of coronary heart disease (CHD) management, however engagement in gym-based exercise (GEX) remains sub-optimal. Water-based exercise (WEX) may provide an alternative, especially for patients with obesity or arthritis due to the buoyancy effect of water. PURPOSE: To examine the effectiveness of WEX for people with CHD. METHODS: Participants were randomised to 12 weeks of WEX, GEX, or control. Training groups undertook three, one-hour sessions of circuit training per week. Aerobic capacity (VO2peak), muscular strength (one repetition maximum; 1RM), body fat (DXA) and endothelial function (flow mediated dilation; FMD) were assessed at baseline and 12 weeks. Data were analysed using STATA 16 with mixed effects linear regression. RESULTS: Forty-five participants completed the study; WEX (n= 15), GEX (n=18), control (n=12). Data reported are estimated mean and 95% confidence interval.CONCLUSION: WEX and GEX improved aerobic fitness, leg strength and fat mass similarly, while WEX alone improved endothelial function. These findings support WEX as an alternative to GEX in patients with CHD. Supported by the Spinnaker Foundation, The Heart Foundation (Australia), and the Australian Government Research Training Programme.

Water-based continuous and interval training in older women: Cardiorespiratory and neuromuscular outcomes (WATER study).

The purpose of this study was to investigate the effects of two water-based aerobic programs on cardiorespiratory and neuromuscular outcomes in older women. Forty-one women (60 to 75years old) volunteered to participate in the study. Participants were randomized into a water-based continuous (CTG; n=21; 63.9±2.5years) or an interval (ITG; n=20; 64.8±3.6years) aerobic training group. Both training programs were performed for 12weeks (45-min sessions twice a week), with exercise intensity based on rating of perceived exertion (Borg's RPE 6-20 Scale). Pre and post training assessments of cardiorespiratory and neuromuscular outcomes were performed. Data analyses were conducted using Generalized Estimating Equations and Bonferroni post-hoc test (α=0.05). After the intervention, the CTG and the ITG displayed similar improvements in time to exhaustion (8% vs. 11%), peak oxygen uptake (9% vs. 7%), maximal dynamic knee extension strength (5% vs. 6%), dynamic muscular endurance of knee extensors (10% vs. 11%), maximal vastus lateralis electromyographic signal amplitude (13% vs. 35%), as well as an increase in muscle thickness (5% vs. 6%) and decrease in muscle echo intensity (-2% vs. -3%) of the quadriceps femoris. In conclusion, older women benefited from water-based exercise training prescribed based on participants' RPE, with both the interval and the continuous training programs resulting in similar increases in the cardiorespiratory and neuromuscular parameters.

Effects of heated water-based versus land-based exercise training on vascular function in individuals with peripheral artery disease.

Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with poor vascular function, walking impairment, and reduced quality of life. Land-based exercise therapy (LBET) is frequently recommended to improve walking and reduce symptoms. Recently, evidence has suggested that heated-water exercise therapy (HWET) is an effective intervention for PAD. However, the efficacy of LBET versus HWET in PAD patients had not been elucidated. Therefore, we sought to compare effects of LBET with HWET on cardiovascular function, exercise tolerance, physical function, and body composition in PAD patients. PAD patients (n = 53) were recruited and randomly assigned to a LBET group (n = 25) or HWET group (n = 28). The LBET group performed treadmill walking, whereas the HWET group performed walking in heated water for 12 wk. Leg (legPWV) and brachial-to-ankle arterial stiffness (baPWV), blood pressure (BP), ankle-brachial index (ABI), 6-min walking distance (6MWD), claudication onset time (COT), physical function, and body composition were assessed before and after 12 wk. There were significant group-by-time interactions (P < 0.05) for legPWV, BP, 6MWD, COT, body composition, and resting metabolic rate (RMR). Both groups significantly reduced (P < 0.05) legPWV, BP, and body fat percentage, and HWET measures were significantly lower than LBET measures. Both groups significantly increased 6MWD, COT, and RMR, and HWET group measures were significantly greater than LBET measures. A time effect was noted for baPWV reduction in both groups (P < 0.05). These results suggest that both LBET and HWET improve cardiovascular function, exercise tolerance, and body composition, and HWET showed considerably greater improvements compared with LBET in patients with PAD.NEW & NOTEWORTHY The results of this study reveal for the first time that although land-based exercise therapy is effective for reducing arterial stiffness and blood pressure in patients with peripheral artery disease (PAD), heated-water exercise therapy demonstrates greater benefits on vascular function. The greater improvements in muscular strength, time to onset of claudication, and exercise tolerance after heated-water exercise therapy may have clinical implications for improving quality of life in patients with PAD. The heated-water exercise therapy intervention demonstrated relatively higher exercise training adherence (∼88%) compared with the land-based exercise intervention (∼81%).

