Effect of the execution order from concurrent exercise session on blood pressure responses in hypertensive older men

Abstract Aim: To compare blood pressure (BP) responses among the different orders of execution of concurrent exercise (CE) sessions in controlled hypertensive older men. Methods: Fifteen older men (64 ± 5 years) participated in three randomized crossover sessions: control session (C), CE in aerobic-resistance order (AR), and resistance-aerobic order (RA). The CE was performed for 1 h, in which 30 min were for the resistance exercise with 5 exercises at 70% of 1RM and 30 min for the aerobic exercise on a treadmill with intensity corresponding to the first ventilatory threshold. Clinical systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) were measured at rest and over 2 h and 24 h after the session. For analysis, the Generalized Estimating Equations (GEE) test was used with Bonferroni's complimentary test (α = 0.05). Results: The SBP decreased by 30 min after AR, while after RA we obtained reductions during 1 h after a session concerning rest. Between sessions, we found lower values in both CE compared to the C at 30 min, 45 min, and 90 min. In the RA there was a lower pressure in relation to the C at minute 60. The DBP reduced 30 min after the AR regarding the pre-session, however with no difference between sessions. The MBP was lower in relation to 30 min rest after AR. Among sessions, a pressure drop was observed in the AR compared to the C at 30 min and 45 min. Conclusion: We can conclude that the CE was effective in generating post-exercise hypotension regardless of the order in controlled hypertensive older men.

The execution order of the concurrent training and its effects on static and dynamic balance, and muscle strength of elderly people

Abstract Aim: Assess the effect of the performance order in the Concurrent Training (CT), Aerobic-Strength (AS), and Strength-Aerobic (SA), in the static balance, dynamic balance, and muscle strength in elderly people. Methods: The study involved 38 elderly people (men and women) aged 60 to 75 years old, divided into SA (n = 19) and AS (n = 19). Within 12 weeks, the aerobic training consisted of walking with intensity prescribed by the Borg's Rating of Perceived Exertion (6-20) and the strength training consisted of six exercises, with intensity controlled by Repetition Maximum training zones. Static balance (plantar pressure center area and displacement in bipedal support with eyes closed and open), dynamic balance (Timed Up and Go and Tandem Gait), and maximum dynamic strength of knee extension and bench press have been evaluated. For data analysis, Generalized Estimating Equations with Bonferroni's complimentary test have been used (α = 0.05). Results: For static and dynamic balance there hasn't been an effect on the 12 weeks of combined training, regardless of the performance order. Both groups maintained the balance variables within the intervention period. When it comes to strength, there has been a noticeable improvement in lower limbs (SA: 16%; AS: 11%; p < 0,001) and upper (SA: 22.0%; AS: 8.7%; p < 0.001), without any differences between the groups. Conclusion: So there is no difference between the order of performance of the CT in the variables of static and dynamic balance and strength of upper and lower limbs. Furthermore, after training, there have been significant improvements in the variables of strength and maintenance of static and dynamic balance.

Effectiveness of exercise and health education interventions in Brazilian primary health care

Abstract AIM This study examined the effectiveness of two different behavioral change interventions to improve Physical Activity (PA) and to reduce Sedentary Behavior (SB) in a primary health care setting. METHODS This quasi-experimental study recruited and enrolled 31 users of a primary health care unit of the Brazilian Unified Health System aged 18 or more. Participants were allocated into two groups: Physical Exercise Group combined with Health Education (EHE) and Health Education Group (HE). The EHE group participated in 60 minutes of exercise, twice a week, and 20 minutes of counseling. The HE group participated in 40 minutes of counseling, once a week. Both programs were conducted for over 18 weeks. PA levels were self-reported (IPAQ) and PA and SB were objectively (accelerometer) assessed before and after the intervention period. Data were analyzed using intention-to-treat analysis with generalized estimating equations adopting p<0.05 for significance. Also, the individual PA and SB deltas were computed. Improvements in PA and SB were observed for both interventions (p<0.05). RESULTS Both groups increased the minutes of weekly leisure PA (p=0.006), time spent in light (p=0.003), and moderated-to-vigorous (p=0.042) PA and decreased the amount of SB, with a significant decrease in the HE group (p=0.010). Delta analyses further demonstrated the effectiveness of the interventions to increase PA in other domains (i.e., transportation, household) and maintenance of occupational PA. CONCLUSION Behavioral change interventions in the primary health care context involving exercise and counseling seem to be effective in improving PA and SB in adults.

