The effects of myofascial release in combined with task-oriented circuit training on balance in people with Parkinson's disease: a randomized pilot trial.

OBJECTIVES: Task-oriented circuit training (TOCT) has been used to improve balance in people with Parkinson's disease (pwPD). To investigate the effectiveness of TOCT on balance, quality of life, and disease symptoms when combined with myofascial release in pwPD. METHODS: Twenty-six pwPD were randomized into two groups for this randomized controlled study. The groups received TOCT three days a week for eight weeks. At the end of each session, the myofascial release was applied to the neck, trunk, and lumbar region with three sets of 60-s foam rolling body weight (Intervention group-IG) and perceived discomfort level 0/10 (Control group-CG) using a numeric rating scale. Primary outcome measures were measured by the Berg Balance Scale (BBS), Parkinson's Disease Questionnaire (PDQ-8), and Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Secondary outcome measures included posturographic assessment, timed-up and go test (TUG), Trunk Impairment Scale (TIS), and rolling time. RESULTS: Data obtained from 26 pwPDs in equal numbers in both groups were analyzed. All groups reported a significant change in MDS-UPDRS, MDS-UPDRS-III, PDQ-8, TIS, and rolling time after treatment compared to pretreatment. Post-hoc analyses showed that IG significantly improved motor symptoms, TUG, and TIS dynamics compared to CG. The mediolateral limits of stability and anterioposterior limits of stability distances of IG increased (p < 0.05). DISCUSSION: Myofascial release, when combined with TOCT, may help to reduce disease-related motor symptoms and improve dynamic balance in pwPD. These findings suggest that myofascial release can be a beneficial addition to TOCT programs for pwPD.Clinical Trial Number: NCT05900934 (ClinicalTrials.gov).

Brief High-Velocity Motor Skill Training Increases Step Frequency and Improves Length/Frequency Coordination in Slow Walkers With Chronic Motor-Incomplete Spinal Cord Injury.

OBJECTIVE: To quantify spatiotemporal coordination during overground walking among persons with motor-incomplete spinal cord injury (PwMISCI) by calculating the step length (SL)/step frequency (SF) ratio (ie, the Walk Ratio [WR]) and to examine the effects of motor skill training (MST) on the relationship between changes in these parameters and walking speed (WS). DESIGN: Between-day exploratory analysis. SETTING: Research laboratory in a rehabilitation hospital PARTICIPANTS: PwMISCI (N=26). INTERVENTIONS: 3-day high-velocity MST. MAIN OUTCOME MEASURES: Overground WS, SL, SF, and WR measured during the 10-Meter Walk Test. RESULTS: Among the full sample, MST was associated with increases in WS, SL, SF, and a decrease in the WR. Relative change in WS and SF was higher among slow (ΔWS=↑46%, ΔSF=↑28%) vs fast (ΔWS=↑16%, ΔSF=↑8%) walkers. Change in the WR differed between groups (slow: ΔWR=↓10%; fast: ΔWR=0%). Twenty-six percent of the variability observed in ΔWR among slow walkers could be explained by ΔSF, while ΔSL did not contribute to ΔWR. Among fast walkers, ΔSL accounted for more than twice the observed ΔWR (43%) compared to ΔSF (15%). CONCLUSIONS: On the whole, WR values among PwMISCI are higher than previous reports in other neurologic populations; however, values among fast walkers were comparable to noninjured adults. Slow walkers demonstrated greater variability in the WR, with higher values associated with slower WS. Following MST, increases in WS coincided with a decrease in the WR among slow walkers, mediated primarily through an effect on SF. This finding may point to a specific mechanism by which MST facilitates improvements in WS among PwMISCI with greater mobility deficits.

Effectiveness of Combined Aerobic and Resistance Exercise on Cognition, Metabolic Health, Physical Function, and Health-related Quality of Life in Middle-aged and Older Adults With Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis.

OBJECTIVES: To evaluate the effectiveness of combined aerobic and resistance exercise on cognition, metabolic health, physical function, and health-related quality of life (HRQoL) in middle-aged and older adults with type 2 diabetes mellitus (T2DM). DATA SOURCE AND STUDY SELECTION: Systematic search of CINAHL, Cochrane, EMBASE, Scopus, PubMed, ProQuest Dissertation and Thesis, PsycINFO, Web of Science databases, and gray literature from Google Scholar. Pertinent randomized controlled trials (RCTs) were selected. The Protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42023387336). DATA EXTRACTION: The risk of bias was evaluated using the Cochrane Risk of Bias tool by 2 reviewers independently. Outcome data were extracted in a fixed-effect model if heterogeneity test were not significant and I2≤50%; otherwise, the random-effects model was used. DATA SYNTHESIS: Sixteen studies with 2426 participants were included in this review. Combined aerobic and resistance exercise had significant positive effects on cognition (SMD=0.34, 95% CI: 0.13 to 0.55), metabolic health on HbA1c (SMD=-0.35, 95% CI: -0.48 to -0.22) and lipid profile (total cholesterol SMD=-0.20, 95% CI: -0.34 to -0.07; low-density lipoprotein SMD=-0.19, 95% CI: -0.33 to -0.05; high-density lipoprotein SMD=0.25, 95% CI: 0.12 to 0.39; and triglycerides SMD=-0.18, 95% CI: -0.31 to -0.04), physical function on aerobic oxygen uptake (SMD=0.58, 95% CI: 0.21 to 0.95) and body mass index (MD=-1.33, 95% CI: -1.84 to -0.82), and physical HRQoL (MD=4.17, 95% CI: 0.86 to 7.48). Our results showed that clinically important effects on cognition may occur in combining the low-moderate intensity of aerobic exercise and progressive intensity of resistance training, the total duration of the exercise needs to be at least 135 minutes per week, among which, resistance training should be at least 60 minutes. CONCLUSION: Combined aerobic and resistance exercise effectively improves cognition, ameliorates metabolic health, enhances physical function, and increases physical HRQoL in middle-aged and older adults with T2DM. More RCTs and longitudinal follow-ups are required to provide future evidence of structured combined aerobic and resistance exercise on other domains of cognition.

