Face-to-face and telerehabilitation delivery of circuit training have similar benefits and acceptability in patients with knee osteoarthritis: a randomised trial.

QUESTION: Is periodised circuit training delivered via a telerehabilitation model of care as effective as the same training applied face-to-face for improving pain intensity, physical function, muscle strength, pain catastrophising, body composition, intermuscular adipose tissue and muscle architecture in people with knee osteoarthritis (OA)? DESIGN: Randomised controlled, non-inferiority trial with concealed allocation, blinded assessors and intention-to-treat analysis. PARTICIPANTS: One hundred adults aged ≥ 40 years with knee OA and pain for ≥ 3 months, with current pain ≥ 40 mm on a 100-mm visual analogue scale (VAS). INTERVENTION: The experimental group received 14 weeks of circuit training delivered via telerehabilitation using video recordings, followed by periodic phone calls in order to motivate and instruct participants. The control group received the same circuit training program in a face-to-face format. OUTCOME MEASURES: The primary outcomes were pain VAS and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale, measured at 14 weeks. Secondary outcomes included objective physical function, strength, pain catastrophising and morphological measures (muscle architecture and thigh and body composition). Outcomes were measured at 14 and 26 weeks. RESULTS: Periodised circuit training delivered via telerehabilitation had equivalent effects to face-to-face delivery for pain intensity, physical function, muscle strength, pain catastrophising, thigh composition, intermuscular adipose tissue and muscle architecture. Whole body composition did not change appreciably in either group. Adherence to the training was excellent and participants in each group reported good perceptions of their randomised intervention. CONCLUSION: A periodised circuit training protocol can be delivered to people with knee OA in their own homes, using available technology while maintaining high levels of acceptability. More importantly, telerehabilitation appears to cause non-inferior physical and functional outcomes to face-to-face rehabilitation programs. TRIAL REGISTRATION: RBR-662hn2.

Short-Term High-Intensity Circuit Training Does Not Modify Resting Heart Rate Variability in Adults during the COVID-19 Confinement.

BACKGROUND/OBJECTIVE: The quarantine caused by the COVID-19 pandemic increased sedentary behavior, psychological stress, and sleep disturbances in the population favoring the installation of alterations in the cardiovascular system. In this sense, physical exercise has widely been suggested as an efficient treatment to improve health. The current study determined the impact of short-term high-intensity circuit training (HICT) on resting heart rate variability (HRV) in adults. METHODS: Nine healthy participants (age: 31.9 ± 4.4 yr.) performed 36 HICT sessions (3 times per day; 3 days per week) and four participants (age: 29.5 ± 1.7 yr.) were assigned to a control group. The HICT consisted of 12 min of whole-body exercises performed during a workout. Twenty-four hours before and after the exercise program, HRV parameters were recorded. RESULTS: The heart rate exercise during the last session trended to be lower when compared with the first HICT session (p = 0.07, d = 0.39, 95% CI = -13.50, 0.72). The interval training did not modify the HRV time (Mean NN, SDNN, RMSSD, NN50, pNN50) and frequency (LF, HF, LF/HF ratio, total power) domain parameters. CONCLUSION: Thirty-six HICT sessions did not provide enough stimuli to modify the resting HRV in adults during social isolation elicited by the COVID-19 pandemic. However, the data suggested that exercise protocol did not induce cardio-vagal adaptations.

Are rating of perceived exertion and heart rate methods useful to monitor the internal training load in functional training?

Abstract Aim: The study aimed to quantify and characterize the Training Load (TL) in a Functional Training (FT) model using Heart Rate (HR) and Session Rating of Perceived Exertion (sRPE) methods, and to verify whether these methods could be valid to monitor the TL during a FT program. Methods: The study design consisted of two phases: phase 1 - composed of a single training session of FT (FTSESSION), in which HR, sRPE, and pre- and post-exercise lactate [La] levels were assessed; phase 2 - composed of a FT program (FTPROGRAM) with eight weeks of duration and two sessions per week. The HR and SRPE were utilized to monitor all training sessions, and the results between sessions 1 vs. 8, 8 vs. 9, and 9 vs. 16 were compared. Results: On phase 1, HR distribution demonstrated that the participants spent about 75% of the total training time above 80% HRmax. Post-exercise [La] values were significantly higher (p < 0.05) than pre-exercise. The mean sRPE score was 8.5 ± 1.2. In phase 2, HR distribution was different between sessions 1-8 and 8-9 (p < 0.05). A strong correlation (r = 0.790) between the internal training load (ITL) and Training impulse (TRIMP) was observed. Conclusion: Our data demonstrated that the FTSESSION can be characterized as a high-intensity exercise, based on the pattern of HR responses and sRPE, and was reinforced by the [Lapeak]. Also, the TL monitoring methods (sRPE and TRIMP) proved to be valid for monitoring FT programs.

Effects of a periodized circuit training protocol delivered by telerehabilitation compared to face-to-face method for knee osteoarthritis: a protocol for a non-inferiority randomized controlled trial.

