Comparison of Nonimmersive Virtual Reality and Task-Oriented Circuit Training on Gait, Balance, and Cognition Among Elderly Population: A Single-Blind Randomized Control Trial.

Purpose: The purpose of this study was to determine the effects of nonimmersive virtual reality (VR) and task-oriented circuit training on gait, balance, cognitive domains, and quality of life among the elderly population. Methods: This is a single-blind randomized control trial in which 28 elderly individuals between 60 and 75 years were selected. The participants were divided into two groups, task-oriented circuit training and the other receiving nonimmersive VR treatment, with 14 participants in each group. To analyze the effects of both training on balance and gait time up and go test (TUGT), dynamic gait index (DGI), measures were used and for cognitive domains Montreal cognitive assessment (MoCA) scale was used. Short form 12 (SF-12) (along with two domains, Physical Component Summary and Mental Component Summary) was used for the measurement of quality of life. The treatment duration was 8 weeks for both groups. Both the pre-test and post-test readings were analyzed and compared. Results: The mean age of participants was 66.91 ± 3.79 years. Within-group comparison between the pre-test and post-test indicated that significant differences (P < 0.05) existed in all the outcome measures (TUGT, DGI, MoCA, and SF-12) in both groups. However, between-group comparison, significant differences were only found in TUGT and DGI in nonimmersive VR group. Conclusion: This study concluded that both interventions nonimmersive VR and task-oriented circuit training were beneficial for improving balance, gait, quality of life, and cognitive domains like memory, attention spans, executive functions, and so on in elderly population. However nonimmersive virtual reality training is a more effective, feasible, and safe alternative and can be proposed as a form of fall prevention exercise for the older adults. ClinicalTrials.gov Identifier: NCT05021432.

Effect of high intensity circuit training on muscle mass, muscular strength, and blood parameters in sedentary workers.

Background: The study aim was to investigate the effect of high intensity circuit training on body composition, muscular performance, and blood parameters in sedentary workers. Methods: A total of 36 middle-aged sedentary female workers were randomly divided into high intensity circuit training (HICT) group, aerobic training (AT) group, and control (CON) group. The exercise training groups performed exercise three times per week for 8 weeks. In HICT, each session was 20-35 min with 2-3 rounds. Rounds were 8 min; the interval between rounds was 4-5 min. In AT, each exercise session comprised 20-35 min of aerobic dance training. Physiological parameters were measured 1 week before and after the interventions. The resulting data were analyzed using two-way mixed design ANOVA, the differences in body composition, muscular performance and blood parameters before and after training were compared. Results: The muscle mass (pre-test: 21.19 ± 2.47 kg; post-test: 21.69 ± 2.46 kg, p < 0.05) and knee extension 60°/s (pre-test: 82.10 ± 22.26 Nm/kg; post-test: 83.47 ± 12.83 Nm/kg, p < 0.05) of HICT group were significantly improved, with knee extension 60°/s significantly higher than that of the CON group (HICT: 83.47 ± 12.83 Nm/kg; CON: 71.09 ± 26.53 Nm/kg). In the AT group, body weight (BW) decreased significantly (Pre-test: 59.37 ± 8.24 kg; Post-test: 58.94 ± 7.98 kg); no significant change was observed in CON group. The groups exhibited no significant change in blood parameters (hs-CRP, TC, and LDL-C) or IGF-1. Conclusions: Sedentary worker's muscle mass and lower-limb muscular performance were effectively improved by performing 8-week HICT with the benefits of short duration, no spatial constraints, and using one's BW, whereas AT caused a significant decrease in BW. However, the AT induced decrease in BW was probably an effect of muscle loss rather than exercise-induced weight loss.

Effect of a High-Intensity Circuit Training Program on the Physical Fitness of Wildland Firefighters.