Group-based circuit training to improve mobility after stroke: a cross-sectional survey of German and Austrian physical therapists in outpatient settings.

BACKGROUND: A contextual transferability analysis identified group-based circuit training (GCT) as an optimal intervention in German and Austrian outpatient physical therapy to improve mobility post-stroke. GCT incorporates task-oriented, high-repetitive, balance, aerobic and strength training and allows for increased therapy time without increasing personnel. OBJECTIVE: To determine the extent to which German and Austrian physical therapists (PTs) use GCT and its components in the outpatient treatment of stroke-related mobility deficits and to identify factors associated with using GCT components. METHODS: A cross-sectional online survey was conducted. Data were analyzed descriptively and using ordinal regression. RESULTS: Ninety-three PTs participated. None reported using GCT moderately to frequently (4-10/10 patients). The percentage of PTs reporting frequent use (7-10/10 patients) of task-oriented, balance, strength, aerobic, and high-repetitive training was 45.2%, 43.0%, 26.9%, 19.4%, and 8.6%, respectively. Teaching or supervising students, time for evidence-based practice activities at work, and working in Austria was associated with using GCT components frequently. CONCLUSION: German and Austrian PTs do not yet use GCT in outpatient physical therapy for stroke. Almost half of PTs, however, employ task-oriented training as recommended across guidelines. A detailed, theory-driven and country-specific evaluation of barriers to GCT uptake is necessary to inform implementation.

Self-selected or fixed: is there an optimal rest interval for controlling intensity in high-intensity interval resistance training?

PURPOSE: This study investigated the effects of different rest interval strategies during high-intensity interval resistance training (HIRT) on cardiorespiratory, perceptual, and enjoyment responses among trained young men. METHODS: Sixteen men experienced with HIRT underwent cardiopulmonary exercise testing and were familiarized with the exercises and HIRT protocol. On the subsequent three visits, interspaced 48-72 h, participants performed HIRT sessions with different rest intervals in a randomized order: 10 s and 30 s fixed rest intervals (FRI-10 and FRI-30), and self-selected rest interval (SSRI). Oxygen uptake (VO2), heart rate (HR), and recovery perception (Total Quality Recovery Scale) were measured during HIRT, while enjoyment responses (Physical Activity Enjoyment Scale) were assessed immediately after the sessions. RESULTS: The VO2 during exercise was greater in FRI-10 than FRI-30 (55% VO2max and 47% VO2max, respectively, p = 0.01), while no difference occurred between SSRI and bouts performed with fixed intervals (52% VO2max vs. FRI, p > 0.05). HR, excess post-exercise oxygen consumption (EPOC), recovery perception, and enjoyment responses were similar across conditions (p > 0.05). CONCLUSION: Exercise intensity was not affected by the rest interval strategy. High exercise intensity was maintained in sessions performed with FRI or SSRI, without negative repercussions on the duration of training sessions and enjoyment responses after exercise sessions.

Effect of Multicomponent Exercise on Cognition, Physical Function and Activities of Daily Life in Older Adults With Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-analysis.

OBJECTIVE: To review the evidence for the effectiveness of multicomponent exercise (an exercise program combining aerobic, endurance, balance, and flexibility exercises) on cognition, physical function, and activities of daily living in people with dementia and mild cognitive impairment (MCI). DATA SOURCES AND STUDY SELECTION: We conducted this study under the guidance of a designated protocol (PROSPERO CRD42022324641). Pertinent randomized controlled trials were selected from PubMed, Embase, Web of Science, and the Cochrane Library by 2 independent authors through May 2022. DATA EXTRACTION: Two authors independently extracted the data and assessed the quality of the included studies following the Cochrane Risk of Bias tool. Outcome data were extracted in a random effects model and estimated as Hedges' g and 95% confidence interval (CI). To validate specific results, the Egger test combined the Duval and Tweedie "trim and fill" method and sensitivity analysis with study removed were performed. DATA SYNTHESIS: A total of 21 publications were eligible for the quantitative analysis. In dementia, estimates of Hedges' g showed effects on global cognition (g=0.403; 95% CI, 0.168-0.638; P<.05), especially executive function (g=0.344; 95% CI, 0.111-0.577; P<.05), flexibility (g=0.671; 95% CI, 0.353-0.989; P<.001), agility and mobility (g=0.402; 95% CI, 0.089-0.714; P<.05), muscle strength (g=1.132; 95% CI, 0.420-1.845; P<.05), and activities of daily living (g=0.402; 95% CI, 0.188-0.615; P<.05). Also, a positive trend was observed in gait speed. Additionally, multicomponent exercise had positive effects on global cognition (g=0.978; 95% CI, 0.298-1.659; P<.05) and executive function (g=0.448; 95% CI, 0.171-0.726; P<.05) in patients with MCI. CONCLUSIONS: Our findings confirm the viability of multicomponent exercise as a management strategy for patients with dementia and MCI.