Lazer, atividade física e comportamento sedentário de idosos participantes de um grupo de aconselhamento / Leisure Time, Physical Activity and Sedentary Behavior of participants in a counseling group

O processo de envelhecimento no mundo torna-se cada vez maior. Na tentativa de se conseguir estimular o idoso a ter um estilo de vida mais saudável, algumas iniciativas em relação à educação para a saúde, lazer e motivação para a prática regular de atividade física já estão em curso, como intervenções físicas em conjunto a intervenções informativas. O objetivo do presente estudo é analisar a efetividade de intervenções informativas, por meio de grupos de aconselhamento, nos aspectos comportamentais relacionados à atividade física, comportamento sedentário e lazer em idosos. A população estudada nesta pesquisa foi de idosos participantes do Programa AFRID (Atividades Físicas e Recreativas para Terceira Idade), sendo a amostra composta por 14 idosos. O projeto foi desenvolvido em um período de 8 semanas, no qual os idosos foram avaliados pré e pós intervenção informativa. Os instrumentos utilizados no presente estudo foram Anamnese, Questionário Internacional de Atividade Física (IPAQ) versão longa, Questionário LASA-SBQ para medida do comportamento sedentário em idosos, EPL ­ Escala de Práticas no Lazer adaptada e grupo focal. Os resultados encontrados destacam que as intervenções realizadas melhoraram significativamente os dados do comportamento sedentário e mostraram uma tendência de melhora para os níveis de atividade física e envolvimento em atividades de lazer Físico/Esportivas e Intelectuais. A análise qualitativa apresentou que as intervenções informativas foram relevantes para a percepção da melhora dos aspectos comportamentais, como um significativo meio para a mudança de hábitos de vida, no qual os idosos puderam apresentar suas reflexões, anseios e sugestões sobre a importância do grupo de aconselhamento em sua saúde e qualidade de vida....(AU)

In an attempt to stimulate the elderly to have a healthier lifestyle, some initiatives in Public Policies are already in progress, such as physical activities interventions with informative interventions. The aim of this study was to analyse the effectiveness of a counseling interventions in the behavioral aspects related to physical activity, sedentary behavior and leisure time in the elderly. The population in this study was the elderly participants in the AFRID Program (Atividades Físicas e Recreativas para Terceira Idade), and the sample was composed of 14 elderly people. This project was developed in 16 weeks, and the subjects were assessed pre and post counseling intervention. The instruments used in the present study were: Anamnesis, International Physical Activity Questionnaire (IPAQ) long version, LASA-SBQ Questionnaire to measure sedentary behavior in older adults, EPL - Adapted Leisure Practice Scale and focal group. The results show that the interventions improved sedentary behavior data and indicated a tendency to improve physical activity levels and involvement in leisure activities, especially in Physical/Sport and Intellectuals.The qualitative analysis revealed that the informative interventions were relevant for the perception of the improvement of the behavioral aspects as a significative device for change of habits and lifestyle. In counseling, this population was able to present their reflections, wishesand suggestions on the importance of the group of counseling and continuity of this....(AU)

Treinamento de força no meio aquático: uma revisão sobre os aspectos históricos, fi siológicos e metodológicos / Aquatic resistance training: a review about historical, physiological and metodological aspects

Exercitar-se na água é uma prática constatada há vários séculos, embora seja recente sua realização de forma sistemática e planejada. A literatura científi ca é ampla no estudo dos efeitos do treinamento aeróbico aquático, tendo investigado diferentes modalidades. Nas últimas décadas têm ganhado elevância os estudos que avaliam treinamentos aquáticos de caráter de força e sua melhora no sistema neuromuscular. Contudo estes trabalhos apresentam métodos de prescrição muito diferentes,dificultando sua comparação. Assim, o objetivo desta revisão é elucidar aspectos metodológicos para prescrição de exercícios de força no meio aquático. Este artigo tem caráter narrativo e para a localização e aquisição dos estudos foram consultadas as bases de dados eletrônicas SCOPUS, SCIELO e MEDLINE, realizando-se buscas de artigos publicados entre os anos 1980 e 2016, com os seguintes descritores: hidroginástica, treinamento de força aquático e corrida em piscina funda. Os resultados demonstraram que os primeiros estudos publicados mundialmente relacionados a este tema datam do início dos anos 2000. Estes seguiam métodos de treinamento que buscavam reproduzir o modelo aplicado no meio terrestre, ou seja, utilizando número de repetições e número de séries. Por outro lado, os estudos mais recentes têm proposto a utilização da velocidade máxima e o tempo de execução para enfatizar vias metabólicas específi cas (anaeróbica alática e anaeróbica lática) e promover níveis adequados de tensão mecânica (velocidade máxima) e estresse metabólico (tempo de execução). Assim, os trabalhos demonstram que o treinamento de força no meio aquático têm proporcionado resultados satisfatórios em variáveis neuromusculares e morfológicas. Ainda, a prescrição de um treinamento de força neste meio, visando a ênfase sobre vias metabólicas específi cas, utilizando o tempo de execução e a máxima velocidade, parece ser uma forma adequada de se alcançar objetivos relacionados ao treinamento de força....(AU)