Wildland firefighting implies high physical and psychological demands for the personnel involved. Therefore, good physical fitness can help increase the work efficiency of wildland firefighters (WFFs) and safeguard their health. High-intensity circuit training (HICT) could be a good alternative to improve the physical condition of WFFs since it stands out for its functionality and economy. Therefore, the objective of this study was to analyze the effects of HICT on the WFFs' physical fitness. The study involved 9 WFFs (8 males and 1 female; 29.8 ± 2.8 years; 175.6 ± 6.7 cm) who completed a training program and 9 WFF candidates (8 males and 1 female; 24.7 ± 6.6 yr, 176.5 ± 7.0 cm) as a control group. WFFs performed an 8-week HICT program (two weekly training sessions). The training sessions lasted approximately 45 min and were performed at an intensity >80% of maximal heart rate and RPE values >7.5. At the beginning and the end of the intervention, subjects' physical fitness (i.e., aerobic capacity, cardiorespiratory endurance, muscular resistance and explosive strength) was assessed through different tests. After completing the training program, WFFs had significantly increased (p < 0.05) the speed at which the ventilatory thresholds were determined (12.4 ± 13.9 and 5.7 ± 7.3% for the ventilatory and respiratory compensation thresholds, respectively) and also their abdominal (31.2 ± 17.2%), lumbar (34.1 ± 13.5%) and upper limb (13.3 ± 16.0%) strength. Moreover, improvements (p < 0.05) in the explosive strength of legs (7.1 ± 5.8%) and performance in a specific physical employment test (12.2 ± 6.1%) were observed. In conclusion, the results of this study show that an 8-week high-intensity circuit training program could be an effective and safe method to improve WFFs' physical fitness and performance.

Resistance Circuit Training or Walking Training: Which Program Improves Muscle Strength and Functional Autonomy More in Older Women?

To evaluate the effects of two programs (resistance and walking training) on the functional autonomy and muscle strength (isometric and dynamic) of older women, 67 subjects were divided randomly into three groups: resistance training (RTG; Mean = 64.70 ± 6.74 years), walking (WG, Mean = 65.56 ± 7.82 years), and control (CG; Mean = 64.81 ± 4.34). The experimental groups underwent a 16-week intervention. Muscle strength (isometric and dynamic) and functional autonomy were assessed. The subjects participating in the RTG showed improvements in the comparison pre to post-test in the maximal forces of upper limb (MULS) (Δ% = 49.48%; p = 0.001) and lower limb (MLLS) (Δ% = 56.70%; p = 0.001), isometric biceps forces (BIS) (Δ% = 30.13%; p = 0.001) and quadriceps forces (QIS) (Δ% = 65.92%; p = 0.001), and in the general index (GI) of functional autonomy (Δ% = −18.32%; p = 0.002). The WG improved in all functional autonomy tests, except for the standing up from prone position test (SVDP). In strength tests, the WG obtained improvements only in the QIS (Δ% = 41.80%; p = 0.001) and MLLS (Δ% = 49.13%; p = 0.001) tests. The RTG obtained better results (p < 0.05) when compared to the WG and CG. The results allow us to infer that resistance exercise programs are more effective in increasing strength and functional autonomy, a fact that may mitigate the deleterious effects on health of aging.

Combining a supervised and home-based task-oriented circuit training improves walking endurance in patients with multiple sclerosis. The MS_TOCT randomized-controlled trial.