Can mixed circuit training elicit the recommended exercise intensity and energy expenditure in people after stroke?

PURPOSE: To investigate whether mixed circuit training (MCT) elicits the recommended exercise intensity and energy expenditure in people after stroke, and to establish the between-day reproducibility for the percentages of heart rate reserve (%HRR), oxygen uptake reserve (%VO2R), and energy expenditure elicited during two bouts of MCT. METHODS: Seven people aged 58 (12) yr, who previously had a stroke, performed a cardiopulmonary exercise test, a non-exercise control session, and two bouts of MCT. The MCT included 3 circuits of 10 resistance exercises at 15-repetition maximum intensity, with each set of resistance exercise interspersed with 45-s of walking. Expired gases were collected during the MCT and control session and for 40 min afterward. Control session was necessary to calculate the net energy expenditure associated with each bout of MCT. RESULTS: Mean %VO2R (1st MCT: 51.1%, P = .037; 2nd MCT: 54.0%, P = .009) and %HRR (1st MCT: 66.4%, P = .007; 2nd MCT: 67.9%, P = .010) exceeded the recommended minimum intensity of 40%. Both %VO2R (P = .586 and 0.987, respectively) and %HRR (P = .681 and 0.237, respectively) during the 1st and 2nd bouts of MCT were not significantly different to their corresponding gas exchange threshold values derived from cardiopulmonary exercise testing. Mean net total energy expenditure significantly exceeded the minimum recommend energy expenditure in the 1st (P = .048) and 2nd (P = .023) bouts of MCT. Between-day reproducibility for %HRR, %VO2R, and energy expenditure was excellent (ICC: 0.92-0.97). CONCLUSIONS: MCT elicited physiological strain recommended for improving health-related fitness in people after stroke and these responses demonstrated excellent between-day reproducibility.

Is postexercise hypotension a method-dependent phenomenon in chronic stroke? A crossover randomized controlled trial.

BACKGROUND: This study assessed the reproducibility of postexercise hypotension (PEH) detection after two bouts of mixed circuit training (MCT) using three approaches that accounts the pre-exercise values and/or a control session (CTL) to calculate PEH [i.e., ( A 1 = post - exercise - pre - exercise ${A}_{1}=\text{post}{\rm{ \mbox{-} }}\text{exercise}-\text{pre}{\rm{ \mbox{-} }}\text{exercise}$ ); ( A 2 = post - exercise - post - CTL ) $({A}_{2}=\text{post}{\rm{ \mbox{-} }}\text{exercise}-\text{post}{\rm{ \mbox{-} }}\text{CTL})$ ; A 3 = ( post - exercise - pre - exercise ) - ( post - CTL - pre - CTL ) ] ${A}_{3}=(\text{post}{\rm{ \mbox{-} }}\text{exercise}-\text{pre}{\rm{ \mbox{-} }}\text{exercise})-(\text{post}{\rm{ \mbox{-} }}\text{CTL}-\text{pre}{\rm{ \mbox{-} }}\text{CTL})]$ in chronic stroke (i.e., ≥6 months poststroke). The proportion of PEH responders determined using different cut-off values for PEH was also compared (4 mmHg vs. minimal detectable difference). METHODS: Seven participants (age: 56 ± 12 years; time post-stroke: 91 ± 55 months) performed two bouts of MCT and a CTL. The MCT involved 10 exercises with 3 sets of 15-repetition maximum, with each set interspersed with 45 s of walking. The systolic (SBP) and diastolic (DBP) blood pressures were assessed 10-min before and every 10-min along 40-min after CTL and MCT. RESULTS: The two-way random intraclass correlation coefficient for single measurements (ICC2,1 ) ranges for SBP were: A1 : 0.580-0.829, A2 : 0.937-0.994, A3 : 0.278-0.774; for DBP: A1 : 0.497-0.916, A2 : 0.133-0.969, A3 : 0.175-0.930. The proportion of PEH responders detected using 4 mmHg or the minimal detectable difference as cut-off values was not different in 97% of analyses (p > 0.05), and higher when using 4 mmHg in 3% of analyses (p = 0.031). The standard error of measurement was ≥4 mmHg in 47% of analyses for SBP, and 40% for DBP. CONCLUSIONS: The most reliable approach for determining PEH in chronic stroke was to subtract the postexercise from the post-CTL values. The proportion of PEH responders was not affected by the cut-off values applied.

Appetite and energy intake following a bout of circuit resistance training in chronic hemiparetic stroke patients: a preliminary randomized controlled trial.

