Water-based Exercise Research Articles

High-intensity interval vs moderate-intensity continuous exercise in heated water-based on acute hemodynamic, vascular, and cardiac autonomic responses in older individuals with hypertension

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP #2017/25648-4 #2018/09695-5) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES – Finance Code 001). OnBehalf Exercise and Chronic Disease Research Laboratory (ECDR) Introduction Post-exercise hypotension is an important tool in the treatment and control of hypertension. In recent years, high-intensity interval exercise (HIIE) has gained significant popularity in exercise-based prevention and rehabilitation of clinical populations. However, to date, it is not clarifying the acute responses of exercise performed in heated water-based in older individuals with hypertension. Purpose To assess hemodynamic, vascular, and cardiac autonomic responses to heated water-based HIIE versus moderate-intensity continuous exercise (MICE) in older individuals with hypertension. Methods Twenty older individuals (67 ± 7 y) under treatment for hypertension were randomly assigned to perform HIIE (25 min), MICE (30 min) and control (CON; 30 min) sessions in a heated swimming pool (30-32ºC). Blood pressure (BP), arterial stiffness, endothelial reactivity, and heart rate variability (HRV) were measured before (PRE), immediately after (POST), and after 45 min (REC). 24-h ambulatory BP monitoring and ambulatory HRV were also performed after each intervention. HRV were analyzed in ms² (ms²) or normalized units (nu) and then converted into natural logarithms (ln). Time domain markers as mean of intervals R-R (µi-RR), and frequency domain such as high frequency band (HF) and low frequency band (LF). Results Systolic BP increased at POST (p < 0.05) in all interventions, with higher increases in CON (29 ± 3 mmHg) and MICE (19 ± 3 mmHg) than HIIE (9 ± 4 mmHg). Although systolic BP reduced at REC in all interventions, it returned to levels similar to PRE in HIIE, and continue at higher levels than PRE in MICE and CON. HIIE promoted a higher response on markers of parasympathetic modulation at REC compared to MICE (HFln,nu 0.14 ± 0.06, p = 0.02) and CON (µi-RR: 0.02 ± 0.01, p = 0.05). By contrast, during night-time, HIIE demonstrated a lower parasympathetic modulation than CON (HFln,nu: -0.06 ± 0.03, p = 0.05). In addition, CON showed a higher HRV during 24-h compared to HIIE and MICE. Conclusion Despite differences between interventions in BP and cardiac autonomic responses, heated water-based HIIE or MICE were not effective to improve hemodynamic and vascular responses. These results may have important implications in the management of older individuals with hypertension in heated water-based.

Respiratory Response to Underwater and Land‐based Cycling at the Matched Oxygen Uptake

Water immersion increases breathing effort against elevated hydrostatic pressure. Thus, aquatic exercise training may have a greater benefit for the respiratory function when compared to the same intensity of exercise performed on dryland. The purpose of this study was to investigate the effect of underwater cycling on the respiratory function and breathing pattern when compared to land-based cycling performed at the matched exercise intensity. Ten healthy men performed maximal graded exercise test and 15 minutes of incremental water-based cycling exercise (WE) and land-based cycling exercise (LE) on separate days. In WE, cycling began at 30 rpm, and the cadence was increased by 15 rpm every 5 minutes. 3 paddles were attached to the wheel of stationary bicycle to increase pedaling resistance. In LE, participants cycled continuously at 60 rpm for 15 minutes while wattage was adjusted to match oxygen uptake (VO2) to the WE condition. Using spirometry, respiratory function and respiratory muscle pressure were measured before and after cycling, and the magnitude of change between pre- and post- exercise was also measured. Breathing pattern was measured continuously during cycling. Water temperature and immersion level were kept at 31.5 ℃ and xiphoid appendix, respectively. VO2 duringcycling in water and on dryland was similar. Minute ventilation, inspiratory and expiratory volumes, and respiratory rate increased whereas, inspiratory and expiratory times decreased as the cycling intensity (VO2) increased (all P < 0.05). Respiratory rate was slightly higher at 60 rpm in WE than LE (27 ± 3 vs. 24 ± 3 bpm, P = 0.053). Inspiratory time was significantly higher at rest in WE than LE (1.4 ± 0.1 vs. 1.2 ± 0.0 sec, P < 0.05). After cycling exercise, change in the forced expiratory volume in one second and change in the peak expiratory flow were significantly lower in WE than LE (-0.04 ± 0.15 vs. 0.06 ± 0.10 L, P < 0.05. -0.37 ± 0.87 vs. 0.04 ± 0.63 L, P < 0.05, respectively). These data suggest that the respiratory and breathing responses were mostly similar during underwater and land-based cycling when VO2 is matched in both conditions. However, breathing may slightly be shallower during a higher-intensity aquatic cycling which may have chronic effects on respiratory function after multiple bouts of aquatic cycling for a longer term.