BACKGROUND: Balance and mobility impairments are widespread in patients with Multiple Sclerosis (PwMS), even at an early stage. They can contribute to disability, physical deconditioning and reduced quality of life. Task-oriented is a training modality that may promote walking abilities and conditioning. However, the effects usually are short-lasting and exercising at home can have several barriers. This randomized controlled trial aimed to test the effectiveness of the combination of a 2-weeks in-person, supervised task-oriented circuit training (TOCT), followed by a 12-weeks home-based task-oriented program with monthly in-person visits. METHODS: 36 PwMS with EDSS 4-5.5 and unassisted walking have been randomly assigned to 10 supervised TOCT sessions over two weeks (Phase 1) followed by a 12-weeks home-based task-oriented program (Phase 2) or a delayed-treatment group. At the end of Phase 2, the delayed-treatment group (usual care) received the same TOCT protocol. Phase 1 was composed of six gait-based workstations and treadmill training, whereas Phase 2 was based on progressive task-oriented tasks practice at home with monthly visits to adjust activities levels. Six Minute Walk Test (6MWT), Timed 25-foot walk test (T25FW), Timed Up and Go test (TUG), Dynamic Gait Index (DGI), Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale - 12 (MSWS-12), Multiple Sclerosis Impact Scale-29 (MSIS-29) and resting muscle oxygen consumption (rmVO2) were assessed as outcome measures at baseline, after Phase 1 and after Phase 2. Retention was tested on the whole sample at a 12-weeks follow-up. RESULTS: The entire sample completed the 2-weeks TOCT, whereas adherence was good for the 12-weeks home-based task-oriented program (6.2/10). The mean repetitions and level of difficulty of each task significantly increased after every timepoint. A superiority of task-oriented program was verified for 6MWT (F, 2,88 = 7.80; p<0.001) on usual care after the 12-weeks home-based program. Moreover, between-group differences were highlighted at the same point, even for T25FW, TUG and MSWS-12. RmVO2 and fatigue were significantly improved only in the experimental group. Positive effects on 6MWT were retained 12 weeks after the end of the protocol (p<0.001) in the whole sample. CONCLUSIONS: The combination of a supervised and self-managed task-oriented program enhances walking endurance with positive effects on walking ability, fatigue and resting muscle oxygen consumption in PwMS with unassisted walking. These preliminary results reflected how this intervention was effective for impairment and activity improvements; moreover, it was cardiorespiratory stressful and possibly reduced deconditioning.

Comparison of affective responses during school physical education classes with different recovery times / Comparação das respostas afetivas durante aulas de educação física escolar com diferentes tempos de recuperação

ABSTRACT This study aimed to verify the effect of exercise recovery time on the affective responses during a circuit training in physical education classes. Forty-six apparently healthy young adolescents (twenty-one girls) (12.85 ± 0.94 years; 49.7 ± 8.93 kg; 1.59 ± 0.08 cm; 19.51 ± 3.28 kg/m2) participated in this study. Were submitted participants for two physical education classes, based on circuited model of the same intensity, but with different recovery times (2 min and 1 min). The study was carried out in two phases: baseline and intervention. Affect, Arousal, and Ratings of Perceived Exertion data were analyzed using paired t-tests, considering a significance level of p < 0.05. The class with longer rest time (2 min) provided greater affection (t(45) = 3.586; p < 0,001) and less perceived effort (t(45) = 2.295; p = 0,026). The intensity manipulation strategy was effective in providing different affective responses, in which classes perceived as more intense, resulting in the decline of affect.

RESUMO O objetivo do estudo foi verificar o efeito do tempo de recuperação do exercício nas respostas afetivas durante um treinamento em circuito nas aulas de educação física. Quarenta e seis jovens adolescentes aparentemente saudáveis (vinte e uma meninas), com (12.85 ± 0.94 anos; 49.7 ± 8.93 kg; 1.59 ± 0.08 cm; 19.51 ± 3.28 kg/m2), participaram do estudo. Os participantes foram submetidos a duas aulas de educação física escolar, baseados em modelo de circuitos de mesma intensidade, porém com tempos de recuperação diferentes (2 min e 1 min). O estudo foi realizado em duas fases: base e intervenção. Os dados de Afeto, Ativação e Percepção Subjetiva do Esforço, foram analisados através de testes t pareados, considerando um nível de significância de p < 0,05. A aula com maior tempo de descanso (2 min) proporcionou maior afeto (t(45) = 3.586; p < 0,001) e menor esforço percebido (t(45) = 2.295; p = 0,026). A estratégia de manipulação da intensidade foi efetiva para proporcionar respostas afetivas diferentes, em que a aula percebida como mais intensa resultou no declínio do afeto.

Chronic musculoskeletal pain, catastrophizing, and physical function in adult women were improved after 3-month aerobic-resistance circuit training.