Exercising in the water environment is a practice that has been observed for several centuries, although its realization in a systematic and planned manner is recent. The scientifi c literature is broad in the study of the eff ects of water-based aerobic training, having investigated diff erent modalities. In the last decades, studies that evaluate water-based resistance training and its improvement in the neuromuscular system have gained relevance. However, these studies present very diff erent prescription methods, making diffi cult to compare them. Thus, the purpose of this review is to elucidate methodological aspects for prescription of water-based resistance exercises. This manuscript is a narrative review and for location and acquisition of the studies the electronic databases SCOPUS, SCIELO and MEDLINE were searched, searching articles published between 1980 and 2016, with the following descriptors: water gymnastics, water--based resistance training and deep water running. The results showed that the fi rst published studies related to this topic date back to the early 2000s. These studies followed training methods that sought to reproduce the model applied in the land environment, that is, using number of repetitions and number of series. On the other hand, more recent studies have proposed the use of maximum velocity and time to execution to emphasize specifi c metabolic pathways (lactic and alactic anaerobic) and to promote adequate levels of mechanical stress (maximal velocity) and metabolic stress (time to execution). Thus, the studies demonstrate that water-based resistance training has provided satisfactory results in neuromuscular and morphological variables. Furthermore, prescribing strength training in this environment, aiming at emphasizing specificmetabolic pathways, using time to execution and maximum velocity, seems to be an appropriate way of achieving goals related to strength training....(AU)

Non-invasive interventions in idiopathic scoliosis: a systematic review / Intervenções não invasivas na escoliose idiopática: revisão sistemática

Abstract Introduction: Idiopathic Scoliosis (IS) is an idiopathic curvature of the spine in all three plans, been treated conservatively (non-invasive) or surgicaly (invasive). The effectiveness of noninvasive therapy still remains lacking in a scientific basis to support their evidence-based applicability. Objective: Evaluate the effects of non-invasive interventions in spine lateral inclination in IS through a systematic literature review. Methods: The search of studies in MEDLINE, SCOPUS and COCHRANE databases was performed on 24th March, 2014. The terms used were: Scoliosis, therapeutic exercise, physical therapy. Clinical trials with scoliotic patients undergoing some type of non-invasive intervention were included. The outcome was spine lateral inclination. Results: The research found 941 studies, seven of these were included after a screening performed by two independent reviewers. Six studies (85.7%) have adopted some sort of kinesiotherapeutic technic, and three studies (42.8%) used corrective orthosis. The average intervention time in kinesiotherapeutic technique studies was of 37.6 weeks and 91.6 weeks in the studies of corrective brace. The progression improvement of the spine lateral inclination was reported by 83.3% (5 of 6) of the kinesiotherapeutic technique studies and in 66.6% (2 of 3) of studies with corrective brace. Conclusion: An improvement was found, in general, in the progression of spine lateral inclination in IS subjects of both sexes from 11 to 25 years of age undergoing non-invasive interventions.

Resumo Introdução: A Escoliose Idiopática (IS) é uma curvatura idiopática da coluna vertebral nos três planos de tratamento conservador (não invasivo) ou cirúrgico (invasivo). Ainda assim, a efetividade da terapêutica não invasiva permanece carente de um embasamento científico que suporte sua aplicabilidade baseada em evidências. Objetivo: avaliar os efeitos de intervenções não invasivas sobre inclinação lateral da coluna IS por meio de uma revisão sistemática da literatura. Métodos: Foi realizada uma busca de estudos nas bases de dados MEDLINE, SCOPUS e COCHRANE, em 24 de março de 2014. Os termos utilizados foram: scoliosis, exercise therapy, physiotherapy, physical therapy. Foram incluídos ensaios clínicos com indivíduos escolióticos submetidos a algum tipo de intervenção não invasiva. O desfecho incluído foi inclinação lateral da coluna. Resultados: A busca inicial resultou em 941 estudos, com 07 estudos incluídos após triagem de dois revisores independentes. Seis estudos (85,7%) adotaram algum tipo de técnica cinesioterapêutica, e três estudos (42,8%) valeram-se do uso de órtese corretiva. O tempo de intervenção médio nos estudos com técnica cinesioterapêutica foi de 37,6 semanas, e de 91,6 semanas nos estudos com órtese corretiva. A melhora na progressão da inclinação lateral da coluna foi relatada em 83,3% (5 de 6) dos estudos com técnica cinesioterapêutica, e em 66,6% (2 de 3) dos estudos com órtese corretiva. Conclusão: Foi encontrada uma melhora, de maneira geral, na progressão da inclinação lateral da coluna na IS em sujeitos de ambos os sexos de 11 a 25 anos de idade submetidos a intervenções não invasivas.