Comparing durability of water- and land-based exercise benefits among older adults in South Korea: A randomized controlled trial with 1-year follow-up.

Aquatic exercise can improve strength, flexibility, and aerobic function while safely providing partial weight-bearing support through viscosity and buoyancy. The aim of the present study was to compare the effects of water-based exercise with land-based exercise before and after a 10-week exercise intervention and again at one-year follow-up. Eighty participants aged 65 years and older were randomly assigned to either a water- or a land-based 10-week exercise program. Assessment included the Senior Fitness Test (SFT), the Modified Falls-Efficacy Scale, and the 36-Item Short-Form Health Survey (SF-36). Hip and knee strength was also measured. All assessments were completed at three time points: pre- (T1), post- (T2), and at 1-year follow-up (T3). Significant differences were observed between the two groups on three parameters: the SFT timed up-and-go test; lower hip muscle strength in extension, adduction, and external rotation; and quality of life (QoL) measured by the SF-36 (p< 0.05). No significant differences were observed in the SFT chair stand test, dominant arm curl test, two-minute step test, chair sit-and-reach test, back scratch test, and Modified Falls-Efficacy Scale. Aquatic exercise provided greater improvement of physical health and QoL among older people than land-based exercise.

The Impact of 6-Month Land versus Water Walking on Cerebrovascular Function in the Aging Brain.

To examine the hypothesis that exercise training induces adaptation in cerebrovascular function, we recruited 63 older adults (62 ± 7 yr, 46 females) to undertake 24 wk of either land walking or water walking, or participate in a nonexercise control group. This is the first multi-interventional study to perform a comprehensive assessment of cerebrovascular function in response to longer term (6-month) training interventions, including water-based exercise, in older healthy individuals. Intracranial blood flow velocities (middle cerebral artery (MCAv) and posterior cerebral artery) were assessed at rest and in response to neurovascular coupling, hypercapnic reactivity, and cerebral autoregulation. We observed no change in resting MCAv in response to either training intervention (pre vs post, mean (95% confidence interval), land walking: 65 (59-70) to 63 (57-68) cm·s-1, P = 0.33; water walking: 63 (58-69) to 61 (55-67) cm·s-1, P = 0.92) compared with controls and no change in neurovascular coupling (land walking: P = 0.18, water walking: P = 0.17). There was a significant but modest improvement in autoregulatory normalized gain after the intervention in the water-walking compared with the land-walking group (P = 0.03). Hypercapnic MCAv reactivity was not different based on exercise group (land: P = 087, water: P = 0.83); however, when data were pooled from the exercise groups, increases in fitness were correlated with decreases in hypercapnic reactivity (r2 = 0.25, P = 0.003). Although exercise was not associated with systematic changes across multiple domains of cerebrovascular function, our data indicate that exercise may induce modest changes in autoregulation and CO2 reactivity. These findings should encourage further studies of the longer-term implications of exercise training on cerebrovascular health.

Evidence for integrating exercise training into the multidisciplinary management of non-specific chronic low back pain.

