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Background: Breast cancer is a prevalent form of cancer among women worldwide, often accompanied by physical and psychological side effects due to the disease and the treatment's aggressiveness. Regular physical exercise has emerged as a non-pharmacological approach to improve the quality of life of breast cancer survivors. We herein report the protocol of the WaterMama Study, which aims to evaluate the effects of land- or water-based aerobic exercise programs, compared to a health education program, on cancer-related fatigue and other health-related outcomes in breast cancer survivors., Methods: The WaterMama trial is a randomized, single-blinded, three-arm, parallel, superiority trial. We aim to recruit 48 women ≥ 18 years of age who have completed primary treatment for stage I-III breast cancer. Participants are randomly allocated in a 1:1:1 ratio to 12-week interventions of aerobic exercise training programs either in the aquatic or land environment (two weekly 45-min sessions) plus health education (a weekly 45-min session), or an active-control group receiving health education alone (a weekly 45-min session). The primary outcome is cancer-related fatigue, and the secondary outcomes include cardiorespiratory fitness, muscular performance, muscle morphology, functional capacity, mental health, cognitive function, pain, and quality of life. Outcomes assessments are conducted before and after the 12-week intervention period. The analysis plan will employ an intention-to-treat approach and per protocol criteria., Discussion: Our conceptual hypothesis is that both aerobic exercise programs will positively impact primary and secondary outcomes compared to the health education group alone. Additionally, due to its multi-component nature, we expect the aquatic exercise program promote more significant effects than the land exercise program on cancer-related fatigue, muscular outcomes, and pain., Trial Registration: The study was prospectively registered at ClinicalTrials.gov NCT05520515. Registered on August 26, 2022. https://clinicaltrials.gov/ct2/show/NCT05520515., (© 2024. The Author(s).)

To compare the acute effects of aquatic walking/running versus dry-land walking/running on blood glucose and plasma renin activity (PRA) in individuals with type 2 diabetes, participants with type 2 diabetes performed deep-water or dry-land walking and/or running sessions in a swimming pool or on an athletics track, respectively. Both sessions comprised seven blocks of 3 min at 85-90% of the heart rate deflection point (HRDP), interspersed with 2 min at <85% HRDP, totaling 35 min, with a 48 h interval between sessions. PRA and blood glucose were assessed before and immediately after the sessions. Generalized estimation equations were used to verify the session effects, with the Bonferroni post hoc test, considering the significance level as 0.05. Twelve individuals (53.2 ± 8.9 years) diagnosed with type 2 diabetes for 6.3 ± 6.34 years participated in the study. A reduction in PRA was found only after the aquatic session (-7.75 ng/mL/h; -69%; p : 0.034), while both aquatic and dry-land sessions similarly reduced the blood glucose levels (aquatic: -38 mg/dL, -21%; dry-land: -26 mg/dL, -14%; time effect, p = 0.007). Despite yielding similar glycemic reductions as dry-land walking/running, aquatic walking/running led to an expressive decrease in PRA among individuals with type 2 diabetes.

Purpose: The aim of the present study was to investigate the effects of acute caffeine supplementation on the performance during a session of resistance training alone (RT) or in combination with aerobic training (i.e. concurrent training; CT). Method: Fourteen resistance-trained men (23.1 ± 4.2 years) were recruited and performed both RT and CT under three different conditions: control (CONT), placebo (PLA), and caffeine (CAF; 6 mg.kg -1 ) for a total of six experimental conditions. Results: Both total and per set number of repetitions, and total volume load were lower during CT as compared to RT, irrespective of the supplementation condition (all p  < .001), whereas a supplementation main effect was observed for the total number of repetitions ( p  = .001), the number of repetitions in the first ( p  = .002) and second sets ( p  = .001), and total volume load ( p  = .001). RPE values were higher after the CT sessions than after the RT sessions ( p  < .001), whereas no differences were observed between supplementation conditions ( p  = .865). Conclusions: Caffeine supplementation was not sufficient to minimize the acute interference effect on strength performance in a CT session when compared to RT alone. In contrast, caffeine improved strength performance during the first set of both CT and RT, while maintaining a similar RPE between the supplementation conditions. However, the overall effect was small.

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 (Fz peak ) 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. Fz peak value was determined in each situation. Data were analysed using repeated-measures three-way ANOVA ( α  = 0.05). Significant lower Fz peak values were observed in water ( p < 0.001), with no significant differences between the exercises. A significant difference in the Fz peak was verified between maximal cadence and 80 b·min -1 ( p = 0.01). Water-based exercises performed by women with obesity revealed a Fz peak reduction from land to water corresponding to 41-67%. Also, the three water-based exercises resulted in similar Fz peak values, while an increase was observed 80 b·min -1 to the maximal cadence.

Objective: This study examined the effectiveness of neuromuscular electrical stimulation (NMES) added to the exercise or superimposed on voluntary contractions on patient-reported outcomes measures (PROMs) in people with knee osteoarthritis (OA)., Methods: This systematic review was described according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) were obtained from a systematic literature search in five electronic databases (PubMed, PEDro, LILACS, EMBASE, and SPORTDiscus) in April 2022. We described the effects of intervention according to each PROMs (scores for Pain; Self-reported functional ability; Symptoms (hear clicking, swelling, catching, restricted range of motion, and stiffness); Daily living function; Sports function; and Quality of life) and used a random-effect model to examine the impact of NMES plus exercise on pain compared with exercise in people with knee OA., Results: Six RCTs (n = 367) were included. In the qualitative synthesis, the systematic literature analysis showed improvement in pain after NMES plus exercise compared with exercise alone in three studies. The other three studies revealed no difference between groups in pain, although similar improvement after treatments. In the meta-analysis, NMES at a specific joint angle combined with exercise was not superior to exercise alone in pain management (standardized mean difference = -0.33, 95% CI = -1.05 to 0.39, p = 0.37). There was no additional effect of NMES on exercise on self-reported functional ability, stiffness, and physical function compared with exercise alone. In only one study, symptoms, activities of daily living, sports function, and quality of life improved after whole-body electrostimulation combined with exercise., Conclusion: This review found insufficient evidence for the effectiveness of NMES combined with exercise in treating knee OA considering PROMs. While pain relief was observed in some studies, more high-quality clinical trials are needed to support the use of NMES added to the exercise in clinical practice. Electrical stimulation in a whole-body configuration combined with exercise shows promise as an alternative treatment option., (© 2023 John Wiley & Sons Ltd.)