Although exercise is beneficial for chronic musculoskeletal pain (CMP), the optimal type and amount of exercise are unclear. This study aimed to determine the impact of circuit training that combines aerobic and resistance exercises on adult women with CMP. A total of 139 women with CMP underwent circuit training for 3 months and were asked to complete the following questionnaires at baseline and 3 months later: Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Roland-Morris Disability Questionnaire (RDQ), Shoulder36, and Knee injury and Osteoarthritis Outcome Score (KOOS). Significant improvements were observed in NRS, PCS, RDQ, and KOOS activities of daily living (ADL) scores after the intervention relative to baseline (p < 0.0001, p = 0.0013, 0.0004, and 0.0295, respectively), whereas shoulder function did not improve. When considering the impact of exercise frequency, NRS scores improved regardless of exercise frequency. Furthermore, PCS, RDQ, and KOOS scores improved in participants who exercised at least twice a week (24 sessions over the course of 3 months). In conclusion, CMP, pain catastrophizing, and physical function in adult female fitness club participants with CMP of NRS 4 or higher improved after 3 months of aerobic-resistance circuit training.

Acute Blood Pressure Response to Different Resistance Programs in Trained Men

Abstract Background Resistance training is used in different exercise programs, with different objectives and different levels of physical fitness. Training-related variables, such as volume, rest time and intensity, can affect the response of blood pressure (BP), but studies on the effect of these variables on BP are still needed. Objective To evaluate the acute response of BP in trained individuals undergoing two different methods of resistance training. Methods The sample was divided into three groups: (1) the German volume training (GVT) (n= 15), which consisted of 10 series of 10 repetitions at 50% of 1-repetition maximum (RM) with intervals of 30 seconds; (2) the sarcoplasm stimulating training (SST) (n= 16), performed at 8 RM and 85% of 1-RM and interval of 10 seconds until failure, followed by removal of 20% of weight and repetition of the whole series (total of three sets), and the control group (CG) (n= 15) who underwent BP measurements only. The two-way repeated measures ANOVA was used for analysis of variations, and a p< 0.05 was considered statistically significant. Results In the within-group analysis, a significant lowering of systolic blood pressure (SBP) was found at 10 minutes (125.4±10.8 mmHg, p= 0.045) and 20 minutes (124.5±8.5 mmHg, p= 0.044) post-training compared with immediately after training. In the between-group comparison, higher SBP values were observed immediately after training in the SST group (142.1±28.2, p= 0.048) compared with the CG. Conclusion High-volume and high-intensity resistance training programs did not cause abnormal changes in blood pressure. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)

Task-oriented circuit training combined with aerobic training improves motor performance and balance in people with Parkinson's Disease.

Goal-based training such as task practice combined with aerobic training (AT) has been suggested to improve motor performance and neuroplasticity for people with Parkinson's Disease (PwPD); however, its effect on clinical outcomes is unclear. Therefore, the main aim was to investigate the effects of task-oriented circuit training combined with AT (TOCT-AT) on balance and gait in PwPD. The secondary aim was to investigate the effects of TOCT-AT on functional mobility, balance confidence, disease severity, and quality of life. Twenty-six PwPD were randomly assigned to either to the experimental group (n = 14) or the control group (n = 12). The control group received AT, while the experimental group received TOCT-AT three times a week for 8 weeks. The main outcomes were the Berg Balance Scale (BBS), Postural Stability Test (PST), Limits of Stability Test (LOS), Pull Test (PT), Six Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Activities-specific Balance Confidence Scale (ABC), Unified Parkinson's Disease Rating Scale (UPDRS), and eight-item Parkinson's Disease Questionnaire (PDQ-8) were secondary outcomes. After intervention, between-group comparisons showed that the experimental group significantly improved more than the control group in all outcomes (p < 0.05). Additionally, both groups significantly improved in BBS, 6MWT, TUG, ABC, UPDRS-II, UPDRS-III, UPDRS total, and PDQ-8 (p < 0.05), while only the experimental group significantly improved in PST, LOS, and PT (p < 0.001). This study suggest that TOCT-AT could improve balance and gait performance, which could also be positively translated into functional mobility, balance confidence, disease severity, and quality of life in PwPD.

Efficacy of task-specific circuit training on physical activity levels and mobility of stroke patients: A randomized controlled trial.