Maximal and anaerobic threshold cardiorespiratory responses during deep-water running / Respostas cardiorrespiratórias máximas e no limiar anaeróbio da corrida em piscina funda

Aquatic exercises provide numerous benefits to the health of their practitioners. To secure these benefits, it is essential to have proper prescriptions to the needs of each individual and, therefore, it is important to study the cardiorespiratory responses of different activities in this environment. Thus, the aim of this study was to compare the cardiorespiratory responses at the anaerobic threshold (AT) between maximal deep-water running (DWR) and maximal treadmill running (TMR). In addition, two methods of determining the AT (the heart rate deflection point [HRDP] and ventilatory method [VM]) are compared in the two evaluated protocols. Twelve young women performed the two maximal protocols. Two-factor ANOVA for repeated measures with a post-hoc Bonferroni test was used (α < 0.05). Significantly higher values of maximal heart rate (TMR: 33.7 ± 3.9; DWR: 22.5 ± 4.1 ml.kg−1.min−1) and maximal oxygen uptake (TMR: 33.7 ± 3.9; DWR: 22.5 ± 4.1 ml.kg−1.min−1) in TMR compared to the DWR were found. Furthermore, no significant differences were found between the methods for determining the AT (TMR: VM: 28.1 ± 5.3, HRDP: 26.6 ± 5.5 ml.kg−1.min−1; DWR: VM: 18.7 ± 4.8, HRDP: 17.8 ± 4.8 ml.kg−1.min−1). The results indicate that a specific maximal test for the trained modality should be conducted and the HRDP can be used as a simple and practical method of determining the AT, based on which the training intensity can be determined.

Os exercícios aquáticos proporcionam inúmeros benefícios à saúde de seus praticantes. Para assegurar esses benefícios, é indispensável uma prescrição adequada às necessidades de cada indivíduo e, para isso, faz-se importante estudar as diferentes respostas cardiorrespiratórias das atividades desenvolvidas nesse meio. Deste modo, o objetivo do estudo foi comparar as respostas cardiorrespiratórias no limiar anaeróbio (LAn) entre o teste máximo de corrida em piscina funda (CPF) e da corrida em esteira terrestre (CET). Além disso, comparar dois métodos de determinação do LAn (ponto de deflexão da frequência cardíaca [PDFC] e método ventilatório [MV]) entre os protocolos máximos. Doze mulheres jovens participaram do estudo. Foi utilizada ANOVA de dois fatores para medidas repetidas com post-hoc de Bonferroni (α<0,05). Foram encontrados valores significativamente maiores de frequência cardíaca máxima (CET: 190±5; CPF: 174±9 bpm) e de consumo de oxigênio máximo (CET: 33,7±3,9; CPF: 22.5±4.1 ml.kg-1.min-1) na CET em comparação à CPF. Além disso, não foram encontradas diferenças significativas entre os métodos de determinação do LAn (CET: MT: 28.1±5.3; PDFC: 26.6±5.5 ml.kg-1.min-1; CPF: MV: 18.7±4.8, PDFC: 17.8±4.8 ml.kg-1.min-1). Os resultados indicam a importância da realização de um teste máximo especifico da modalidade treinada e o PDFC parece ser uma alternativa simples e prática para a determinação do LAn.

Comparação do índice de esforço percebido e consumo de oxigênio em exercício em cicloergômetro entre gestantes e não-gestantes e entre o exercício aquático e terrestre / Comparison of the rating of perceived exertion and oxygen uptake during exercise between pregnant and non-pregnant women and between water and land-based exercises

O objetivo do presente estudo foi comparar o índice de esforço percebido (IEP) e o consumo de oxigênio (VO2) durante o exercício aquático e terrestre, na intensidade do primeiro limiar ventilatório entre gestantes e não-gestantes. Sete gestantes (idade gestacional entre 27ª e 30ª semanas) e sete não-gestantes realizaram dois testes contínuos em cicloergômetro (água e terra) na intensidade do primeiro limiar ventilatório. Durante os testes, os gases respiratórios foram coletados com um analisador de gases portátil KB1-C da marca Aerosport. A frequência cardíaca (FC) foi obtida através de um Polar modelo F1. Os dados foram coletados a cada 20s. O IEP era indicado ao término do exercício através da escala RPE de Borg (6-20). Utilizou-se ANOVA para medidas repetidas de 1 FATOR, com post hoc de Bonferroni (p < 0,05). Não foram encontradas diferenças significativas para o VO2 e para o IEP comparando os exercícios aquático e terrestre. Além disso, não foram encontradas diferenças significativas entre gestantes e não-gestantes. Concluímos que o IEP pode ser usado para prescrição do exercício aquático e terrestre e para gestantes e não-gestantes, quando este for realizado na intensidade do primeiro limiar ventilatório e em cicloergômetro.