PURPOSE: The main aim of this study was to investigate the effects of circuit resistance training (CRT) on post-exercise appetite and energy intake in chronic hemiparetic stroke patients. A secondary aim was to evaluate the reproducibility of these effects. METHODS: Seven participants met the eligibility criteria and, in a randomized order, participated in a non-exercise control session (CTL) and two bouts of CRT. The CRT involved 10 exercises with 3 sets of 15-repetition maximum per exercise, performed using a vertical loading approach, with each set interspersed with 45s of walking. Expired gases were carried out   to calculate the net energy cost of the exercise and the relative energy intake post-CTL/CRT. Hunger, fullness, desire to eat, and energy intake were assessed at baseline and for 12 h after CTL and CRT. RESULTS: Compared to CTL, hunger, desire to eat (P < .001), and relative energy intake (P < .05) were significantly lower after CRT, whereas the perception of fullness was significantly higher (P < .001). Significant differences between CTL and CRT were observed only for the first 9 h of the post-exercise period for hunger, fullness, and desire to eat (P < .05). No significant differences in appetite or relative energy intake were observed between the two bouts of CRT. CONCLUSIONS: A bout of CRT elicited decreased post-exercise appetite and relative energy intake in chronic hemiparetic stroke patients. Decreased appetite perceptions lasted for around 9 h and were reproducible.

Influence of HIIRT With Fixed and Self-Selected Recovery Intervals on Physiological, Affective, and Enjoyment Responses.

Purpose: Recovery-interval strategies may influence physiological and psychological responses during highintensity interval resistance training (HIIRT). This study compared the intensity, performance, and psychological outcomes during all-out effort HIIRT performed with fixed (FRI) and self-selected (SSRI) recovery intervals. Methods: Sixteen trained males (27.2 ± 4.1 years; 84.5 ± 8.9 kg; 55.8 ± 7.1 mL.kg-1.min-1) performed HIIRT bouts interspersed with FRI (10 s) and SSRI (15.3 ± 7.9 s). Results: Relative heart rate (%HRmax) and oxygen uptake (%VO2Peak), number of repetitions, and psychological responses (affection: Feeling ScaleFS; Felt Arousal ScaleFAS; enjoyment: Physical Activity Enjoyment ScalePACES) were assessed. FRI and SSRI elicited similar relative average intensity (p > .05) (%HRmax: 88.1 ± 3.5% vs. 87.6 ± 3.0%; %VO2Peak: 55.3 ± 7.4% vs. 54.1 ± 8.1%, respectively). The number of repetitions similarly decreased in SSRI and FRI from rounds 1 to 4 (~15%; p < .006), with no difference of total volume across conditions (FRI: 358.6 ± 32 reps vs. SSRI:357.5 ± 28.2; p = .89). In each round, no difference between FRI and SSRI (p > .05) was found for FS (3- to 3.5 vs. 2- to 4, respectively) or FAS (2- to 4 vs. 2- to 4, respectively), while PACES was lower in FRI than SSRI (102.8 ± 15.8 vs. 109.2 ± 13.2; p = .04). Conclusion: In conclusion, relative intensity, total repetitions, and affective perception were not influenced by the strategy of recovery intervals. On the other hand, overall enjoyment was favored in SSRI vs. FRI.

Mixed circuit training acutely reduces arterial stiffness in patients with chronic stroke: a crossover randomized controlled trial.

PURPOSE: Investigate whether a single bout of mixed circuit training (MCT) can elicit changes in arterial stiffness in patients with chronic stroke. Second, to assess the between-day reproducibility of post-MCT arterial stiffness measurements. METHODS: Seven participants (58 ± 12 years) performed a non-exercise control session (CTL) and two bouts of MCT on separate days in a randomized counterbalanced order. The MCT involved 3 sets of 15 repetition maximum for 10 exercises, with each set separated by 45-s of walking. Brachial-radial pulse wave velocity (br-PWV), radial artery compliance (AC) and reflection index (RI1,2) were assessed 10 min before and 60 min after CTL and MCT. Ambulatory arterial stiffness index (AASI) was calculated from 24-h recovery ambulatory blood pressure monitoring. RESULTS: Compared to CTL, after 60 min of recovery from the 1st and 2nd bouts of MCT, lower values were observed for br-PWV (mean diff = - 3.9 and - 3.7 m/s, respectively, P < 0.01; ICC2,1 = 0.75) and RI1,2 (mean diff = - 16.1 and - 16.0%, respectively, P < 0.05; ICC2,1 = 0.83) concomitant with higher AC (mean diff = 1.2 and 1.0 × 10-6 cm5/dyna, respectively, P < 0.01; ICC2,1 = 0.40). The 24-h AASI was reduced after bouts of MCT vs. CTL (1st and 2nd bouts of MCT vs. CTL: mean diff = - 0.32 and - 0.29 units, respectively, P < 0.001; ICC2,1 = 0.64). CONCLUSION: A single bout of MCT reduces arterial stiffness during laboratory (60 min) and ambulatory (24 h) recovery phases in patients with chronic stroke with moderate-to-high reproducibility. TRIAL REGISTRATION: Ensaiosclinicos.gov.br identifier RBR-5dn5zd.