BACKGROUND: Impaired mobility is related to low physical activity (PA) levels observed after stroke. Therapeutic approaches, such as task-specific circuit training (TSCT), used to improve mobility in individuals with stroke, could also improve PA levels. OBJECTIVE: To investigate the efficacy of TSCT, focused on both upper (UL) and lower (LL) limbs, in improving PA levels and mobility (primary outcomes), as well as muscle strength, exercise capacity, and quality of life (secondary outcomes) in subjects with stroke. METHODS: A randomized controlled trial with 36 subjects with chronic stroke was conducted. Experimental group: TSCT, involving both UL and LL. CONTROL GROUP: global stretching, memory exercises, and education sessions. Both groups received 60 minute sessions/week over 12 weeks. Outcomes were measured at baseline, post-intervention and 16 week follow-up. RESULTS: No changes were found for primary and secondary outcomes (0.11≤p≤0.99), except for quality of life, which improved in the experimental group post-intervention and 16 week follow-up (p = 0.02). CONCLUSION: TSCT focused on both UL and LL was not effective on PA levels and mobility of individuals with chronic stroke, however, improvements in quality of life were observed. Since this is the first study to investigate this combined training aimed at improving PA levels, future studies are necessary to better understand the impact of this type of intervention.

Progressive task-oriented circuit training for cognition, physical functioning and societal participation in individuals with dementia.

BACKGROUND AND OBJECTIVES: Dementia is commonly associated with cognitive deficit, functional decline and societal participation restriction across multiple domains of functioning. The decline impacts not only on the individual, but also on their informal caregivers, healthcare and the social system. This clinical random controlled study investigated the efficacy of 12-week Progressive Task-oriented circuit training on cognition, physical functioning and societal participation of individuals with dementia. METHODS: This study involved 31 individuals living with dementia recruited from a tertiary health institution in Lagos Nigeria. They were randomized into two groups: Progressive Task-oriented circuit training (involved in 12-week circuit training, two times a week for 70 min per session consisting of six workstations) and Control group (training with conventional treatment and home programmes). They were assessed at baseline, mid-intervention and post-intervention using Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognition (ADAS-Cog), Bristol ADLs, Community integration Questionnaire, 6-min walk test. Data analysed using the independent-samples t tests, paired t tests, Friedman two-way analysis of variance and Mann-Whitney U test (p ≤ .05). RESULTS: Participants were aged 69.61 ± 3.44 years. There was significant improvement from baseline to post-intervention in cognition (30.77 ± 1.02 vs. 28.77 ± 3.30), physical functioning (28.19 ± 3.90 vs. 25.84 ± 6.26) and societal participation (3.64 ± 0.73 vs. 5.59 ± 2.76). However, the progressive Task-oriented circuit training had more significant improvement than the control group within the group in cognition (p = .000), physical functioning (p = .000), and societal participation (p = .000). There was no statistical difference within the Control group with cognition (p = .097), Physical functioning (p = 1.000). Meanwhile there was statistically significant effect between both groups on cognition, physical functioning and societal participation post-intervention (p < .005). CONCLUSION: Although both Task-oriented Circuit Training and conventional treatment with home exercise programmes are efficacious, Progressive Task-oriented Circuit Training is more efficacious in enhancing and developing therapeutic strategies to train cognition, improve functional performance and societal participation in the rehabilitation of individuals with dementia.

Standardized, comprehensive, hospital-based circuit training in people with multiple sclerosis: results on feasibility, adherence and satisfaction of the training intervention.