The purpose of the present study was to assess the differences in ratings of perceived exertion (RPE) and oxygen uptake (VO2) behavior during water and land-based exercise, performed in the exercise intensity of the first ventilatory threshold between pregnant and non-pregnant women. Seven pregnant (gestational ages between the 27th and 30th week) and seven non-pregnant women performed two continuous cycle ergometer tests (water and land-based) at the first ventilatory threshold intensity. During all sessions, respiratory gases were collected with a portable AEROSPORT KB1-C mixing box gas analyzer. A pneumotach was used with a neoprene mask. Heart rate (HR) measurements were obtained with a POLAR F1. Data were collected every 20s. RPE on Borg scale from 6 to 20 was derived at the end of the exercise. One-way ANOVA was applied for repeated measures using the post-hoc Bonferroni test (p<0.05). No significant differences were found in VO2 or RPE when comparing water with land-based exercise. In the same way, no significant difference was found between pregnant and non-pregnant subjects. We suggest that RPE can be used for water and land-based exercise prescription on cycle ergometer at the intensity of first ventilatory threshold, for both pregnant and non-pregnant women.

Comparação das respostas cardiorrespiratórias de um exercício de hidroginástica com e sem deslocamento horizontal nos meios terrestre e aquático / Comparisons of cardiorrespiratory responses in a hydrogymnastics exercise with and without horizontal movement on land and in aquatic environment

O objetivo do estudo foi comparar as respostas cardiorrespiratórias de um exercício de hidroginástica (corrida estacionária) realizado com e sem deslocamento horizontal no meio terrestre (MT), em piscina funda (PF) e em piscina rasa (PR). Seis mulheres jovens realizaram os exercícios durante 4 min numa cadência de 80 bpm. O exercício consistia em flexão e extensão de quadril com os braços simulando um movimento de corrida. A frequência cardíaca (FC) e o consumo de oxigênio (VO2 ) foram coletados no último minuto de exercício e a percepção de esforço (PE) foi coletada ao término do exercício. Para a comparação das variáveis utilizou-se ANOVA two-way para medidas repetidas com fatores meio e forma de execução (p < 0,05). Para todas as variáveis analisadas foram encontrados valores menores no exercício em PR comparado ao exercício no MT. Porém, nenhuma diferença foi observada entre o exercício no MT e em PF, exceto para a FC, que foi menor no exercício em PF. Em relação à forma de execução, para a FC, foram encontrados valores maiores no exercício com deslocamento quando comparado ao exercício sem deslocamento somente na PF. Estes achados sugerem a possibilidade de executar o exercício analisado em PF com gasto energético (GE) similar e FC menor quando comparado ao mesmo exercício no MT. Fato de grande relevância para populações que querem obter um GE semelhante ao exercício no MT, mas que necessitam de uma menor sobrecarga cardiovascular.

The aim of the study was to compare the cardiorespiratory responses during an hydrogymnastics exercise performed with and without horizontal movement on land environment (LE) and in a deep (DS) and in a shallow swimming pool (SS). Six YOUNG women performed the exercise during four minutes in each environment (LE, DS and SS) and situation (with and without horizontal movement) in a cadence of 80 bpm. The exercise consisted in a hip flexion/extension while the arms simulating a running movement. The heart rate (HR) and oxygen uptake (VO2 ) were veriefied during the last minute in each exercise and the rate of perceived exertion (RPE) was collected in the ending of the exercise. To variables comparisons was used ANOVA two-way for repeated measures with factors environment and situation (p < 0,05). For all cardiorespiratory variables analyzed, SS exercise were lower than that found on LE. Although, no difference was observed in the exercise performed on LE or in DS, except for the HR, that was lower during DS. Acording to the different situations, higher HR value was found during the exercise with horizontal movement when compared with the exercise without horizontal movement in the DS. These findings suggest the possibility to perform the exercise analyzed with similar energy expenditure and lower FC in DS when compared with exercise in LE. It is very important for people that need similar energy expenditure and lower cardiovascular overload during aquatic exercise.