Background: Low back pain (LBP) is the leading cause of years lived with disability worldwide. Public safety workers are highly exposed to physically demanding activities and inappropriate postures, increasing the risk of experiencing LBP. Smartphone app-based self-managed interventions may be an alternative for chronic non-specific LBP (CNSLBP) treatment. This study aims to evaluate the effectiveness of a smartphone app-based self-managed exercise program plus health education, compared to a health education program alone, on neuromuscular and perceptual outcomes in police officers and firefighters with CNSLBP., Methods: This is a parallel, two-armed, blinded evaluator randomized clinical trial. Police officers and firefighters (from public safety institutions in the Rio Grande do Sul state, Brazil) will be randomly assigned to a m-health self-managed exercise program (twice a week) plus health education or health education alone. Self-management exercise program components are mobility and core resistance exercises, available on the app. Follow-ups will be conducted post-treatment (8 weeks) and 16 weeks after randomization. The co-primary outcomes will be pain intensity and disability post-treatment (8 weeks). Secondary outcomes will be biopsychosocial factors related to CNSLBP., Discussion: We hypothesize that the effects of a smartphone app-based self-managed exercise program on co-primary and secondary outcomes will be superior, compared to the health education only in public safety workers with CNSLBP., Trial Registration: The study was prospectively registered at ClinicalTrials.gov (NCT05481996. Registered on August 01, 2022)., (© 2023. The Author(s).)

Objectives: To examine the effect of high-velocity resistance training (HVRT) on the executive function of middle-aged and older adults with and without mobility limitations., Methods: Participants (n = 41, female: 48.9%) completed a supervised 12-week HVRT intervention (2 sessions/week; at 40-60% of one-repetition maximum). The sample included 17 middle-aged adults (40-55 years); 16 older adults (>60 years) and 8 mobility-limited older adults (LIM). Executive function was assessed before and after the intervention period and was reported as z-scores. Maximal dynamic strength, peak power, quadriceps muscle thickness, maximal isometric voluntary contraction (MVIC), and functional performance were also measured pre and post intervention. Training-related adaptations in cognitive measures were calculated using a Generalized Estimating Equation model., Results: HVRT improved executive function in LIM (adjusted marginal mean differences [AMMD]: 0.21; 95%CI: 0.04, 0.38; p = 0.040) although no effect on middle-aged (AMMD: 0.04; 95%CI: -0.09; 0.17; p = 0.533) and older (AMMD: -0.11; 95%CI: -0.25; 0.02; p = 0.107) participants was observed. Improvements in maximal dynamic strength, peak power, MVIC, quadriceps muscle thickness, and functional performance were all associated with changes in executive function, and changes in the first four also seem to mediate the association between changes in functional performance and executive function., Conclusions: HVRT-induced improvement in executive function of mobility-limited older adults were mediated by changes in lower-body muscle strength, power, and muscle thickness. Our findings reinforce the relevance of muscle-strengthening exercises to preserve cognition and mobility in older adults., Competing Interests: Declaration of Competing Interest The authors report no biomedical financial interests or potential conflicts of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Type 2 diabetes mellitus (T2D) is a serious global health problem, and exercise is considered an essential non-pharmacological tool in T2D prevention and treatment. During periods of social isolation experienced by the COVID-19 pandemic, home-based exercise programs were strongly recommended as a strategy to facilitate exercise practice and reduce the negative impacts of social isolation. Remotely supervised exercise stands out as an easily accessible strategy after the pandemic, as it is a tool that aims to facilitate access to exercise by this population. The purpose of the RED study is to verify the effects of a remotely supervised home-based exercise program compared to a control group on cardiometabolic, functional, and psychosocial outcomes in patients with T2D., Methods: Participants are randomized into the control group (CG) and the intervention group (IG). Participants allocated to the CG receive recommendations for the practice of physical activity based on information from chapters of the Physical Activity Guide for the Brazilian Population, while the IG will perform a 12-week home-based exercise program supervised remotely by video call. The intervention has a weekly frequency of two sessions per week on non-consecutive days during the first 6 weeks and three sessions per week on non-consecutive days for the remaining 6 weeks. The RED study has HbA1c as the primary outcome, and the participants' cardiometabolic, functional, and psychosocial parameters are assessed at baseline (week 0) and post-intervention (week 13)., Discussion: Expected results of the proposed study will provide the knowledge base of health professionals and deliver more evidence for a growing area, i.e., home-based exercise and T2D. Additionally, this protocol aims to verify and demonstrate whether this program can be accessible and effective for different health outcomes in patients with T2D., Trial Registration: The RED study protocol was prospectively registered at ClinicalTrials.gov (NCT05362071). Date registered April 6, 2022. https://clinicaltrials.gov/ct2/show/NCT05362071 ., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Despite the robust body of evidence for the benefits of home-based physical exercise, there is still a paucity of data on the benefits of home-based cognitive training for older adults, especially in those at increased risk of clinical-functional vulnerability. As such, the present study aims to compare the chronic effects of a telehealth-delivered physical training intervention alone or combined with a cognitive training program in older adults at increased clinical-functional vulnerability risk., Methods: A randomized clinical trial will be conducted including 62 sedentary older individuals classified as at increased risk of clinical-functional vulnerability based on their Clinical-Functional Vulnerability Index score. Participants will be randomly allocated in a 1:1 ratio to one of two groups, an intervention group including physical training combined with cognitive training, or an active control group including physical training alone. Both groups will receive home-based supervised training remotely for 12 weeks and will be assessed for the primary and secondary outcomes of the study before and after the training period. Primary outcomes include cognitive function and dynamic balance with a dual task. Secondary outcomes encompass physical, cognitive, and occupational performance, functional capacity, quality of life, and anxiety and depression symptoms, as well as hemodynamic measures. Data analysis will be performed by intention-to-treat and per protocol using mixed linear models and Bonferroni's post hoc (α = 0.05)., Discussion: Our conceptual hypothesis is that both groups will show improvements in the primary and secondary outcomes. Nevertheless, we expect physical combined with cognitive training to improve cognitive function, dual task, and occupational performance to a greater degree as compared to physical training alone., Trial Registration: NCT05309278. Registered on April 4, 2022., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Detecting the physiological and biomechanical alterations in shallow water walking (SWW) due to water depth and speed is important for health professionals to perform accurate exercise prescription. This systematic review with meta-analysis aimed to investigate the acute physiological and biomechanical responses of SWW at different immersion depths in comparison to dry land walking. The main result (initial search: 1960 studies; systematic review: 42 studies; meta-analysis: 22 studies) indicated that metabolic power was higher in the immersion depth levels of xiphoid process (standardized mean differences (SMD) = 0.90; 95% confidence intervals (CI): 0.26 to 1.54) and waist (SMD = 3.35; 95% CI: -0.18 to 6.87) in comparison to dry land. SWW at xiphoid and waist depths seems to be an adequate exercise if the objective is to increase the energy expenditure and cardiovascular demand while the lower limb impact forces are reduced in comparison to dry land walking. PROSPERO registration: CRD42018113040.