Are Self-Selected Intervals as Effective as Fixed Intervals in Controlling Acute Responses in High-Intensity Interval Resistance Training?

Physical conditioning programs often apply high-intensity resistance training (HIRT), but there is a lack of research investigating the effects of using fixed or self-selected resting intervals between exercises on the performance, relative intensity, and affective perception during this modality of training. This study compared fixed versus self-selected rest intervals in HIRT sessions on cardiorespiratory responses, number of repetitions, and enjoyment perception in trained young men. Sixteen trained males (27.1 ± 3.9 years; 56.6 ± 7.5 mL.kg-1.min-1) performed HIRT circuits with 30-s and self-selected recovery interval. The duration of resting intervals was longer in HIRT performed with fixed than self-selected intervals (14.04 ± 5.82 s; p < 0.0001; ES = 3.2). Both sessions elicited similar relative HRR (79.4 ± 6.2 % vs. 81.6 ± 4.2 %; p = 0.14), VO2R (43.0 ± 12.2% vs. 47.7 ± 9.6%; p = 0.10), and enjoyment reflected by scores in the PACES questionnaire (107.9 ± 15.1 vs. 109.2 ± 12.8; p = 0.65). The total number of repetitions (403.4 ± 45.5 vs. 353.1 ± 27.4; p < 0.01, ES = 1.3) and caloric expenditure (154.4 ± 28.6 kcal vs. 121.4 ± 21.6 kcal; p < 0.001, ES = 0.13) were greater in HIRT performed with fixed vs. self-selected intervals. In conclusion, HIRT performed with fixed and self-selected rest intervals elicited similar relative intensity and enjoyment perception. However, the number of repetitions and caloric expenditure were greater in sessions performed with fixed 30-s.

Circuit training reduces cardiometabolic risk factors in women / El entrenamiento en circuito reduce los factores de riesgo cardiometabólico en mujeres / Treinamento em circuito reduz os fatores de risco cardiometabólicos em mulheres

ABSTRACT Introduction Combined training is more effective than an isolated modality in reducing cardiometabolic risk indicators. Objective To evaluate the effect of circuit training volume on anthropometric and biochemical risk indicators for cardiometabolic diseases in overweight women. Methods Thirty-two participants underwent 24 weeks of circuit training with free weights combined with aerobic exercise. The training volume during the 24 weeks was used to distribute the women into moderate-volume physical activity (MVA), low-volume physical activity (LVA) and control (CON) groups. Anthropometric indices (body mass, body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR)), blood glucose, insulin, insulin resistance (HOMA-IR), total cholesterol (TC), triglycerides, HDL-c, and LDL-c were evaluated at the beginning of the program and after 12 and 24 weeks. Results There was no interaction between training volume and time for any of the variables studied, but the intervention time influenced body mass (p=0.013) and BMI (p=0.012), and there was a tendency for participation time to reduce body mass (p=0.063) and BMI (p=0.062) after six months of intervention. The volume of the physical activity affected HDL-c (p=0.037), being significant (p=0.030) in the comparison between the MVA and CON groups. Additionally, there was a downward trend in HDL-c after six months of intervention (p=0.073), with a smaller reduction observed in the MVA group, indicating a protective role of moderate physical activity in the reduction of this lipid fraction. The association between physical activity volume and participation time resulted in a clinical improvement in total cholesterol (χ2 = 5.453, p = 0.02), with a higher probability of reaching clinically adequate values in the MVA group (OR = 0.126; 95%CI 0.019 - 0.827). Conclusion Training volume improved cardiometabolic risk factors in overweight women. Level of evidence II; Therapeutic Studies - Investigating the Results of Treatment.

RESUMEN Introducción El entrenamiento combinado es más eficiente que la modalidad aislada en indicadores de riesgo cardiometabólico. Objetivo Evaluar el efecto del volumen de entrenamiento en circuito sobre indicadores antropométricos y bioquímicos con riesgo de enfermedades cardiometabólicas en mujeres con sobrepeso. Métodos Treinta y dos participantes se sometieron a 24 semanas de entrenamiento en circuito con pesos libres combinados con ejercicio aeróbico. El volumen de entrenamiento durante las 24 semanas se utilizó para distribuir a las mujeres en los grupos: actividad física de volumen moderado (AVM), actividad física de volumen bajo (AVB) y control (CON). Se evaluaron los índices antropométricos masa corporal, índice de masa corporal (IMC), circunferencia de la cintura (CC), relación cintura-cadera (RCC), glucemia, insulina, resistencia a la insulina (HOMA-IR), colesterol total (CT), triglicéridos, HDL-c y LDL-c al inicio del programa y después de las semanas 12 y 24. Resultados No hubo interacción entre el volumen y el tiempo de entrenamiento para ninguna de las variables estudiadas, pero el tiempo de intervención influyó en la masa corporal (p=0,013) y en el IMC (p=0,012), y el tiempo de participación tendió a reducir la masa corporal (p=0,063) y el IMC (p=0,062), después de seis meses de intervención. El volumen de actividad física afectó al HDL-c (p =0,037), siendo significativo (p=0,030) en la comparación entre AVM y CON. Además, hubo una tendencia a la reducción del HDL-c después de seis meses de intervención (p=0,073), observándose la menor reducción en AVM, lo que indica el papel protector de la actividad física de volumen moderado en la reducción de esta fracción lipídica. La actividad física y el tiempo de participación mostraron una mejora clínica en colesterol total (χ2 = 5,453, p = 0,02), con mayor probabilidad de alcanzar valores clínicamente adecuados de AVM (OR = 0,126; IC95% 0,019 - 0,827). Conclusión El volumen de entrenamiento atenuó los factores de riesgo cardiometabólico en mujeres con sobrepeso. Nivel de Evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