Worldwide, low back pain (LBP) is the leading cause of disability and affects 16% of the Australian population. Pain that lasts more than 12 weeks and is presumed lumbar musculoskeletal in origin is deemed non-specific chronic LBP. Managing LBP requires a multidisciplinary approach. The aim of this article is to provide evidence for incorporating exercise training into the multidisciplinary treatment plans of patients with non‑specific chronic LBP. There is mounting evidence in support of the integration of exercise training for the multidisciplinary treatment of non specific chronic LBP. Clinically meaningful reductions in pain intensity may be achieved with Pilates, aerobic, stabilisation/motor control and resistance exercise training. Clinically meaningful reductions in disability may be attained with resistance, stabilisation/motor control, water-based, Pilates and yoga exercise. Resistance and aerobic exercise can also improve mental health in this susceptible population group. The evidence suggests it is reasonable to consider including exercise-based services in the care team to enable patients with non-specific chronic LBP to transition to self-management.

Magnitude of vertical ground reaction force during water-based exercises in women with obesity

ABSTRACT Individuals with obesity are recommended to practice physical activity with reduced weight bearing, such as water-based exercises. However, the magnitude of the vertical ground reaction force (Fz) during these exercises is unknown in this population. This study aimed to verify the magnitude of peak Fz (Fzpeak) in women with obesity during different exercises performed in water and on land and at different intensities. Ten adult women with obesity class 1 (body mass index: 31.6 ± 0.57 kg·m−2) completed two randomised sessions, one performed on land and other in water, composed by three exercises (stationary running, frontal kick, butt kick) performed at cadences of 80 b·min−1, 100 b·min−1 and maximal. Fzpeak value was determined in each situation. Data were analysed using repeated-measures three-way ANOVA (α = 0.05). Significant lower Fzpeak values were observed in water (p < 0.001), with no significant differences between the exercises. A significant difference in the Fzpeak was verified between maximal cadence and 80 b·min−1 (p = 0.01). Water-based exercises performed by women with obesity revealed a Fzpeak reduction from land to water corresponding to 41–67%. Also, the three water-based exercises resulted in similar Fzpeak values, while an increase was observed 80 b·min−1 to the maximal cadence.

Rewinding sarcopenia: a narrative review on the renin-angiotensin system.

The purpose of this review was two-fold. First, we aimed to provide an in-depth glance on the relationship between renin-angiotensin system (RAS) dysregulation and sarcopenia. Second, we aimed to touch upon potential treatments of sarcopenia (including RAS blockers, vitamin D, and exercise) in light of the pertinent literature. Currently available research regarding the effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers on knee extensor strength, grip strength, chair stand test, gate speed together with the effects of exercise on muscle mass, strength, physical performance, blood pressure and cognitive tests (particularly in older adults) was reviewed. Although some studies have shown favorable effects of ACEIs on muscle strength and/or physical function tests, some studies have reported no/negative association in between. The favorable impact of exercise on reducing blood pressure is shown, and exercise treatment is widely recommended in the relevant literature. Different types of exercises (aerobic, resistance, dancing, music movement, water-based, golf, knitting activities or multicomponent exercises) have shown improvement in cognitive functions as well. Classical RAS activity results in deleterious effects not only on the cardiovascular but also on the neuromusculoskeletal system. Therefore, treatments targeting inhibition of the classical RAS activity seem to be important in the management of several age-related pathologies, including sarcopenia. As such, ACEIs, vitamin D, exercise, and healthy diet can have prominent effects not only on the modulation of RAS but also on physical and cognitive functions and sarcopenia as well.

Physical Activity in Patients with Inflammatory Bowel Disease: A Cross-Sectional Study

Introduction and Objective: Despite the known benefits of physical activity in the management of chronic diseases, the use of exercise as a treatment is relatively underemployed, with many patients reporting their disease to be a barrier. This study aimed to assess physical activity levels, attitudes, and barriers towards exercise in a cohort of patients with inflammatory bowel disease (IBD). In addition, this study aimed to assess possible relationships between physical well-being, psychological well-being, and sociodemographic factors. Methods: 306 patients >18 years with diagnosed IBD in Dunedin, New Zealand, were approached to participate in this study. Participants who consented completed questionnaires regarding exercise preferences and attitudes, physical activity levels, and psychological well-being. Results: Seventy-seven patients participated in the study (77/308 = 25%). Sixty-six percent of participants met physical activity guidelines and the median metabolic equivalent minutes/week of 1,027.5 (505.5–2,339.5). Walking was the most preferred activity (30%) followed by water-based exercise (20%). Two-thirds of participants reported their disease limited the amount of physical activity undertaken. Common barriers to participating in physical activity included fatigue (34%) and abdominal pain (20%). Patients with active disease reported higher levels of barriers than those in remission (80 vs. 54%, p = 0.018). Higher physical activity levels were correlated with lower levels of fatigue (p = 0.022–0.046). Conclusions: While patients with IBD in Dunedin, New Zealand, are physically active, reducing real and perceived barriers is crucial to further increase physical activity in patients with IBD who are in remission or with active disease.