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.

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.

Aim: This study aimed to summarize the effects of aquatic training on the health outcomes of type 2 diabetes (T2D) patients., Methods: This is a systematic review with meta-analysis that followed the PRISMA recommendations. Searches were performed in four databases in April 2021. The following eligibility criteria were adopted: adults with T2D; aquatic training (AT) intervention in an upright position; pre- and post-intervention assessments of the following outcomes: HbA1c, SBP and DBP, functional capacity, VO 2peak . The random-effects meta-analysis results are presented as mean differences and 95% confidence intervals., Results: Of the 375 studies, 12 studies were eligible and included in the meta-analysis. Favorable effects of AT post-intervention were observed in HbA1c (-0.62 %), VO 2peak (2.16 mL.Kg -1 .min -1 ), SBP (-5.55 mmHg), DBP (-4.99 mmHg), and the 6-minute walk test (76.64 m). AT also revealed superior effects when compared to the control group (CG) and similar effects to land training (LT) in HbA1c (AT vs CG = -0.67 % and AT vs LT = -0.40 %), VO 2peak (AT vs CG = 3.78 mL.Kg -1 .min -1 ; AT vs LT = -0.12 mL/Kg-1.min -1 ), SBP (AT vs LT = -0.85 mmHg), and DBP (AT vs LT = 2.12 mmHg)., Conclusion: AT improves HbA1c, VO 2peak , SBP, DBP, and functional capacity in T2D patients. Beneficial effects favored AT over CG, while similar effects were verified between AT and LT on HbA1c, VO 2peak , and blood pressure., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: To determine the effect of resistance training volume on physical and perceptual outcomes of breast cancer survivors submitted to a combined training program., Design: Randomized single-blinded study., Methods: Nineteen breast cancer survivor women were randomized to a single-set (SS) or a multiple-set (MS) group. Both groups completed an 8-week combined training intervention in which the SS and MS groups performed 1 and 3 sets per resistance exercise, respectively. The following outcomes were assessed preintervention and postintervention: maximal knee extension dynamic strength (1-repetition maximum), quadriceps muscle thickness, peak oxygen uptake, time to exhaustion, cancer-related fatigue, and quality of life., Results: Both interventions increased knee extension 1-repetition maximum (SS: 29.8% [37.5%]; MS: 19.3% [11.8%]), quadriceps muscle thickness (9.4% [4.1%]; 8.9% [5.9%]), and quality of life (4.3% [6.3%]; 7.9% [9.0%]), with no difference between the groups. However, only MS improved cancer-related fatigue (-2.1% [1.7%]) and time to exhaustion (21.3% [14.9%]), whereas peak oxygen uptake remained unchanged in both groups., Conclusions: Cancer-related fatigue and time to exhaustion, improved only in the MS group after the intervention. On the other hand, similar knee extension 1-repetition maximum, quadriceps muscle thickness, and quality of life improvements were observed in breast cancer survivors irrespective of the resistance training volume performed.

Background: Police officers are exposed to specific occupational tasks, which require lifting, trunk flexion and rotation, carrying weight, and frequent standing periods, which may be associated with an increased risk of experiencing low back pain (LBP)., Objective: To describe the prevalence and intensity of chronic LBP (CLBP) in Brazilian Federal Highway Police officers (FHPO) from the Rio Grande do Sul state and evaluate its associated factors., Methods: A total of 208 FHPOs participated in this study. The participants answered an electronic questionnaire containing sociodemographic, behavioral, and occupational questions, and CLBP history. Data analysis comprises descriptive statistics and Poisson regression models., Results: Most of the FHPO were male, aged 41 or more, lived with a partner and were physically active. Sixty-seven percent of FHPO had CLBP, and the median pain intensity was 3.0 (IQR = 0- 5). Participants who lived with a partner were less likely to report CLBP (PR = 0.80; 95% CI = 0.64; 0.99). On the other hand, those who worked as FHPO for more than 11 years were more likely to report CLPB (PR = 1.32; 95% CI = 1.06; 1.63), and high pain intensity (β= 0.95; 95% CI = 0.19; 1.71)., Conclusions: The high CLBP prevalence among FHPO from Rio Grande do Sul state indicates a need to highlight the importance for police organizations to promote CLBP prevention and implement workplace management programs.

Considering that water immersion may acutely reduce blood pressure (BP) and that exercise may elicit positive post-exercise hypotension (PEH) responses, we aimed to analyze the presence of PEH in normotensive individuals and compare its magnitude between two resistance training sessions performed in aquatic or land environments. Ten physically active men (23.2 ± 3.1 years) performed the two training protocols in a randomized, counterbalanced fashion. BP measurements were performed for 30 min (at 5 min intervals) both prior to (resting) and after each of the protocols. No differences were observed between protocols at baseline (p > 0.05). Only the water-based resistance training protocol resulted in a systolic BP reduction from 10 to 20 min post-exercise (all p < 0.05) compared to baseline. Compared to the land-based session, systolic BP was lower in the water-based protocol from 10 to 25 min post-exercise (all p < 0.05). On the other hand, diastolic BP showed a similar PEH effect between water and land-based protocols for the entire 30 min post-session period (all p < 0.001). Our results suggest that water-based resistance training holds the potential as a nonpharmacological strategy to lower BP levels following exercise.