ABSTRACT Introdução O treinamento combinado é mais eficiente do que a modalidade isolada com relação aos indicadores de risco cardiometabólico. Objetivos Avaliar o efeito do volume de treinamento em circuito sobre indicadores antropométricos e bioquímicos com risco de doenças cardiometabólicas em mulheres com excesso de peso. Métodos Trinta e duas participantes foram submetidas a 24 semanas de treinamento em circuito, com pesos livres combinados com exercício aeróbico. O volume de treinamento durante as 24 semanas foi utilizado para distribuir as mulheres nos grupos: atividade física de volume moderado (AVM), atividade física de baixo volume (AVB) e controle (CON). Os índices antropométricos massa corporal, índice de massa corporal (IMC), circunferência de cintura (CC), relação cintura-quadril (RCQ), glicemia, insulina, resistência à insulina (HOMA-IR), colesterol total (CT), triglicerídeos, HDL-c e LDL-c, foram avaliados no início do programa e depois de 12 e 24 semanas. Resultados Não houve interação entre o volume de treinamento e o tempo para nenhuma das variáveis estudadas, mas o tempo de intervenção influenciou a massa corporal (p = 0,013) e o IMC (p = 0,012), e o tempo de participação tendeu a reduzir a massa corporal (p = 0,063) e o IMC (p = 0,062), depois de seis meses de intervenção. O volume de atividade física afetou o HDL-c (p = 0,037), sendo significativo (p = 0,030) na comparação entre AVM e CON. Adicionalmente, verificou-se tendência de redução HDL-c depois seis meses de intervenção (p = 0,073), sendo a menor redução observada no AVM, que indica o papel protetor de atividade física de volume moderado na redução dessa fração lipídica. A associação entre o volume de atividade física e o tempo de participação mostrou melhora clínica do colesterol total (χ2= 5,453, p = 0,02), com maior probabilidade de atingir valores clinicamente adequados de AVM (OR = 0,126; IC de 95% 0,019 - 0,827). Conclusão O volume de treinamento atenuou os fatores de risco cardiometabólico em mulheres com excesso de peso. Nível de evidência II; Estudos terapêuticos - Investigação dos resultados do tratamento.

Acute effects of mixed circuit training on hemodynamic and cardiac autonomic control in chronic hemiparetic stroke patients: A randomized controlled crossover trial.

Objectives: To investigate whether a single bout of mixed circuit training (MCT) can elicit acute blood pressure (BP) reduction in chronic hemiparetic stroke patients, a phenomenon also known as post-exercise hypotension (PEH). Methods: Seven participants (58 ± 12 years) performed a non-exercise control session (CTL) and a single bout of MCT on separate days and in a randomized counterbalanced order. The MCT included 10 exercises with 3 sets of 15-repetition maximum per exercise, with each set interspersed with 45 s of walking. Systolic (SBP) and diastolic (DBP) blood pressure, mean arterial pressure (MAP), cardiac output (Q), systemic vascular resistance (SVR), baroreflex sensitivity (BRS), and heart rate variability (HRV) were assessed 10 min before and 40 min after CTL and MCT. BP and HRV were also measured during an ambulatory 24-h recovery period. Results: Compared to CTL, SBP (∆-22%), DBP (∆-28%), SVR (∆-43%), BRS (∆-63%), and parasympathetic activity (HF; high-frequency component: ∆-63%) were reduced during 40 min post-MCT (p < 0.05), while Q (∆35%), sympathetic activity (LF; low-frequency component: ∆139%) and sympathovagal balance (LF:HF ratio: ∆145%) were higher (p < 0.001). In the first 10 h of ambulatory assessment, SBP (∆-7%), MAP (∆-6%), and HF (∆-26%) remained lowered, and LF (∆11%) and LF:HF ratio (∆13%) remained elevated post-MCT vs. CTL (p < 0.05). Conclusion: A single bout of MCT elicited prolonged PEH in chronic hemiparetic stroke patients. This occurred concurrently with increased sympathovagal balance and lowered SVR, suggesting vasodilation capacity is a major determinant of PEH in these patients. This clinical trial was registered in the Brazilian Clinical Trials Registry (RBR-5dn5zd), available at https://ensaiosclinicos.gov.br/rg/RBR-5dn5zd. Clinical Trial Registration: https://ensaiosclinicos.gov.br/rg/RBR-5dn5zd, identifier RBR-5dn5zd.

Balance Exercise Circuit for fall prevention in older adults: a randomized controlled crossover trial.