Friendships Forged in Fitness: An Ethnographic Exploration of Older Women’s Social Experiences in Water Aerobics

Research shows that participants, especially older women, are more likely to adhere to a fitness program when they have social supports. Gerontology research also demonstrates that the social relationships forged by older women at community and fitness centers can be long-lasting and provide a variety of supportive functions. Older adults respond well to pool- or water-based aerobic exercises that are safe on the joints and provide a comfortable environment away from the intimidating nature of the gym. Therefore, water-based classes provided at community fitness centers are well positioned to provide ample social opportunities to further reinforce continued physical activity for older women, resulting in health and quality-of-life improvements. This project is a 5-month ethnographic exploration of the social relationships created and maintained in the context of water-based fitness classes (water aerobics) at a local community center (YMCA) that is attended by a culturally diverse group of older adults. The friendships forged by women in the pool at the YMCA provide a variety of social supports that help to maintain healthy aging outcomes among participants. Drawing on components of Activity Theory and Social Support Theory, this presentation utilizes participant observation, semi-structured interviews, and questionnaires (N=35) to provide an anthropological “thick description” of the important role that fitness center friendships can form in the social lives of older women in the U.S.

Aquatic Therapy Reduces Pain and Fatigue in Breast Cancer Survivors: A Systematic Review

Background and Purpose: Pain and cancer-related fatigue (CRF) are impairments from breast cancer or the medical and surgical therapies for breast cancer. Aquatic therapy has been found to be effective for the problems of pain and CRF. The purpose of this systematic review was to determine whether aquatic therapy reduced pain and CRF among people with breast cancer and to identify any elements of aquatic therapy associated with those effects. Methods: The protocol for this systematic review was registered with PROSPERO, and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards were followed. Four databases were searched, and studies were selected on the basis of predetermined criteria. Data were extracted into a template for analysis and thematic synthesis. Measures of methodological quality (risk of bias) and level of evidence were applied. Results: Six studies involving 137 subjects who received treatment were included. Subjects received aquatic therapy (water-based exercise for rehabilitation) that was compared with various land-based interventions. Studies were evaluated with the Oxford Centre for Evidence-based Medicine—Levels of Evidence for Therapy/Prevention Studies Rating Scale, and all studies had a high or acceptable level of evidence. Studies were evaluated with the APTA Critical Appraisal Tool for Experimental Intervention Studies, and 5 studies had a high or acceptable quality. High-quality evidence supported the use of aquatic therapy for reducing CRF, and acceptable quality evidence supported the use of aquatic therapy for reducing pain. Adverse responses to aquatic therapy were minor symptoms that resolved within days and had no effect on attrition. Limitations: Searches were limited to publications in English. Analysis was confounded by heterogeneity of pain measures. Conclusions: Aquatic therapy is recommended as an intervention for the impairments of pain and CRF associated with breast cancer. Aquatic therapy is safe and feasible for this population.

Hemodynamic response to heated water immersion in older individuals with hypertension.