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 (VO 2 ), 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: VO 2 (maximal, VO 2max ; anaerobic threshold, VO 2AT ), HR (HR max ; HR AT ), and RPE (RPE max ; RPE AT ). The random-effects meta-analysis included mean difference and 95% confidence interval for VO 2 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 VO 2max (- 7.07 mL.kg -1 .min -1 ; - 8.43 to - 5.70; n = 502), VO 2AT (- 6.19 mL.kg -1 .min -1 ; - 7.66 to - 4.73; n = 145), HR max (- 11.71 bpm; - 13.84 to - 9.58; n = 503), and HR AT (- 15.29 bpm; - 19.05 to - 11.53; n = 145). RPE max (0.01; - 0.16 to 0.18; n = 299) and RPE AT (- 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 VO 2 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 VO 2max and HR max 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)., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

The time-efficient nature of HIIT using bodyweight exercises can facilitate the application of exercise programs at home by encouraging more people to perform regular physical exercise. However, there are no studies investigating the influence of the distribution/order of exercises during HIIT training sessions using this method. The aim of the present study was to evaluate the effects of different exercise orders on training load indicators during HIIT sessions using body weight. Twenty male participants performed three 20-min sessions of HIIT using whole body exercise, consisting of 20 sets with 30 s of activity performed at maximal intensity, followed by 30 s of passive recovery. Three designs of exercise protocols were randomly performed according to the following exercise distribution: A: jumping jack, burpee, mountain climb and squat jump); B: jumping jack, mountain climb, burpee, and squat jump) and C: burpee, squat jump, jumping jack and mountain climb. No differences were found between protocols for relative heart rate, perceived exertion, and lactate concentrations. Significant differences ( p < 0.001) were found for the number of movements (A:712 ± 59, B:524 ± 49, C:452 ± 65). No differences were observed for the area under curve when examining perceived exertion between protocols. However, the values for perceived recovery significantly differed ( p < 0.001) between protocols (A:64 ± 19; B:52 ± 11; C:17 ± 13). Interestingly, protocol B and C induced a displeasure perception compared to protocol A. Our findings suggest that exercise distribution/order using HIIT whole body exercise promotes alterations in psychophysiological responses in HIIT using whole body exercises., Competing Interests: The authors AM and AE declare conflict of interest for selling clinics and workshops associated with the topic of the manuscript. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Machado, Zovico, Evangelista, Rica, Miranda, Alberton, Bullo, Gobbo, Bergamin, Baker and Bocalini.)

Background: it is well known in literature that sedentary lifestyle contributes to worsening people's health. This issue highlights the need for effective interventions to promote an active lifestyle. Research suggested multilevel intervention strategies to promote adherence to recommended physical activity levels, including the use of social networks that may simplify access to health notions. Being Facebook ® the most extensive worldwide social network, this document aimed to analyze the current body of evidence on the role of Facebook ® in the promotion of physical activity., Methods: eighteen manuscripts were considered eligible for this systematic review, and it was performed a meta-analysis (PRISMA guidelines) for overall physical activity parameters in eleven out of eighteen studies., Results: significant improvements were detected in the total amount of physical activity. In parallel, an increase in other parameters, such as cardiovascular, body composition, and social support, were found. The aerobic training, with supervised and tailored modalities, showed more considerable improvements., Conclusions: this study showed that Facebook ® might be considered a feasible and accessible approach to promoting regular exercise practice and achieving health benefits indicators. Future research on the cross-link between physical activity and social network management could also focus on strength training to verify if a more structured intervention would show an effect.

The present study aimed to investigate whether training status would influence the capacity of a verification phase (VER) to confirm maximal oxygen uptake (VO 2 max) 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 VO 2 max, respiratory exchange ratio (RER), maximal heart rate (HR max ), and rating of perceived exertion (RPE) were measured during both GXT and VER tests. Absolute and relative VO 2 max values were higher in VER than in GXT at baseline, but only absolute VO 2 max differed between bouts post-intervention (all p < 0.05). Individual VO 2 max comparisons revealed that 75% of the participants (9/12) achieved a VO 2max 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 VO 2 max during a GXT, as assessed by VER.

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., (© 2022. The Author(s), under exclusive licence to American Aging Association.)

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., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

The aim of this study was to evaluate how accurate is a smartphone app to measure a physical activity parameter (steps). Physical Education undergraduate students (n = 46), both male and female, were recruited. A tally counter, a validated device (Xiaomi Mi Band 2®) and My Active Life app were used to perform the steps count. Each participant took three low-intensity treadmill walks (5 km h -1 ), with a number of target steps (500-, 1000- and 1500-steps walk). Visual agreement analyses was performed through Bland-Altman plots. There was no significant interaction between steps walks and device during treadmill walking test ( F (2,84)  = 3.854; p = 0.07). Differences in steps measured by Mi Band were not different from 0 in 500-steps walk ( p = 0.243) and 1000-steps walk ( p = 0.350), and in My Active Life in 500-steps walk ( p = 0.177) and 1500-steps walk ( p = 0.221). Bland-Altman analyses indicated an acceptable agreement between My active Life app and Mi Band devices for 1000-steps walk (-359.01; 310.43) and 1500-steps walk (-572.97; 377.11). In conclusion, My Active Life app showed accuracy in measuring total steps, in longer walking activities (e.g. higher than 1000 steps), and can be used on a daily basis and in research setting.