Objectives: This study aimed to assess the immediate and short-term effects of the Balance Exercise Circuit (BEC) on muscle strength, postural balance, and quality of life, with the aim of preventing falls in older adults. Methods: Twenty-two volunteers participated in this randomized controlled crossover study. Group A performed BEC training in the initial 3 months and received no intervention in the following 3 months. Group B received no intervention during the first 3 months and then participated in BEC training for the next 3 months. In addition, participants were followed for an additional 3 months. Muscle strength, postural balance, functional mobility, and quality of life were assessed, respectively, using an isokinetic dynamometer, force platform, TUG test, and the WHOQOL. Results: After 3 months of training, Group A presented improved balance and rate of force development (RFD), while Group B presented improvements in RFD, TUG performance, and WHOQOL physical and psychological domains. Regarding the short-term effects, the participants maintained the training effects in WHOQOL balance, RFD, and the social domain. In addition, the number of falls decreased during follow-up. Conclusion: The BEC intervention improved muscle strength, postural balance, and quality of life in older adults, in addition to reducing the risk of falls. Trial registration: Brazilian Registry of Clinical Trials (ReBEC) - RBR-5nvrwm.

Effects of Resistance Circuit Training on Health-Related Physical Fitness in People With Paraplegia: A Pilot Randomized Controlled Trial.

OBJECTIVE: To evaluate the efficacy and safety of 8 weeks of resistance circuit training in people with paraplegia due to spinal cord injury. METHODS: Participants were randomized into experimental and control groups. Although the intensity and sequence of movements of the exercise programs were identical in both groups, the resting time between sets was limited to 1 minute in the experimental group. In the control group, the participants were allowed to rest until they were comfortable. Both groups received 8 weeks of training twice per week. Before and after the program, muscle mass, body fat percentage, fat mass, blood pressure, heart rate, muscle strength and muscular endurance were evaluated, and 6-minute propulsion test was conducted. Additionally, the safety of the program was assessed. RESULTS: Twenty-two individuals with paraplegia were enrolled (11 in each group). After the training program, the experimental group showed a significant decrease in the resting blood pressure and improvement in the upper extremity muscle mass, strength, and endurance (p<0.05). Each variable showed significant inter-group differences (p<0.05). Furthermore, none of the participants showed autonomic adverse events, musculoskeletal side effects, or discomfort. CONCLUSION: The results show that resistance circuit training programs with short resting intervals are superior to the usual resistance exercise programs in improving the blood pressure and physical strength and are safe for people with upper thoracic level injuries at T6 or higher.

Effects of functional training on pain and functional capacity in elderly women / Efeito do treinamento funcional na dor e capacidade funcional de mulheres idosas

Abstract Introduction: The growing rate of elderly people in the world can became a public health problem when they exhibit insufficient levels of physical activity, which can increase chronic pain and lead to functional disability. Objective: To analyze the effects of functional training on pain and functional capacity in elderly women. Methods: A non-randomized controlled clinical trial was conducted with 32 elderly women, divided into two groups: functional training (FT: n = 17) and control group (CG: n = 15). Functional capacity was analyzed using the Physical Fitness Test for the Elderly. Pain was assessed by reports of musculoskeletal discomfort symptoms and their characteristics using the Nordic Musculoskeletal Pain Questionnaire and pain visual analog scale (VAS). The functional training program was applied for 12 weeks at a frequency of three times a week. Results: Significant effects after the intervention in the FT group were observed, with pain reduction, increased flexibility and resistance for lower limbs, and cardiorespiratory capacity (p < 0.05). Conclusion: The functional training program in elderly women was effective in improving the variables of lower limb flexibility, pain perception, lower limb strength resistance and cardiorespiratory capacity.

Resumo Introdução: O crescimento da taxa de idosos no mundo pode tornar-se um problema de saúde pública quando estes exibem níveis insuficientes de atividade física, que têm o potencial de aumentar dores crônicas e causar incapacidade funcional. Objetivo: Analisar os efeitos do treinamento funcional na dor e capacidade funcional de mulheres idosas. Métodos: Desenvolveu-se um ensaio clínico controlado não randomizado com 32 idosas, divididas em dois grupos: treino funcional (TF: n = 17) e grupo controle (GC: n = 15). Como indicador da capacidade funcional foi utilizado o Teste de Aptidão Física para Idosos. A dor foi avaliada pelos relatos de sintomas de desconforto musculoesquelético e suas características por meio do Questionário Nórdico de Sintomas Osteomusculares de Dor e Escala visual Analógica de Dor (EVA). O programa de treinamento funcional foi aplicado por 12 semanas em uma frequên-cia de três vezes semanais. Resultados: Verificaram-se efeitos significativos após a intervenção no grupo TF, com redução da dor e aumento da flexibilidade e resistência para membros inferiores e capacidade cardiorrespiratória (p < 0,05). Conclusão: O programa de treinamento funcional em idosas foi efetivo para a melhoria das variáveis de flexibilidade de membros inferiores, percepção de dor, resistência de força de membros inferiores e capacidade cardiorrespiratória.