The aim of this study was to evaluate blood pressure (BP), heart rate, arterial stiffness and endothelial reactivity responses to heated water immersion in older individuals with hypertension. Thirty-five sedentary individuals (67 ± 5 years) under treatment for hypertension were randomly assigned to water-based [n = 20; 30 min of seated resting in a heated swimming pool (30-32 °C)] or land-based group [n = 15; 30 min of seated resting in a quiet room with controlled temperature (21-23 °C)]. BP, heart rate, arterial stiffness and endothelial reactivity were measured before, immediately after (post) and 45 min after (recovery) each session. Heart rate reduced (P < 0.05) during the land-based session, and the reduction was maintained at post (~7 bpm) and recovery (~9 bpm), but no heart rate changes occurred during and after the water-based session. Systolic/diastolic BP increased (P = <0.001) at post (~29/10 mmHg) and recovery (~10/7 mmHg) in the water-based group, but not in the land-based group. No significant changes in pulse wave velocity and endothelial reactivity occurred in both groups. These results suggest that the hemodynamic response to heated water immersion should be taken into account when assessing the effect of heated water-based exercise on postexercise hypotension in older individuals with hypertension.

The effect of aquatic exercise on functional disability, flexibility and function of trunk muscles in postmenopausal women with chronic non-specific low back pain: Randomized controlled trial

This study investigated the effect of 8-week aquatic exercise training on pain, flexibility, and function of trunk muscles in postmenopausal women with non-specific chronic low back pain. Twenty women with Chronic non-specific low back pain were voluntarily selected and randomly divided into the experimental ( n = 10) and control ( n = 10) groups. The experimental group participated in 24 sessions (3 sessions per week) water-based exercises, consisting of a 15 minutes warm-up, 35 minutes of main exercises, and 10 minutes to cool down. Baseline measurements, such as age, height, weight, BMI, functional disability, flexibility, and function of trunk muscles for each participant were assessed and recorded one week before and after the intervention period. After 8 weeks of aquatic exercise training, functional disability ( P ≤ 0.007) and flexibility ( P ≤ 0.009) of participants in the experimental group significantly improved compared to the control. Furthermore, the EMG values of the rectus abdominis ( P < 0.001), external oblique ( P < 0.001), longissimus thoracic ( P < 0.021) and lumbar multifidus ( P < 0.009) muscles in the experimental group significantly improved compared to the control group. It can be concluded that aquatic exercise has a positive effect on pain reduction, flexibility, and EMG values of postmenopausal women with chronic low back pain. Cette étude a examiné l’effet d’un entraînement aquatique de 8 semaines sur la douleur, la souplesse et la fonction des muscles du tronc chez les femmes ménopausées souffrant de lombalgie chronique non spécifique. Vingt femmes souffrant de lombalgie chronique non spécifique ont été choisies volontairement et réparties de manière aléatoire en groupes expérimental ( n = 10) et contrôle ( n = 10). Le groupe expérimental a participé à 24 séances (3 séances par semaine) d’exercices aquatiques comprenant 15 minutes d’échauffement, 35 minutes d’exercices principaux et 10 minutes de récupération. Les mesures de base, telles que l’âge, la taille, le poids, l’IMC, l’incapacité fonctionnelle, la souplesse et la fonction des muscles du tronc, ont été évaluées et enregistrées pour chaque participant une semaine avant et après la période d’intervention. Après 8 semaines d’entraînement aquatique, l’incapacité fonctionnelle ( p ≤ 0,007) et la souplesse ( p ≤ 0,009) des participants du groupe expérimental se sont nettement améliorées par rapport au groupe témoin. En outre, les valeurs EMG des muscles rectus abdominaux ( p < 0,001), obliques externes ( p < 0,001), longissimus thoracique ( p < 0,021) et multifidus lombaire ( p < 0,009) du groupe expérimental ont été significativement améliorées par rapport au groupe témoin. On peut en conclure que l’exercice aquatique a un effet positif sur la réduction de la douleur, la souplesse et les valeurs EMG des femmes ménopausées souffrant de lombalgie chronique.