BACKGROUND: We developed a standardized, comprehensive, ambulatory, hospital-based neurorehabilitation program ("MS-Fit") to improve disability, activities of daily living and quality of life in people with multiple sclerosis (PwMS). AIM: The aim of this study was to assess feasibility, adherence and satisfaction of the training intervention. DESIGN: Prospective multicenter cohort study analysis. SETTING: Ambulatory, hospital-based study. POPULATION: PwMS, aged 18 to 75 years, complaining about multiple sclerosis-related disability affecting activities of daily living and/or quality of life. METHODS: A standardized, ambulatory, hospital-based circuit training consisting of six workstations (aerobic exercise training, strength upper limbs, balance, manual dexterity, reactivity, strength and flexibility lower limbs) was performed two hours, twice weekly, for two months in groups of two to six participants supervised by experienced physiotherapists. Physiotherapists adapted the type and intensity of training according to the participants' individual performance using a training booklet. Program satisfaction and adherence were evaluated using a questionnaire and the attendance rate (clinicaltrials.gov Identifier: NCT02440516). RESULTS: Fifty-five participants started (mean age 52.82 years±10.68 standard deviation, range 29-74; 69% female; median Expanded Disability Status Scale 3.5, range 1.0-7.0) and 49 (89%) finished the training program. Main reasons to drop out during the training were lack of time, travel problems, social issues or Uthoff's phenomenon during the summer. All participants finalizing the training achieved >80% (mean 92.26%, ±7.59) attendance rate and sent back the questionnaire. Overall participant's satisfaction was high with a median of 9 points (range 4-10) on a Likert Scale from 0-10. Program quality was rated "good" with an overall median score of 39/50 points (range 26-50) and 95% of the participants would recommend the program to others. CONCLUSIONS: MS-Fit is a feasible training program with high patient satisfaction and adherence. It enables high intensity ambulatory training and can be easily reproduced due to its standardized nature. CLINICAL REHABILITATION IMPACT: MS-FIT enables a standardized ambulatory high intensity training that is easily reproducible. Participants benefit from group training and from individual adaption of the training through professional supervision.

Task-Oriented Circuit Training for Mobility in Outpatient Stroke Rehabilitation in Germany and Austria: A Contextual Transferability Analysis.

People with stroke cite mobility deficits as one of the most burdensome limitations. National and international stroke guidelines recommend physical therapy based on task-oriented practice, with high numbers of repetitions to improve mobility. In the outpatient setting in Germany and Austria, these principles have not yet been established. The purpose of this study was to identify an evidence-based intervention that could help reduce this research-practice gap. A stepwise approach proposed by Voigt-Radloff and colleagues and Cochrane Germany was used. First, the specific health service problem in the German and Austrian physical therapy outpatient context was identified. Second, a promising intervention was identified using a systematic search in the Cochrane Library and by grading the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation. Finally, the transferability of the promising intervention into the local context was evaluated using predefined questions from the Cochrane guide and reports from health insurances, professional organizations, and national stroke guidelines. Task-oriented circuit training reviewed by English and colleagues was chosen. The review showed clinically important improvements in walking distance and speed. The quality of the evidence was graded high for these 2 outcomes. We identified contextual challenges for implementation at the setting level (eg, insufficient reimbursement for group therapy by insurance companies), the participant and therapist level (eg, unknown motivation for group therapy due to the established 1:1 patient-therapist ratio), and the outcome measure level (eg, lack of standardized, cross-culturally translated manuals). Although task-oriented circuit training is scientifically well established, barriers to implementation into routine care in Germany and Austria can be expected. In a next step, research using knowledge translation methodology will focus on the detailed evaluation of barriers and facilitators with relevant stakeholders.

An intensive task-oriented circuit training positively impacts gait biomechanics in MS patients.

BACKGROUND: An intensive task-oriented circuit training (TOCT) provides a valid approach in improving motor function in Multiple Sclerosis (MS). OBJECTIVE: We aimed at testing the efficacy of TOCT on gait kinematics in MS patients with mild-moderate disability. METHODS: Nineteen MS patients able of independent walking performed 3-D Gait Analysis before (T0) and after (T1) a two-week TOCT program. Patients were clustered in two different subgroups, according to clinical neurological impairments assessed with specific functional system of Expanded Disability Status Scale (EDSS): pyramidal (Group 1) and cerebellar (Group 2) subjects. Spatio-temporal and kinematic data were compared before and after the TOCT intervention in the total sample of patients and in the two selected subgroups at two time intervals. RESULTS: Data obtained revealed increased dynamic ROM at knee joint after training in the whole study sample. Of note, knee dynamic excursion improved significantly in Group 1 but not in Group 2 patients after TOCT. Moreover, sagittal plane kinematics revealed significant modifications on knee and ankle biomechanics in Group 1 after rehabilitation. CONCLUSIONS: These data point out the benefits of the task specific training on gait dynamics in mild impaired MS subjects, linking to treatment opportunity in patients with a prevalent pyramidal impairment.

Effect of task-oriented circuit training on motor and cognitive performance in patients with multiple sclerosis: A single-blinded randomized controlled trial.