The Effects of Water-based Exercise Training in People with Type 2 Diabetes.

To investigate the effects of 8 wk of upright water-based exercise training in people with type 2 diabetes. Thirteen participants with type 2 diabetes (54% male; 60.9 ± 9.6 yr, mean ± standard deviation) completed 8 wk of upright water-based exercise training at a moderate intensity (60%-80% of exercise test-derived maximum HR), for 1 h, three times a week (TG). Fourteen participants (64% male; 63.9 ± 9.8 yr) acted as a control group (CG) who maintained their usual activities. Preintervention and postintervention, participants performed cardiopulmonary exercise testing to determine V˙O2peak and one-repetition maximum testing to assess muscular strength. Blood profiles were assessed with standard assays. Body mass index and waist/hip ratio were employed as measures of anthropometry. Endothelium-dependent (brachial artery flow-mediated dilation) and independent (glyceryl trinitrate-mediated) function were assessed using vascular ultrasound. Water-based training increased V˙O2peak (18.5 ± 4.3 mL·kg·min to 21.5 ± 5.4 mL·kg·min) (P = 0.002), overall muscle strength (123 ± 44 kg to 139 ± 43 kg) and leg strength (92 ± 28 kg to 104 ± 29 kg), compared with the CG (P = 0.001). The effect on pectoral strength (31 ± 17 kg to 35 ± 16 kg) was not significantly different to the CG (24 ± 12 kg to 26 ± 14 kg) (P = 0.08). No change was observed in anthropometry, blood profiles, or glyceryl trinitrate-mediated vascular function. Flow-mediated dilation was increased after training (6.1% ± 2.4% to 6.5% ± 3.0%), compared with controls who demonstrated a slight decrease (6.2% ± 1.6% to 5.4% ± 1.6%) (P = 0.002). Water-based circuit training was well tolerated and appears to be an effective exercise modality for improving aerobic fitness, strength, and vascular function in people with type 2 diabetes.

Effects of land- and water-based exercise programmes on postural balance in individuals with COPD: additional results from a randomised clinical trial

ObjectiveTo investigate the effects of water-based exercise training on postural balance in individuals with chronic obstructive pulmonary disease (COPD), and compare the effects of two similar protocols of land- and water-based exercise programmes on postural balance in this population. DesignRandomised clinical trial. SettingUniversity-based, outpatient, physical therapy clinic. SubjectsFifty individuals with COPD. InterventionsParticipants were assigned at random to the land group (LG; n=27) or the water group (WG; n=23), and underwent high-intensity endurance and strength training three times per week for 3months. Main outcome measuresFunctional balance was assessed by the timed up and go test (TUG), and static balance was assessed with a force platform in the following conditions: standing with feet hip-width apart and eyes open; standing with feet hip-width apart and eyes closed; standing on a short base; and one-legged stance. ResultsSeventeen subjects completed the intervention in the LG {nine males, mean age 64 [standard deviation (SD) 8] years, mean forced expiratory volume in 1 second (FEV1) 48 (SD 17) %predicted} compared with 14 subjects in the WG [nine males, mean age 65 (SD 8) years, FEV1 51 (SD 15) %predicted]. Water-based exercise training had a positive effect on functional balance [TUG: mean difference −1.17 (−1.93 to −0.41 95% confidence interval) seconds; P=0.006], whereas static balance remained unaltered for both groups. There was no between-group difference in postural balance after exercise training; however, a higher proportion of participants who had a clinically relevant improvement in the TUG were in the WG (LG 35%, WG 64%; P<0.001). ConclusionFunctional balance improved after 3months of high-intensity exercise training performed in water. Despite the environment, non-specific training seems to be insufficient to improve static balance. Clinical trial registration numberclinicalTrials.gov NCT01691131.

Effects of Water-Based Exercise Training on the Cognitive Function and Quality of Life of Healthy Adult Women.

Research regarding the impact of aquatic exercise on cognition is scarce. This study aimed at identifying the effects of water-based exercise training on the cognitive function and quality of life of healthy adult women. Fifty-one healthy women [mean age: 46.5 (12.3) y]were assigned to group A or B and followed a water-based exercise program for 6 months. During the first 3 months, the sessions performed by group A were focused on stimulating cognitive function. For the next 3 months, the sessions were mainly aimed at improving physical fitness. Participants in group B followed the same program in reverse order. The trail making and symbol digit modality tests were used to assess the impact of the program on cognition. The effects of the intervention on the participants' physical and mental health were measured by means of the medical outcomes study 36-item short-form health survey. Once the intervention ended, significant improvements were observed in the participants' cognitive function and mental health domain, regardless of the group in which they were initially included. Water-based exercise is a training modality capable of enhancing cognitive function and quality of life through improvements in mental health in healthy adult women.