Evaluation of the Feasibility of a Two-Week Course of Aquatic Therapy and Thalassotherapy in a Mild Post-Stroke Population

Strokes are a leading cause of disability in developed countries. Patients with disabilities need rehabilitation to improve their physical functioning, mental status, and quality of life. Currently, no high-quality evidence can be found attesting the benefits of any of the interventions that are nowadays used. Water-based exercise may improve the physical conditions and quality of life of people in the post-stroke phase. The objective of this study is to test whether aquatic therapy in an enriched environment at the seaside (a thalassotherapy center) could play a role in this condition. A quasi-experimental prospective study consisting of a specific program assessed 62 patients with a mild–moderate disability pre- and post-2 weeks of intensive treatment. They followed a thalassotherapy regimen including aquatic therapy in a sea water pool at 32–34 °C for 45 min daily five times a week. The outcomes measured were the Berg Balance scale, the Timed Up and Go test, the 10-meter walking test, the 6-min walking test, the Pain Visual Analogue Scale, the WHO Well-being index, EuroQoL VAS and EuroQoL 5D. We observed a significant improvement in all outcomes measured (p < 0.001, except mobility EuroQoL p < 0.05), except in the other four dimensions of the EuroQoL 5D and 10-metre walking test (NS). Conclusion: A two-week intensive course of aquatic therapy and thalassotherapy may be beneficial in the short term by reducing pain and improving the functional status and overall well-being of post-stroke patients.

The effect of an exercise program in water on pain level and functional status in chronic nonspecific low back pain patients: A single-blind randomised controlled trial

Lower back pain is one of the most widespread health issues today. Water-based exercise is an effective treatment to reduce pain intensity and disability.

Land vs. water HIIE effects on muscle oxygenation and physiological parameter responses in postmenopausal women

Muscle oxygenation (MO) status is the dynamic balance between O2 utilization and O2 delivery. Low-impact high-intensity interval exercise MO responses in the exercise and recovery stage are still unclear. We compared the differences in MO and physiological parameters between high-intensity interval water-based exercise (WHIIE) and high-intensity interval land bike ergonomic exercise (LBEHIIE) in postmenopausal women. Eleven postmenopausal women completed WHIIE or LBEHIIE in counter-balanced order. Eight sets were performed and each exercise set included high intensity with 80% heart rate reserve (HRR) in 30 s and dynamic recovery with 50% HRR in 90 s. Muscle tissue oxygen saturation index (TSI), total hemoglobin (tHb), oxy-hemoglobin (O2Hb), and deoxy-hemoglobin (HHb) were recorded. Blood lactate, heart rate and rating of perceived exertion (RPE) were measured at pre and post-exercise. Under similar exercise intensity, RPE in WHIIE was lower than that in LBEHIIE. The heart rate in WHIIE was lower than that in LBEHIIE at 1 and 2 min post-exercise. During the dynamic recovery, TSI, tHb, and O2Hb in water were higher than on land. A negative correlation was found between the change in TSI and lactate concentration (r = − 0.664). WHIIE produced greater muscle oxygenation during dynamic recovery. Muscle TSI% was inversely related to blood lactate concentration during exercise in water.

Effects of water-based exercise on functioning and quality of life in people with Parkinson’s disease: a systematic review and meta-analysis

Aim: To investigate the effects of the water-based exercise on balance, mobility, mobility and functional independence, functional performance, fear of falling and quality of life in people with Parkinson’s disease. Methods: We searched pubmed/MEDLINE, Cochrane Central Register of Controlled Trials, PEDro data base and SciELO to June 2020 for randomised controlled trials that investigated the effects of water-based exercise in people with Parkinson’s disease. Two comparisons were made: water-based exercise versus usual care and water-based exercise versus land-exercise. The main outcomes were Balance, Confidence, Mobility, Unified Parkinson’s Disease Rating Scale and quality of life. Mean differences (MD) with 95% confidence interval (CI) were calculated, and heterogeneity was assessed using the I2 test. Results: Fifteen randomised controlled trials were found (435 people). Compared to usual care, water-based exercise resulted in improvement in balance MD (9.1, 95% CI: 6.5, 11.8, N = 45). Water-based exercise resulted in improvement in balance MD (3.1, 95% CI: 1.2, 5.0, N = 179), mobility MD (−2.2, 95% CI: −3.3, −1.0, N = 197) and quality of life MD (−5.5, 95% CI: −11, −0.07, N = 98) compared to land-based exercise, but without significant difference in functional performance MD (0.01, 95% CI: −2.6 to 2.7, N = 69). Land-based exercise resulted in improvement in fear of falling MD (−3.5, 95% CI: −5.6, −1.3, N = 58) compared to water-based exercise. Conclusion: Water-based exercise was more efficient than land-based exercise and/or usual care in improving balance, mobility and quality of life in people with Parkinson’s disease.