Purpose : Even though multiple training methods appear to be effective to improve cardiorespiratory fitness, they also need to be perceived as tolerable or enjoyable by exercisers to maximize long-term behavioral maintenance. Therefore, the purpose of the current study was to compare perceived enjoyment between whole-body interval training (SIT-WB), treadmill-based interval training (SIT-T) and moderate-intensity continuous training (MICT). Method : Forty-one healthy adult men (age: 23.7 ± 0.7 years, height: 1.79 ± 0.01 m, body mass: 78.5 ± 1.7 kg; VO 2max : 46.7 ± 7.3 ml.kg -1 .min -1 ) were randomly assigned to SIT-WB, SIT-T, or MICT and underwent 16 weeks of training (3x/w). SIT-WB and SIT-T completed eight 20 s bouts interspersed by 10 s passive recovery, differing as to the exercise mode performed (i.e., calisthenics exercises and treadmill running, respectively) whereas MICT participants ran for 30 min at an intensity below the second ventilatory threshold. Perceived enjoyment was assessed 10 min post-exercise at weeks 1, 5, 9, 13, and 16, using the Physical Activity Enjoyment Scale. Results : Compliance was high (~90%) across all three training groups ( p = .803). All training modes were rated as enjoyable and no significant within- (F (4, 152)  = 1.132, p = .344) or between-group (F (2, 38)  = 0.662, p = .521) differences were found during the intervention period. Conclusions : These results suggest that SIT-WB can be employed as an enjoyable low-cost alternative to traditional treadmill-based SIT and MICT for up to 16 weeks.

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.

Background: Dual task influences postural control. A cognitive task seems to reduce muscle excitation during a postural balance, especially in older adults (OA)., Aim: The aim of this study is to evaluate the effect of three cognitive tasks on muscle excitation and static postural control in OA and young adults (YA) in an upright posture maintenance task., Methods: 31 YA and 30 OA were evaluated while performing a modified Romberg Test in five different conditions over a force plate: open eyes, closed eyes, spatial-memory brooks' test, counting backwards aloud test and mental arithmetic task. The surface electromyographic signals of Tibialis anterior (TA), Lateral Gastrocnemius (GL), Peroneus Longus (PL), and Erector Spinae (ES) was acquired with an 8-channel surface electromyographic system. The following variables were computed for both the electromyographic analysis and the posturographic assessment: Root mean square (RMS), centre of pressure (CoP) excursion (Path) and velocity, sway area, RMS of the CoP Path and 50%, 95% of the power frequency. Mixed ANOVA was used to detect differences with group membership as factor between and type of task as within. The analysis was performed on the differences between each condition from OE., Results: An interaction effect was found for Log (logarithmic) Sway Area. A main effect for task emerged on all posturographic variables except Log 95% frequencies and for Log PL and ES RMS. A main effect for group was never detected., Discussion and Conclusion: This study indicates a facilitating effect of mental secondary task on posturographic variables. Non-silent secondary task causes increase in ES and TA muscle activation and a worsening in static postural control performance., (© 2021. The Author(s).)

The aging process results in several physiological impairments that, in turn, may predispose older individuals to a series of restrictions on their functional capacity. These impairments are important to understand so that suitable conditions for healthier aging can be pursued. In this review, we first summarize the effects of aging on the neuromuscular system, as well as on the relation between the main age-associated physiological impairments and functional performance with an emphasis on muscle power output. We then proceed to discuss the effects of resistance training, specifically high-velocity resistance training (HVRT), on the aforementioned neuromuscular impairments, and on functional performance in healthy and mobility-limited older adults. Collectively, available evidence suggests that HVRT seems to be a safe and effective intervention for improving muscle power, functional performance, and mobility of older individuals. It also seems that mobility-limited older adults may improve power and functional performance to a greater extent than their healthy counterparts after HVRT, which is in line with the principle of diminishing returns. Considering that only a very limited number of investigations directly compared the effects of HVRT in more than one of the aforementioned groups, studies comparing the adaptations to HVRT of middle-aged adults and older adults with distinct functional capacities would be valuable to determine whether there are differences in neuromuscular adaptations, functional performance, and functional reserve among these groups., (Copyright © 2021. Published by Elsevier Inc.)

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., (Copyright © 2019 National Strength and Conditioning Association.)

Objective : The aim of this study was to compare the effects of training using loads from a repetition maximum value (%1RM) and rating of perceived exertion (RPE) in elderly women. Methods : Twenty-five elderly women (60-75 years old) were randomly assigned to a group that trained using loads determined by 1RM test (G%; n = 12) or to a group that trained using loads determined by RPE (GPE; n = 13). Elderly women trained for 12 weeks using five exercises performed with 2-3 sets of 8-15 repetitions. Loads progressed from 45% to 75% of 1RM (G%) and from 13 to 18 from Rating Perceived Exertion of Borg Scale (GPE). The outcome measures, 1RM and maximum repetitions (RMs with 70% 1RM), were assessed before, between and after training programs. Results : Increased 1RM value and RMs were observed in both groups (20-42%, p < 0.001 and 56-76%, p < 0.001, respectively, for %G; and 17-56%, p < 0.001 and 47-106%, p < 0.001, respectively, for GPE), without differences between them. Conclusions : Prescribing loads using the RPE and 1RM might be similarly effective for training elderly women in order to promote strength gains. As a practical application, RPE could be an additional method to determine training loads. In spite of the promising results of the present study, it is not possible to state that the use of RPE is effective in monitoring loads during sub maximal strength training in elderly and more research must be carried out to confirm it.

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., (Copyright © 2021 by the American College of Sports Medicine.)

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.

The aim of this study was to compare the acute responses to three time-matched exercise regimens. Ten trained adults (age, maximum oxygen consumption (VO 2max ), and body mass index (BMI) = 25.9 ± 5.6 yr, 50.9 ± 5.4 mL·kg -1 ·min -1 , and 22.1 ± 1.8 kg·m -2 ) completed sprint interval training (SIT) requiring 14 × 5 s efforts with 35 s of recovery, high-intensity interval training (HIIT) consisting of 18 × 15 s efforts at ~90% of peak heart rate (HR peak ) with 15 s of recovery, and vigorous continuous training (CT) consisting of 8.75 min at ~85 %HR peak , in randomized order. Heart rate, blood lactate concentration, rating of perceived exertion, affective valence, and enjoyment were monitored. Moreover, indices of neuromuscular function, autonomic balance, diet, mental stress, incidental physical activity (PA), and sleep were measured 24 h after each session to analyze the magnitude of recovery. Both HIIT and CT exhibited a greater %HR peak and time ≥ 90 %HR peak than SIT ( p < 0.05). Blood lactate and rating of perceived exertion were higher in response to SIT and HIIT vs. CT ( p < 0.05); however, there were no differences in enjoyment ( p > 0.05). No differences were exhibited in any variable assessed along 24 h post-exercise between conditions ( p > 0.05). These data suggest that HIIT and CT accumulate the longest duration at near maximal intensities, which is considered a key factor to enhance VO 2max .