BACKGROUND: Regular exercise is an effective method for reducing pain and disability in patients with knee osteoarthritis (OA), as well as improving body composition. Thus, a combination of both resistance and aerobic training (circuit training) has shown to be promising for this population. However, access to physical therapy is limited by physical distance, social isolation, and/or treatment costs. Remote rehabilitation seems to be an effective way to minimize these barriers, but the benefits are dependent on the participants' adherence to the interventions provided at a distance. The objectives of this protocol are to compare the effects of a periodized circuit training applied via telerehabilitation with the same protocol applied in the face-to-face model for individuals with knee OA. METHODS: This study presents a single-blinded protocol for a non-inferiority randomized controlled trial. One hundred participants diagnosed with knee OA (grades II and III Kellgren and Lawrence system), aged 40 years or more, and BMI < 30 kg/m2 will be randomly divided into two groups: telerehabilitation (TR) and face-to-face (FtF) circuit training. The FtF group will perform a 14-week periodized circuit training protocol supervised by a physical therapist, 3 times a week. The TR group will perform the same exercise protocol at home, at least 3 times a week. In addition, the TR group will be able to follow the execution and orientations of the exercises by DVD, a website, and online file sharing tools, and they will receive periodic phone calls in order to motivate, clarify, and inform some aspects of knee OA. The primary outcomes are changes in self-reported pain intensity (visual analog scale (VAS)) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)), with a primary end-point of 14 weeks and a secondary end-point of 26 weeks. Secondary outcomes include changes in other clinical outcomes, in morphological characteristics, adherence, acceptability, and treatment perspective. DISCUSSION: A circuit training through telerehabilitation may contribute to developing early intervention in the causative and potentiating factors of the knee OA, verifying the effects of a low-cost, non-pharmacological and non-invasive treatment. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC) ID: RBR-662hn2. Registered on 31 March 2019. Link: http://www.ensaiosclinicos.gov.br ; Universal Trial Number (UTN) of World Health Organization: U1111-1230-9517.

Can intensity in strength training change caloric expenditure? Systematic review and meta-analysis.

INTRODUCTION: Strength training (ST) is considered an important strategy for maintaining body weight, as it promotes an increase in total energy expenditure (EE). However, the combination and manipulation of variables (intensity and volume) allow for different training adaptations. However, it remains unclear as to what is the most important variable between volume or intensity for example number of sets, repetitions, or total load for maximizing EE during ST. Several studies have analyzed the EE response in ST, but still unclear the variable is able to increase EE in the ST. OBJECTIVE: This review aimed to investigate the effect of ST on EE in adults using a systematic literature review and subsequent meta-analysis. METHODS: The search was performed on the electronic databases using the following keywords: strength training (resistance training; strength training; strength training method) and energy expenditure (energy metabolism; energy expenditure; caloric expenditure, caloric cost) with 'AND' and 'OR' combination. Manual searches of references were also conducted for additional relevant studies. After evaluating the inclusion and exclusion criteria, the selected studies were analysed according to strength training methods and the training variables used to measure EE. RESULTS: We identified two ST methods from the literature review: circuit training (CT) and traditional training (TT). Meta-analysis showed a significant effect on EE increase, which favour TT when compared with CT [-0·99 (95%CI: -1·96, -0·02), P<0·01] with I2 of 89% (P<0·01). After adjusting for bias risk, no significant differences were found in EE associated with intensity [-0·40, 95% CI (0·98, 0·18), P = 0·18). CONCLUSION: The present review and meta-analysis indicated that the intensity of exercise does not seem to be associated with an increase of EE in ST.

Circuito de treinamento e capacidades físicas em idosos: uma revisão sistemática / Circuit training and physical capacities in older adults: a systematic review

Introdução: Um dos grandes benefícios que o exercício físico promove no envelhecimento é a preservação das capacidades funcionais. O circuito de treinamento visa melhorar controle corporal, equilíbrio muscular, diminuindo a incidência de lesões e aumentando a eficiência dos movimentos. O objetivo deste trabalho é apresentar as evidências cientificas disponíveis na literatura sobre a relação entre a aplicação do circuito de treinamento e capacidades físicas em idosos. Métodos: Os bancos de dados Bireme, Web of Science, PubMed e Science Direct foram utilizados para a seleção dos artigos publicados nos últimos cinco anos. Resultados: Apenas quatro estudos foram selecionados para a realização da revisão sistemática, preenchendo os critérios de inclusão e exclusão. Conclusão: Diante das evidências existentes em relação à intervenção baseada em circuitos de treinamento, foi observado melhora no funcionamento físico e fisiológico dos idosos.

Introduction: One of the great benefits that physical activity promotes in ageing is the preservation of functional capabilities. The training circuit aims to improve body control, muscle balance, reducing the incidence of injuries and increasing the efficiency of movements. The objective of this work is to present the scientific evidence available in the literature on the relationship between the application of the training circuit and physical capacities in older adults. Methods: the database Bireme, Web of Science, PubMed and Science Direct were used to identify the articles published in the last five years. Results: Only four studies were included to perform the systematic review, fulfilling the inclusion and exclusion criteria. Conclusion: Regular physical exercise can reduce functional declines by improving physical abilities in older adults. Given the existing evidence regarding circuit-based intervention, the training circuit improves physical and physiological functioning of older adults.

Are extreme conditioning programmes effective and safe? A narrative review of high-intensity functional training methods research paradigms and findings.

Extreme conditioning programmes (ECPs, eg, CrossFit, Insanity and Gym Jones) are a growing fitness regimen characterised by functional movements performed at high-intensity and with constantly varying movements. While the popularity and number of practitioners of ECPs are growing, a debate has been established between what is observed in the scientific literature and anecdotal reports from athletes, coaches and physicians about safety (incidence and prevalence of injuries and rhabdomyolysis) and benefits (physical and mental health). In this article, we review the prevalence and incidence of injuries, rhabdomyolysis, physiological responses and chronic adaptations to ECPs. The majority of the available evidence confirm that the estimated injury rate among athletes participating in ECPs is similar to that in weightlifting and most other recreational activities. Additionally, ECP sessions resulted in increased acute oxidative, metabolic and cardiovascular stress, and depending on the stimulus (intensity, duration and non-usual exercise) and training status of the practitioner, an ECP session may precipitate rhabdomyolysis. In the scientific literature, the current chronic effects of ECPs showed little or no effects on body composition and improvements in physical fitness and psychological parameters; however, further studies are important.