Water-Based Exercises Performed with High-Speed Movement Improves Strength and Physical Function in Older Women with Knee Osteoarthritis

Aims To verify the effects of aquatic exercises performed with high-speed movement on physical function, muscle function, and quality of life of older women with knee osteoarthritis (KOA). Methods This was a single-group experimental study with double pretest and a post-test. Dependent outcomes were assessed three times: 4 weeks before the intervention (pretest one), before the intervention (pretest two) and 16 weeks after (post-test). Women aged from 60 years with KOA (n = 12) participated in an aquatic exercise program during 16 weeks. Results Outcomes did not change from pretest one to two. After the intervention, there were improvements in knee extensor strength (11%) and power (15.6 to 16.2%), and knee flexor power (40.7%). Performance of mobility (9.2%), strength (10.1%), aerobic capacity (13.2%) tests also improved. Participants’ perceived quality of life related to KOA symptoms also increased. Conclusions This intervention approach is feasible, effective, and safe for older women with KOA. Trial registration: RBR-7ZCGDD (http://www.ensaiosclinicos.gov.br/rg/RBR-7zcgdd/).

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.

High-intensity Interval Versus Moderate-intensity Continuous Heated Water-based Exercise On Cardiovascular Variables In Hypertensive Older Individuals

PURPOSE: To evaluate acute hemodynamic and autonomic responses to high-intensity interval (HIIT) vs moderate-intensity continuous (MICE) exercise in heated water-based in older hypertensive individuals. METHODS: 15 sedentary older hypertensives were randomized in 2:2:1 to HIIT, MICE or without exercise (CON) sessions. Systolic/diastolic blood pressure (SBP/DBP), pulse wave velocity (PWV), endothelial function (EF) and variability of heart rate (HRV) were assessed before (pre), immediately after (post) and 45 min after intervention (rec). HIIT was consisted of warm-up (4 min), 21 min of 1 min of high-intensity alternating with 2 min of walking at moderate-intensity. MICE was performed by 4 min warm-up followed by 26 min of walking at moderate-intensity. Sessions were controlled using Rating Perceived of Exertion Scale (RPE).Two-way ANOVA (repeated measures) was used to indicate interventions differences and Bonferroni post hoc was used to identify significant differences (p<0.05). RESULTS: No significant differences were found for PWV and EF. HRV showed an increase in the μHP (high frequency band) when compared the moments PRE vs REC within CON group (PRE: 906 ± 132 ms vs REC: 942 ± 148 ms; p = 0.007). Moreover, even though POST-HIIT session we found a decrease of HFaHP (PRE: 413 ± 874 ms2 vs POST: 272 ± 716 ms2; p < 0.001), during REC only the HIIT group was able to increase the HFaHP index (POST: 272 ± 716 ms2 vs REC: 530 ± 1336 ms2; p < 0.001). The changes in HFaHP during REC was followed by a decreased of LFHP (low frequency band) index after HIIT (POST: 49 ± 24 n.u. vs REC: 33 ± 18 n.u.; p = 0.013). None difference was found in pre SBP/DBP (p>0.05). Although in post moment SBP was different between CON (153±4) vs MICE (141±6, p<0.02) and CON vs HIIT (136±5, p<0.001), with no difference in DBP. For REC, only CON (131±3) vs HIIT (123±4, p<0.02), with no difference in CON vs MICE and MICE vs HIIT (p>0.05) were founded. Only HIIT modality was able to return the SBP values to the PRE (122±4) in REC moment (123±4, p<0.66), but increasing in POST (136±5) moment comparing with PRE (p<0.01) and REC (p<0.02). For DBP, all intensities increase the values in POST (p<0.05) and maintain greater in REC moment comparing with pre (p<0.05). CONCLUSION: Water-based HIIT using RPE may be a time-efficient intervention in hypertension treatment of older individuals.

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.