The purpose of the present study was to analyse vertical ground reaction force (Fz) and oxygen uptake (VO 2 ) responses in six different water-based exercises performed at different cadences by postmenopausal women. Twelve postmenopausal women (57.3 ± 2.6 years, 158.1 ± 6.9 cm, 69.1 ± 10.9 kg) voluntarily took part in the study. Participants completed six sessions corresponding to maximal tests for each water-based exercise. Then, two sessions were performed for the experimental protocols, which comprised the performance of three exercises at three cadences (80, 100 and 120 b min -1 ), with Fz and VO 2 measurements. Peak (Fz peak ) and impulse of Fz were determined. In addition, VO 2 percentages relative to maximal VO 2 (VO 2max ) values obtained in each maximal test were expressed as %VO 2max . Data were analysed using two-way ANOVA with repeated measures ( α  = 0.05). As results, significant differences were found in Fz peak and impulse between the water-based exercises, with similar VO 2 and %VO 2max values between them for each cadence. In addition, with the increasing cadence, Fz peak (0.20-0.80 BW), VO 2 (5.3-9.4 ml kg - 1  min - 1 ) and %VO 2max (32.1-57.6%) values increased, while impulse (0.20-0.07 N.s/BW) values were reduced. Therefore, for a same physiological intensity, postmenopausal women experience different Fz loads during different water-based exercises.

Different parameters can be used to control the intensity of aerobic exercises, a choice that should consider the population and exercise environment targeted. Therefore, our study aimed to verify the relationship between oxygen uptake (VO 2 ), heart rate (HR), rating of perceived exertion (RPE), and cadence during an aquatic incremental test in older women. Nine older women (64.3 ± 4.4 years) engaged in a water-based aerobic training performed an aquatic incremental test using the stationary running exercise (cadence increases of 15 b·min -1 every 2 min) until participants' volitional exhaustion. VO 2 , HR, and RPE data were measured, and the percentage of peak VO 2 (%VO 2peak ) and percentage of maximal HR (%HR max ) were calculated. Linear and polynomial regression analyses were performed (α = 0.05). Polynomial regressions revealed the best adjustments for all analyses. Data showed a significant relationship ( p < 0.001) between %VO 2peak and %HR max ( r = 0.921), %VO 2peak and RPE ( r = 0.870), and %HR max and RPE ( r = 0.878). Likewise, significant relationships between cadence ( p < 0.001) and %VO 2peak ( r = 0.873), %HR max ( r = 0.874), and RPE ( r = 0.910) were also observed. In summary, the physiological, subjective, and mechanical variables investigated were highly associated during an aquatic incremental test to exhaustion in older women. Therefore, these different parameters can be employed to adequately prescribe water-based programs according to preference and availability.

The aim of this study was to investigate the mechanical and metabolic reasons for the spontaneous gait/speed choice when ascending a short flight of stairs, where walking on every step or running on every other step are frequently interchangeable options. The kinematics, oxygen uptake ( V̇ O 2 ), ventilation and heart rate of 24 subjects were sampled during climbing one and two flights of stairs while using the two gaits. Although motor acts were very short in time (5-22 s), metabolic kinetics, extending into the 250 s after the end of climbing, consistently reflected the (metabolic equivalent of the) required mechanical energy and allowed comparison of the two ascent choices: despite a 250% higher mechanical power associated with running, measured [Formula: see text], ventilation and heart rate peaked at only +25% with respect to walking, and in both gaits at much lower values than [Formula: see text] despite predictions based on previous gradient locomotion studies. Mechanical work and metabolic cost of transport, as expected, showed a similar increase (+25%) in running. For stairs up to a height of 4.8 m (30 steps at 53% gradient), running makes us consume slightly more calories than walking, and in both gaits with no discomfort at all. The cardio-respiratory-metabolic responses similarly delay and dampen the replenishment of phosphocreatine stores, which were depleted much faster during the impulsive, highly powered mechanical event, with almost overlapping time courses. This discrepancy between mechanical and metabolic dynamics allows us to afford climbs ranging from almost to very anaerobic, and to interchangeably decide whether to walk or run up a short flight of stairs., Competing Interests: Competing interestsThe authors declare no competing or financial interests., (© 2020. Published by The Company of Biologists Ltd.)

Background: The purpose of this study was to investigate the effects of 2 water-based aerobic training programs on functional capacity and quality of life (QoL) of older women., Design: Randomized clinical trial., Methods: A total of 41 women (64.3 [3.1] y) were randomized into a continuous (CTG) and an interval (ITG) water-based aerobic training group. Training programs were performed with exercise intensity based on rating of perceived exertion throughout 12 weeks (twice a week). Functional tests with and without dual-task and QoL questionnaire were applied pretraining and posttraining. Per protocol and intention to treat analysis were conducted using generalized estimating equations, with Bonferroni post hoc test (α = .05)., Results: The per protocol analysis showed an increase in the 30-second chair stand (6% [12%] vs 18% [13%]), 6-minute walk (4% [7%] vs 2% [8%]), and 5-m habitual gait velocity (6% [11%] vs 4% [7%]) tests after CTG and ITG training groups. In addition, the intention to treat analysis revealed an increase in the 30-second chair stand test (7% [13%] vs 12% [13%]) and physical domain of QoL (8% [26%] vs 14% [22%]) after CTG and ITG training groups, as well as an increase in the gait velocity with verbal task after CTG (6% [11%])., Conclusions: Both water-based aerobic training programs induced similar improvements in the functional capacity and maintained the QoL perception in older women.