BACKGROUND: Exercise training has positive effects on motor and cognitive performance which deteriorates over time in patients with Multiple Sclerosis (MS). The effects of task-oriented circuit training (TOCT) on motor and cognitive performance in patients with MS are not yet clear. OBJECTIVE: The aims of this study are to investigate the effects of TOCT on balance, walking, manual dexterity, cognitive performance, and to determine the extent to which patients are able to transfer changes in their performance to activities of daily living. METHODS: Twenty patients with MS (EDSS: 2-5.5), were randomly assigned to two groups; the task-oriented circuit training group (TOCTG, n:10) and the control group (CG, n:10). The TOCTG received TOCT twice a week for six weeks while the CG performed the relaxation exercises at home. All patients were assessed by using Modified Sensory Organization Test, Berg Balance Scale, Activities-specific Balance Confidence, Timed Up and Go, Functional Gait Assessment, 12-item Multiple Sclerosis Walking Scale, Nine-Hole Peg Test, Brief Repeatable Battery of Neuropsychological Tests, Multiple Sclerosis Neuropsychological Questionnaire. RESULTS: Balance and walking performance were improved after TOCT (p < 0.05), whereas manual dexterity and cognitive performance except for verbal memory did not change significantly (p > 0.05). The CG showed no changes in any measurements (p > 0.05). CONCLUSIONS: TOCT is quite effective to improve balance and walking in patients with MS. However, further studies are needed to determine the effect of TOCT on cognitive performance.

Circuit resistance training and cardiovascular health in breast cancer survivors.

OBJECTIVE: Cardiovascular disease is the leading cause of death in breast cancer survivors. While evidence shows circuit resistance training (CRT) is effective for improving muscle and cardiorespiratory fitness, whether CRT is an efficacious therapy for decreasing cardiovascular risk in cancer survivors is unclear. METHODS: Fifty-one breast cancer survivors were recruited to either 12 weeks CRT (n = 26), or a non-exercising wait-list control (n = 25). Two supervised 60 min CRT sessions per week were undertaken, comprising resistance and functional exercises, and aerobic exercise stations. Primary outcome measure was the gold-standard assessment of arterial stiffness, aortic pulse wave velocity (PWV). Secondary outcomes included: cardiorespiratory fitness (CRF), upper and lower body strength, arterial wave reflections, central blood pressure and rate pressure product. RESULTS: Compared to the control group, the CRT group had a statistically significant medium effect decrease in PWV 0.9 m/s (95% CI: 0.1, 1.7). There were large effect improvements in VO2 max (4.3 ml kg-1  min-1 , 95% CI: 5.8, 2.8), upper and lower body strength (3.7 kg, 95% CI: 1.9, 5.6 and 10.4 kg, 1.6, 19.1) respectively. CONCLUSION: Findings support the existing literature demonstrating that 12 weeks CRT improves muscle and cardiorespiratory fitness and is also an effective strategy for decreasing a proven cardiovascular risk factor in breast cancer survivors.

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

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

Strength and Conditioning Habits of Competitive Distance Runners.

Blagrove, RC, Brown, N, Howatson, G, and Hayes, PR. Strength and conditioning habits of competitive distance runners. J Strength Cond Res 34(5): 1392-1399, 2020-Targeted strength and conditioning (S&C) programs can potentially improve performance and reduce injury risk factors in competitive runners. However, S&C practices of distance runners are unknown. This study aimed to explore S&C practices of competitive middle- and long-distance runners and examined whether reported frequency of injuries was influenced by training behaviors. One thousand eight hundred eighty-three distance runners (≥15 years old) completed an online survey. All runners who raced competitively were included in data analysis (n = 667). Distance runners mainly engaged with S&C activities to lower risk of injury (63.1%) and improve performance (53.8%). The most common activities used were stretching (86.2%) and core stability exercises (70.2%). Resistance training (RT) and plyometric training (PT) were used by 62.5 and 35.1% of runners, respectively. Junior (under-20) runners include PT, running drills, and circuit training more so than masters runners. Significantly more international standard runners engaged in RT, PT, and fundamental movement skills training compared with competitive club runners. Middle-distance (800-3,000 m) specialists were more likely to include RT, PT, running drills, circuit training, and barefoot exercises in their program than longer-distance runners. Injury frequency was associated with typical weekly running volume and run frequency. Strength and conditioning did not seem to confer a protection against the number of injuries the runners experienced. Practitioners working with distance runners should critically evaluate the current S&C practices of their athletes, to ensure that activities prescribed have a sound evidence-based rationale.