Acute Effects of Heated Water Based Exercise on Ambulatory Blood Pressure and Heart Rate Variability in Long Term Treated Elderly Hypertensive Patients

PURPOSE: Although heated water-based exercise (HEx) training has shown to largely reduce blood pressure (BP) in patients with resistant hypertension, the effect of a single exercise bout on ambulatory BP (ABP) in elderly subjects is unknown. Our purpose was to evaluate the acute effect of HEx versus land-based exercise (LEx) on ABP and heart rate variability (HRV) in long-term treated elderly hypertensive patients. METHODS: Twelve sedentary elderly hypertensive patients (6 women) aged 60±10 yr, under drug therapy for 15±3 yr, underwent a 30 min of HEx (walking inside the pool), LEx (walking on a treadmill) and nonexercise control session (CON) in random order (2-5 days between interventions). HEx and LEx intensity was set at 11-13 in the 6-20 RPE scale. HRV was analyzed before and after each intervention, and twenty-four hour (24-h) ABP monitoring was performed after each intervention. RESULTS: There was a tendency toward (P = 0.06) increase in low-frequency (pre = 43±7.3 n.u.; post = 57.9±5.5 n.u.) and decrease in high-frequency (pre = 56.7±7.3 n.u.; post = 42±5.5 n.u.) HRV after LEx, but no changes were observed after HEx and CON. However, 24-h (-6 mmHg), daytime (-6 mmHg) and nighttime (-6 mmHg) systolic ABP were significant lower (P < 0.05) after HEx than after LEx and CON. Although daytime (-3 mmHg) and nighttime (-4 mmHg) diastolic ABP was lower after HEx than after LEx and CON, this reduction was not statistically significant. CONCLUSIONS: Although there was an improvement in HRV after LEx, 24-h, daytime and nighttime systolic ABP reduced only after HEx. This result suggest that HEx may be superior than LEx to manage BP hypertension in long-term treated elderly hypertensive patients.

The Relative Efficacy of Land-Based and Water-Based Exercise Training on Macro- and Microvascular Functions in Older Patients With Type 2 Diabetes.

Microvascular and macrovascular dysfunction plays an important role in the pathogenesis of diabetic vascular disease. Twenty-nine older patients with type 2 diabetes were randomly assigned into the land-based (LB; n = 14) or water-based (WB; n = 15) groups. Both groups completed supervised aerobic cycling exercises three times per week for 12 weeks. The WB group performed cycling exercise training in warm water (36 °C) immersed to the hip level. After 12 weeks, blood glucose concentration and insulin resistance did not change but hemoglobin A1c levels decreased (P < .05) in both groups. Plasma nitric oxide concentrations increased (P < .05) in both groups. Flow-mediated dilation in the popliteal artery increased and arterial stiffness decreased (P < .05) in both exercise groups. Indices of microvascular reactivity improved (P < .05) only in the WB group. The benefits of warm water-based training were similar in general, and superior in some measures, to the more established land-based cycling exercise.

Individually and Combined Water-Based Exercise With Ginger Supplement, on Systemic Inflammation and Metabolic Syndrome Indices, Among the Obese Women With Breast Neoplasms.

Background:Breast neoplasms has known as the most common cancer among the women worldwide, and relationship between obesity, metabolic syndrome, inflammation and cancer has been recognized since many years ago.Objectives:The aim of this study was to determine the individual and concomitant effect of 6-weeks water-based exercise and oral ginger supplement on markers that have related to metabolic syndrome and systemic inflammation in obese women with breast neoplasms.Patients and Methods:Forty women whose have diagnosed with breast neoplasms have volunteered to participate in the study. Subjects have randomly assigned into four groups; placebo, exercise training, ginger supplement and exercise training+ ginger supplement groups. Subjects in the ginger supplement group and the exercise training+ ginger supplement group have orally received 4 capsules, 7 days a week and for 6 weeks. The water-based exercise training program have collected at a progressive intensity and time, have ranged from 50% to 75% of heart rate reserve, in a pool, 4 times a week for 6 weeks. Fasting blood sampling has collected at the pretest and post-test.Results:The ginger supplementation and the water-base exercise have resulted in a reduction of hs-CRP, IL-10, insulin, glucose, insulin resistance, LDL-C, TG; but an increase in HDL-C and HDL-C/LDL-C. The water-base exercise and ginger supplement group have significantly shown larger positive effect in all outcomes, in comparison with the water-base exercise or ginger supplement alone groups.Conclusions:Findings have suggested that obese breast neoplasms survivors have commonly shown metabolic syndrome and elevated inflammation, which placed them at an increased risk for cardiovascular diseases. Moreover, data has indicated a protective effect of the nondrug strategies, such as water-base exercise and ginger supplementation have played an important role in pathogenesis of inflammatory and metabolic responses, among diagnosed breast neoplasms.