Background: Down Syndrome (DS) is a genetic condition presenting delay in acquisition of main motor milestones, such as walking. Although studies have been investigating the biomechanical parameters during land walking performed by individual with DS, the literature is scarce regarding kinetic parameters analysis in this population, specially during water walking., Research Question: This study sought to assess the vertical ground reaction force (Fz) of walking performed in water and on land at different speeds by individuals with DS., Methods: Fourteen adults with DS (age: 27.9 ± 7.9 years; body mass: 58.4 ± 12.9 kg; height: 1.4 ± 0.1 m, body mass index: 29.2 ± 5.4 kg.m -2 ) completed two sessions of data collection, one on land and another in aquatic environment. The protocol consisted of walking performed at three self-selected speeds (slow, comfortable and fast) in randomized order. The Fz was assessed with a waterproof force plate in each condition. Two-way repeated-measures ANOVA (environment and speed), with Bonferroni's post hoc tests, were used for analysis. A significance level was set as α = 0.05., Results: Significant differences were observed between environments (p < 0.001), with reduced first peak of Fz (68-73%), second peak of Fz (66-70%), loading rate (75-78%) and impulse (40-41%) in the water walking for all speeds analyzed. In the aquatic environment, no significant difference was observed for the first and second Fz peaks with the increasing speed of walking. Moreover, the loading rate significantly increased (p = 0.019) as the impulse significantly reduced (p < 0.001) in the higher speeds., Significance: Individuals with DS present reduced Fz outcomes during water walking in comparison to land. Therefore, water walking may be performed by individuals with DS with safe vertical loads on lower limbs regardless the self-selected speed for rehabilitation, correction of gait and training purposes., (Copyright © 2020 Elsevier B.V. All rights reserved.)

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 75 years old) volunteered to participate in the study. Participants were randomized into a water-based continuous (CTG; n = 21; 63.9 ± 2.5 years) or an interval (ITG; n = 20; 64.8 ± 3.6 years) aerobic training group. Both training programs were performed for 12 weeks (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., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objectives: To evaluate the acute effects of a session of water-based aerobic exercise on the blood lipid levels of women with dyslipidemia and to compare these results according to their training status., Method: Fourteen premenopausal women with dyslipidemia, aged 40-50 years, participated in two water-based aerobic exercise sessions, the first when they were generally sedentary and the second after they were trained with a water-based aerobic training program for 12 weeks. Both experimental sessions were performed using the same protocol, lasted 45 min, and incorporated an interval method, alternating 3 min at a rating of perceived exertion (RPE) of 13 and 2 min at an RPE of 9. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and lipoprotein lipase enzyme (LPL) were obtained through venous blood collection before and immediately after each session. A generalized estimating equation method and Bonferroni tests were conducted (with time and training status as factors) for statistical analyses., Results: At enrollment, the mean age of the participants was 46.57 years (95% confidence interval [CI] 44.81-48.34). The statistical analyses showed a significant time effect for all variables (TC: p=0.008; TG: p=0.012; HDL: p<0.001; LPL: p<0.001) except for LDL (p=0.307). However, the training status effect was not significant for any variable (TC: p=0.527; TG: p=0.899; HDL: p=0.938; LDL: p=0.522; LPL: p=0.737). These results indicate that the TC and TG levels reduced and the HDL and LPL concentrations increased from pre- to post-session in similar magnitudes in both sedentary and trained women., Conclusions: A single water-based aerobic exercise session is sufficient and effective to beneficially modify the lipid profile of women with dyslipidemia, regardless of their training status.

Background: To compare the acute effects of water-based aerobic-resistance and resistance-aerobic concurrent training (CT) sessions on energy expenditure (EE) during and postexercise in young women., Methods: Nine active women (24 [3] y; 60 [5] kg) completed 4 sessions: (1) familiarization, (2) aquatic maximal test to determine the heart rate corresponding to the anaerobic threshold, (3) CT protocol with aerobic-resistance sequence, and (4) CT protocol with resistance-aerobic sequence. Both protocols started and ended with the participants in the supine position for 30 minutes to perform resting and postexercise oxygen consumption measurements. The water-based resistance protocol comprised 4 sets of 15 seconds at maximal velocity, and the water-based aerobic protocol was performed at a continuous intensity (heart rate corresponding to the anaerobic threshold). EE measurements were calculated based on oxygen consumption and the corresponding caloric equivalent. Paired t test was used to compare the EE values between the water-based CT intrasession exercise sequences (α = .05)., Results: There was no difference between the water-based aerobic-resistance and resistance-aerobic in total EE (330.78 vs 329.56 kcal; P = .96), EE per minute (7.35 vs 7.32 kcal·min-1; P = .96), and postexercise EE (63.65 vs 59.92 kcal; P = .50)., Conclusions: The intrasession exercise sequence during water-based CT had no influence on the EE in young women.

Purpose : The present study aimed to compare the vertical ground reaction force responses during the performance of the stationary running water-based exercise with and without equipment at different cadences by elderly women. Method : Nineteen elderly women (age: 68.6 ± 5.0 years; body mass: 69.0 ± 9.5 kg; height: 154.9 ± 5.6 cm) completed one session consisting of the performance of the water-based stationary running with elbow flexion and extension immersed to the xiphoid process depth. The exercise was performed in three conditions, without equipment, with water-floating and with water-resistance equipment, at three cadences (80 b·min -1 , 100 b·min -1 and maximal) in a randomized order. Peak and impulse of vertical ground reaction force were collected during the exercise using an underwater force plate. Repeated measures two-way ANOVA was used (α = 0.05). Results : Peak vertical ground reaction force ( p  < .001) and impulse ( p  ≤ 0.002) resulted in lower values for the water-floating use (0.42-0.48 BW and 0.07-0.13 N.s/BW) in comparison to the water-resistance equipment use (0.46-0.60 BW and 0.09-0.16 N.s/BW) and to the non-use of equipment (0.45-0.60 BW and 0.07-0.17 N.s/BW), except for the impulse at the maximal cadence. In addition, peak vertical ground reaction force at 80 b·min -1 ( p  = .002) and impulse at the maximal cadence ( p  < .001) showed lower values compared to the other cadences. Conclusion : The use of water-floating equipment minimizes the vertical ground reaction force during the stationary running water-based exercise performed by elderly women regardless of the cadence.