Periodized combined training in physically active overweight women over 50 years

Abstract Aim: This quasi-experimental study, analyzes if periodized combined training's influence on plasma cytokine levels, muscle strength, and cardiorespiratory fitness in physically active women with overweight and/or obesity over 50 years. Methods: The sample was composed of 33 physically active women who were randomly allocated to three groups: Non-Periodized (NP) (n = 11); Undulating Periodization (UP) (n = 9); and Flexible Undulating Periodization (FUP) (n = 13). This study was conducted for 17 weeks, which included adaptation (weeks 1-3), baseline testing (week 4), training program (weeks 5-16), and post-evaluation (week 17). The training frequency comprised of three weekly sessions, with 30 min of aerobic exercise and 45 min of strength exercises. The data were analyzed using descriptive statistics and analysis of variance. The level of significance was p ≤ 0.05. Results: No differences were observed in weight parameters, plasma levels of cytokines, and biochemical parameters in any group, before and after the completion of the training period. Participants demonstrated increase in strength of the upper limbs in the UP (p = 0.032) and FUP (p = 0.021) groups, an increase in aerobic fitness in the NP (p = 0.041) and UP (p = 0.005) groups, and an increase in the amount of time of vigorous activity per week in the NP group (p = 0.019). Conclusion: This study shows that periodized combined training in physically active women with overweight and/or obesity over 50 years proved to be beneficial for all groups; although, the UP group exhibited better performance.

Twelve weeks of water-based circuit training exercise improves fitness, body fat and leg strength in people with stable coronary heart disease: a randomised trial.

QUESTION: In people with stable coronary heart disease, what are the effects of water-based circuit training exercise on aerobic capacity, strength and body composition? How do these effects compare with those of gym-based exercise? DESIGN: Parallel group, randomised controlled trial with concealed allocation and intention-to-treat analysis. PARTICIPANTS: Fifty-two participants with stable coronary heart disease. INTERVENTIONS: Twelve weeks of: three 1-hour sessions per week of moderate-intensity water-based circuit training exercise with alternating aerobic and resistance stations (WEX); three 1-hour sessions per week of moderate-intensity gym-based circuit training exercise (GEX); or continuing usual activities (control). OUTCOME MEASURES: Aerobic capacity (VO2peak), upper and lower limb one repetition maximum strength (biceps curl, latissimus dorsi pulldown, hamstring curl and leg press), anthropometry (weight, body mass index and girth) and dual energy x-ray absorptiometry. RESULTS: Forty-five participants completed the study (WEX n = 15, GEX n = 18, control n = 12). Both training groups significantly improved VO2peak compared with control: WEX by 2.5 ml/kg/min (95% CI 0.6 to 4.4) and GEX by 2.3 ml/kg/min (95% CI 0.6 to 4.0). WEX and GEX improved hamstring strength compared with control: WEX by 6.3 kg (95% CI 1.2 to 11.3) and GEX by 7.6 kg (95% CI 2.9 to 12.2). Compared with control, GEX increased leg press strength by 15.5 kg (95% CI 5.7 to 25.3), whereas the effect of WEX was less clear (MD 7.1 kg, 95% CI -3.5 to 17.7). Only GEX improved latissimus dorsi pulldown strength. Compared with control, total body fat was reduced with WEX (-1.1 kg, 95% CI -2.3 to 0.0) and GEX (-1.2 kg, 95% CI -2.3 to -0.1). There were negligible between-group differences in weight or waist circumference. CONCLUSION: WEX was well tolerated and improved aerobic capacity, leg strength and body fat to a similar degree as GEX in people with coronary heart disease. These findings suggest that WEX is an effective exercise training alternative to GEX for people with coronary heart disease. TRIAL REGISTRATION: ANZCTR12616000102471.

Combined Training Improves the Expression Profile of Inflammation-associated Antimicrobial Peptides, MicroRNAs, and TLR-4 in Patients with Multiple Sclerosis.

Some antimicrobial peptides (AMPs), microRNAs (miRs), and Toll-like receptor 4 (TLR-4) are involved in autoimmune diseases, which may be affected by exercise training. The purpose of this study was to investigate the effect of an eight-week combined exercise training (aerobic and resistance) on the expression of inflammatory factors, including, human beta-defensin-2 (hBD-2), cathelicidin (LL-37), TLR-4, miR-23b, miR-155, and miR-326 in women with relapsing and remitting multiple sclerosis (RRMS), which has not been investigated yet. Twenty-three women (20-40 years) with RRMS were randomized into the combined training (CT) and control (CON) groups. The CT group subjects completed eight weeks of supervised CT using a treadmill and stationary bicycle for aerobic exercise and weight machines for resistance exercise. The expression levels of hBD-2, LL-37, TLR-4, miR-23b, miR-155, and miR-326 were measured by real-time polymerase chain reaction (RT-PCR) at the baseline and end of the study. Although the expression of hBD-2 and miR-23b decreased in both CT and CON groups, the reduction was lower in the CT group than in the CON group (p=0.001). The expression of LL-37 in the CT group remained unchanged, but that of the CON group increased; thus, the between-group difference was significant. Although the TLR-4, miR-155, and miR-326 expression increased in both groups compared to the baseline, the increase in the CT group was lower than the CON group. Our results showed that the combined training might improve inflammatory symptoms by affecting the expression of some AMPs, miRs, and TLR-4 in patients with relapsing and remitting multiple sclerosis.