Managing osteoarthritis.

Management of osteoarthritis should be based on a combination of non-drug and drug treatments targeted towards prevention, modifying risk and disease progression. Obesity is the most important modifiable risk factor, so losing weight in addition to land- and water-based exercise and strength training is important. While paracetamol can be tried, guidelines recommend non-steroidal anti-inflammatory drugs as first-line treatment for osteoarthritis. If there are concerns about the adverse effects of oral treatment, particularly in older patients or those with comorbidities, topical non-steroidal anti-inflammatory drugs can be used. Glucosamine does not appear to be any better than placebo for pain. Its effect on the structural progression of disease when taken alone or in combination with chondroitin is uncertain. Fish oil has not been found to reduce the structural progression of knee arthritis. Surgical interventions should be avoided in the first instance, with arthroscopic procedures not showing benefit over sham procedures or optimised physical and medical therapy. Joint replacement surgery should be considered for severe osteoarthritis.

Neuroendocrine Response To Heated Water-based Exercise Training On Resistant Hypertensive Patients

PURPOSE: Heated water based EXercise training (HEx) is a new alternative intervention in cardiac rehabilitation, and it has been studied about its effects on cardiovascular adaptations; but still there is no data about neuroendocrine effects of this training. This study examines the effects of HEx on neuroendocrine response in resistant hypertensive patients. METHODS: This is a parallel, randomized controlled trial. 125 nonconsecutive sedentary patients with resistant hypertension from a hypertension outpatient clinic in a university hospital were screened; 44 patients fulfilled the study requirements and had their blood analyzed for the concentration of plasma catecholamines (dopamine, adrenaline and noradrenaline), endothelin -1, nitric oxide (NO), plasma aldosterone concentration and plasma renin activity (PRA) than the patients were divided in two groups, one group was trained in a heated pool (32oC) for 12 weeks, 3 times a week; and the other group was the control group. The sessions were performed for 60 minutes and were consisted of callisthenic exercises and walking inside the pool. The control group was asked to maintain habitual activities. After 12 weeks all patients repeated the blood tests. RESULTS: 44 patients (HEx n=28; control n=16) were randomized; there was no loss during the follow-up and no adverse events occurred during the study. HEx decreased plasma concentration of dopamine (from 145±88 to 26±21 ng/ml, p<0.0001), adrenaline (from 353±156 to 169±93 ng/ml, p=0.009), noradrenaline (from 720±255 to 307±137 ng/ml, p=0.001), andothelin-1 (from 42±14 to 26±8 pg/ml, p=0.003), aldosterone (from 94±48 to 77±22 pg/ml, p=0.006) PRA (from 35±14 to 3±3 mmHg ng/ml/H, p<0.0001); and increased NO (from 25±7 to 77±22 uM, p= 0.001).The control group after 12 weeks did not have any changes on blood analysis results. CONCLUSIONS: HEx was able to improve important neuroendocrine adaptations in resistant hypertensive patients. These effects suggest that HEx may be a potential new therapeutic approach in these patients.

Acceptability of the aquatic environment for exercise training by people with chronic obstructive pulmonary disease with physical comorbidities: Additional results from a randomised controlled trial

ObjectivesWater-based exercise training is a relatively new concept in the management of people with COPD. This study aimed to examine the acceptability of the aquatic environment as a medium for exercise training in people with COPD with physical comorbidities. DesignFollowing a supervised eight week, three times a week, water-based exercise training programme conducted in a hospital hydrotherapy pool as part of a randomised controlled trial, participants completed a questionnaire about their experience with exercise training in the pool including adverse events, barriers and factors enabling exercise programme completion, satisfaction with the aquatic environment and their preference for an exercise training environment. ResultsAll 18 participants (mean (SD) age 72 (10) years; FEV1% predicted 60 (10) %) who commenced the water-based exercise training programme completed the questionnaire. Three participants withdrew from training. High acceptability of the water and air temperature, shower and change-room facilities, staff assistance and modes of pool entry was reported (94% to 100%). Six factors were highly rated as enabling exercise programme adherence and completion: staff support (chosen by 93% of participants), enjoyment (80%), sense of achievement (80%), noticeable improvements (73%), personal motivation (73%) and participant support (53%). Eighty-nine percent of the participants indicated they would continue with water-based exercise. ConclusionsThis study provides the first insight into the acceptability of the aquatic environment for exercise training in people with COPD and indicates water-based exercise and the aquatic environment is well accepted.

Heated Water-based Exercise Training Improves Physical Capacity In Resistant Hypertension Patients

Heated Water-based Exercise Training Improves Physical Capacity In Resistant Hypertension Patients