This systematic review aimed to analyze the effects of a physical exercise (PE) program on low back pain (LBP) symptoms of office workers and the modification of flexibility and range of motion (ROM), muscular strength, and quality of life (QoL). A literature research was performed on PubMed, Scopus, MEDLINE, and SPORTDiscus from April to May 2018. The keyword "low back pain" was associated with "office worker" OR "VDT operators" OR "office employees" OR "workplace" AND "exercise", OR "exercise therapy" OR "physical activity". Inclusion criteria were a home- or work-based exercise protocol for office workers with LBP symptoms and pre- to post-intervention evaluation of LBP symptoms. Three researchers independently examined all abstracts. The modified Cochrane methodological quality criteria were used for quality assessment and 11 articles were included. Exercise protocols were performed from 6 weeks to 12 months, 1-5 day per week, lasting 10-60 min for each session. Physical Exercise in the workplace improved all the considered outcomes. The best improvement was recorded in supervised protocols and in video-supported protocols performed in the workplace. The effect may be generated with small duration sessions during the working day, with only 10-15 min of adapted exercise to be performed 3-5 days per week.

Background: The morphological alterations during pregnancy may affect the biomechanical loads during exercise practice. Aquatic exercises may suit pregnant women, who are recommended to exercise with low vertical ground reaction force loads. Therefore, the study aimed to determine the apparent weight reduction during immersion and the vertical ground reaction force of three specific water-based exercises in pregnant women at the third trimester., Methods: Eleven pregnant women volunteered to take part in the study [32.0 (SD 1.3) weeks, 28.1 (SD 5.7) years, 72.5 (SD 10.1) kg]. The protocol started with the participants immersed to the xiphoid process depth for the apparent weight assessment. Then, three water-based exercises (stationary running, frontal kick and butt kick) were randomly performed at a pre-selected cadence, with 5-min interval. The vertical ground reaction force was measured in each exercise and peak, impulse, contact time and swing time were determined. Repeated measures ANOVA was used (α = 0.05)., Findings: The apparent weight reduction resulted a mean of 82.9 (SD 6.5)% of body weight. Peak, impulse, contact time and swing time revealed no significant difference between exercises (P > 0.05). Values of peak of vertical ground reaction force ranged from 0.67 to 0.72 units of body weight., Interpretation: Pregnant women at the third trimester can benefit from the apparent weight reduction during immersion for exercising. The three water-based exercises presented similar vertical ground reaction force values, which are considered as low odds for musculoskeletal injuries. Therefore, these findings highlight the safety of the water-based exercise program during pregnancy., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The neuromuscular adaptations between ergometer-based high-intensity interval training (HIIT-T; n = 15), whole-body high-intensity interval training (HIIT-WB; n = 12) and moderate-intensity continuous training (MICT; n = 14) were compared in forty-one healthy men randomized to 16 weeks of training (3x per week). Two-way repeated measures analysis of variance (ANOVA) showed countermovement (CMJ) and squat (SJ) jump height (HIIT-T: 8.5 ± 13.3%; 3.1 ± 9.7%, HIIT-WB: 6.4 ± 9.8%, 10.4 ± 16.1% and MICT: 2.2 ± 9.5%; 4.4 ± 12.1%, respectively), SJ peak power (HIIT-T: 1.7 ± 3.9%; HIIT-WB : 6.4 ± 7.9%; MICT: 0.5 ± 6.5%) and CMJ rate of force development (HIIT-T: 58.1 ± 50.5%; HIIT-WB: 36.9 ± 54.2%; MICT: 38.4 ± 64.3%) improved similarly in all training groups (all p < 0.05). CMJ peak power increased only after HIIT-T (4.3 ± 5.5%) and HIIT-WB (4.5 ± 5.2%), while no differences were observed in both the rectus femoris and vastus lateralis maximal electromyographic amplitude. Finally, marked improvements were also observed in the number of repetitions in the HIIT-WB protocol at the eighth week, with no further improvement at the sixteenth week. These data suggest that 16 weeks of HIIT-WB is capable to improve neuromuscular function to a similar extent as HIIT-T and MICT.

The aim of this systematic review was to analyze the effect of Nordic Walking (NW) on anthropometric parameters, body composition, cardiovascular parameters, aerobic capacity, blood sample, and glucose tolerance in overweight and obese subjects. The main keywords "Nordic Walking" or "Pole Walking", associated with either "obese", "obesity", "overweight", or "weight loss" were used on the online database MEDLINE, PubMed, SPORTDiscus and Scopus. Additionally, references of the studies included were screened to identify eligible articles. Applying the inclusion and exclusion criteria, ten manuscripts were considered as eligible for this review. The results of the studies were categorized in several domains with regard to "anthropometric parameters and body composition", "cardiovascular parameters and aerobic capacity", and "blood sample and glucose tolerance". The results showed positive effects on the anthropometric parameters, body composition, cardiovascular parameters, blood sample, and glucose tolerance. The greatest improvements were observed in supervised and high weekly frequency of NW interventions. NW could be considered as an effective modality through which to involve the obese in physical activity. For weight loss, NW should be prescribed 4-5 times per week, at least 60 min per session, preferably combined with diet control.

Background: Hypertension is a clinical condition highly prevalent in the elderly, imposing great risks to cardiovascular diseases and loss of quality of life. Current guidelines emphasize the importance of nonpharmacological strategies as a first-line approach to lower blood pressure. Exercise is an efficient lifestyle tool that can benefit a myriad of health-related outcomes, including blood pressure control, in older adults. We herein report the protocol of the HAEL Study, which aims to evaluate the efficacy of a pragmatic combined exercise training compared with a health education program on ambulatory blood pressure and other health-related outcomes in older individuals., Methods: Randomized, single-blinded, multicenter, two-arm, parallel, superiority trial. A total of 184 subjects (92/center), ≥60 years of age, with no recent history of cardiovascular events, will be randomized on a 1:1 ratio to 12-week interventions consisting either of a combined exercise (aerobic and strength) training, three times per week, or an active-control group receiving health education intervention, once a week. Ambulatory (primary outcome) and office blood pressures, cardiorespiratory fitness and endothelial function, together with quality of life, functional fitness and autonomic control will be measured in before and after intervention., Discussion: Our conceptual hypothesis is that combined training intervention will reduce ambulatory blood pressure in comparison with health education group. Using a superiority framework, analysis plan prespecifies an intention-to-treat approach, per protocol criteria, subgroups analysis, and handling of missing data. The trial is recruiting since September 2017. Finally, this study was designed to adhere to data sharing practices., Trial Registration: NCT03264443 . Registered on 29 August, 2017.

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