High-intensity interval neuromuscular training promotes exercise behavioral regulation, adherence and weight loss in inactive obese women.

It is unclear how high-intensity, interval-type nontraditional exercise training programmes can be feasible and effective options for inactive obese individuals. This randomized controlled trial investigated the hypothesis that a 10-month high-intensity, interval-type neuromuscular training programme (DoIT) with adjunct portable modalities, performed in a small-group setting, induces improvements in psychological well-being, subjective vitality and exercise behavioural regulations in obese women. Associations between adherence, psychological and physiological indicators were also investigated. Forty-nine previously inactive obese females (36.4 ± 4.4 yrs) were randomly assigned to three groups (control; N = 21, 10-month training; N = 14, or 5-month training plus 5 month-detraining; N = 14). DoIT was a supervised, progressive, and time-efficient (<30 min) programme that used 10-12 functional/neuromotor exercises and prescribed work and rest time intervals (20-40 sec) in a circuit fashion (1-3 rounds) for 10 months. Questionnaires were used to measure psychological distress, subjective vitality, and behavioural regulations in exercise at pre-, mid-, and post-intervention. The 10-month training reduced psychological distress (72%, p = 0.001), external regulation (75%, p = 0.011) and increased vitality (53%, p = 0.001), introjected regulation (63%, p = 0.001), intrinsic regulation (33%, p = 0.004), and identified regulation (88%, p = 0.001). A moderate to strong positive relationship was found between adherence rate and identified regulation scores (r = 0.59, p = 0.001) and between VO2peak and identified regulation scores (r = 0.59, p = 0.001). A mild dissociation between exercise intensity and perceived exertion was also observed. Our novel findings suggest that a 10-month implementation of a high-intensity interval neuromuscular training programme promotes positive psychological adaptations provoking exercise behavioural regulation and adherence while inducing weight loss in inactive obese women.

A periodized training attenuates thigh intermuscular fat and improves muscle quality in patients with knee osteoarthritis: results from a randomized controlled trial.

OBJECTIVE: To analyze the influence of a 14-week periodized circuit training (CT) protocol on thigh intermuscular fat and muscle quality (force per unit area of lean tissue) in patients with knee osteoarthritis (KOA). DESIGN: Randomized controlled trial METHODS: Sixty-one selected participants with KOA grades 2 and 3, 40-65 years old, and BMI < 30 kg/m2 were randomized into three groups: CT, conventional strength training (ST), and educational protocol (EP). The CT and ST protocols consisted of 14-week training protocols conducted 3 times a week. The CT group performed exercises stratified as light, moderate, and intense, arranged progressively in a circuit model. The ST group performed conventional strength exercises, and the EP group participated in lectures twice a month about healthy lifestyles. Baseline and follow-up (week 0 and week 14) evaluations were conducted for thigh intermuscular fat (computed tomography), knee extension maximal isometric voluntary contraction (MIVC), and muscle quality (knee extension MIVC/muscle mass cross-sectional area). RESULTS: Only the CT group presented significant reductions in thigh intermuscular fat (p = 0.003) and significantly lower values in week 14 compared with the EP (p = 0.032). Both trained groups presented significant increases in muscle mass area (p=0.002 for CT and p=0.008 for ST) and increments in knee extension MIVC (p=0,033 for CT nd p=0.019 for ST) in week 14 compared with the EP and increases in muscle quality (p = 0.004 and 0.042). CONCLUSION: It can be concluded that a 14-week periodized CT protocol attenuates thigh intermuscular fat and improves muscle quality in patients with KOA. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02761590; https://clinicaltrials.gov/ct2/show/NCT02761590Key Points•Fourteen weeks of periodized circuit training attenuates thigh intermuscular fat in patients with knee osteoarthritis.•Circuit training is as effective as strength training for improving muscle mass, strength, and quality.