Neurohumoral and metabolic response to exercise in water

The Effects of 6-Month Aqua Aerobics Training on Cardiometabolic Parameters in Perimenopausal Women-A Randomized Controlled Trial

BACKGROUND

Menopause is a time when women experience a number of physiological and anatomical changes resulting from a decline in ovarian function. It can be concluded that cardiovascular disease increases in perimenopausal and postmenopausal women, irrespective of age-related changes. Engaging in the amount of moderate physical activity recommended by the World Health Organization helps reduce the risk of death and adverse health events. The aim of the present study was to assess the effect of a 6-month aqua aerobics programme on cardiometabolic (anthropometric and biochemical) parameters in perimenopausal women.

METHODS

In this study, 30 women (control group-16, study group-14) participated in the 6-month aqua aerobics training programme. The mean age of women was 47.67 ± 6.79 year and BMI 26.33 ± 3.64 kg/m2. At the beginning and at the end of the study, anthropometric and blood samples analysis were performed. In the blood, lipid profile, morphotic elements were determined. Body composition, waist-hip ratio (WHR), visceral adiposity index (VAI), blood pressure (BP) were measured.

RESULTS

The aqua aerobics programme resulted in a significant decrease in the WHR (p < 0.05; ES: 2.143), diastolic blood pressure (DBP) (p < 0.05; ES: 1.005), and platelet-to-lymphocyte ratio (PRL) (p < 0.05; ES: 0.460) and an increase in haemoglobin (HGB) concentration (p < 0.05; ES: 0.643).

CONCLUSIONS

The type of physical activity described in the present study is a great way for perimenopausal women to take care of their overall well-being. The reduction in selected cardiometabolic parameters is important from the point of view of the protection of women's health.

Cardiorespiratory Parameters Comparison Between Incremental Protocols Performed in Aquatic and Land Environments by Healthy Individuals: A Systematic Review and Meta-Analysis

BACKGROUND

Physical properties of water cause physiological changes in the immersed human body compared with the land environment. Understanding the magnitude of cardiorespiratory alterations might ensure adequate intensity control during aquatic exercise programs.

OBJECTIVE

We aimed to compare the oxygen uptake (VO₂), heart rate (HR), and rating of perceived exertion (RPE) parameters during aquatic and land incremental tests.

METHODS

Four databases (PubMed, LILACS, EMBASE, and SPORTDiscus) were searched in September 2020. Eligibility criteria included studies in a crossover design comparing aquatic and land incremental tests for healthy individuals with at least one of the following parameters: VO₂ (maximal, VO_2max; anaerobic threshold, VO_2AT), HR (HR_max; HR_AT), and RPE (RPE_max; RPE_AT). The random-effects meta-analysis included mean difference and 95% confidence interval for VO₂ and HR or standardized mean difference for RPE. The Joanna Briggs Institute Critical Appraisal tool was adapted to assess methodological quality.

RESULTS

Twenty-eight studies were eligible and included in the meta-analysis. Aquatic protocols showed lower values compared with land for VO_2max (- 7.07 mL.kg^-1.min^-1; - 8.43 to - 5.70; n = 502), VO_2AT (- 6.19 mL.kg^-1.min^-1; - 7.66 to - 4.73; n = 145), HR_max (- 11.71 bpm; - 13.84 to - 9.58; n = 503), and HR_AT (- 15.29 bpm; - 19.05 to - 11.53; n = 145). RPE_max (0.01; - 0.16 to 0.18; n = 299) and RPE_AT (- 0.67; - 1.35 to 0.02; n = 55) values were similar between aquatic and land protocols.

CONCLUSIONS

Our study reinforces the specificity of the environment during incremental tests for prescribing exercises based on physiological parameters as VO₂ and HR parameters presented lower values in aquatic protocols than land protocols. Conversely, RPE seems an interchangeable measure of exercise intensity, with similar values during the protocols in both environments. Substantial levels of heterogeneity were present for the VO_2max and HR_max meta-analyses, and as such, results should be interpreted with attention. PROTOCOL REGISTRATION: This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020212508).

Aquatic Therapy in Contemporary Neurorehabilitation: An Update

Aquatic therapy has been used extensively in a number of neurologic diseases and pathologies. This review describes disease-specific rehabilitative applications for this population. Recent research has offered scientific support for use in common neurological diseases that are part of rehabilitative practice, and very recent findings may create even firmer support for its use in these as well as other conditions. Stroke, Parkinsonism, and multiple sclerosis are areas that have recently received a significant number of published studies. Dementia is another area that has been more recently studied and received basic science support. Cerebral palsy has also had recent supportive evidence published. Available literature is reviewed to create a more evidence-based support for the use of aquatic therapy in neurorehabilitation.

The beneficial effects of a water-based aerobic exercise session on the blood lipids of women with dyslipidemia are independent of their training status

OBJECTIVES

To evaluate the acute effects of a session of water-based aerobic exercise on the blood lipid levels of women with dyslipidemia and to compare these results according to their training status.

METHOD

Fourteen premenopausal women with dyslipidemia, aged 40-50 years, participated in two water-based aerobic exercise sessions, the first when they were generally sedentary and the second after they were trained with a water-based aerobic training program for 12 weeks. Both experimental sessions were performed using the same protocol, lasted 45 min, and incorporated an interval method, alternating 3 min at a rating of perceived exertion (RPE) of 13 and 2 min at an RPE of 9. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and lipoprotein lipase enzyme (LPL) were obtained through venous blood collection before and immediately after each session. A generalized estimating equation method and Bonferroni tests were conducted (with time and training status as factors) for statistical analyses.

RESULTS

At enrollment, the mean age of the participants was 46.57 years (95% confidence interval [CI] 44.81-48.34). The statistical analyses showed a significant time effect for all variables (TC: p=0.008; TG: p=0.012; HDL: p<0.001; LPL: p<0.001) except for LDL (p=0.307). However, the training status effect was not significant for any variable (TC: p=0.527; TG: p=0.899; HDL: p=0.938; LDL: p=0.522; LPL: p=0.737). These results indicate that the TC and TG levels reduced and the HDL and LPL concentrations increased from pre- to post-session in similar magnitudes in both sedentary and trained women.

CONCLUSIONS

A single water-based aerobic exercise session is sufficient and effective to beneficially modify the lipid profile of women with dyslipidemia, regardless of their training status.

Water-Based Aerobic and Resistance Training as a Treatment to Improve the Lipid Profile of Women With Dyslipidemia: A Randomized Controlled Trial

Background: Regular exercise is recommended for the treatment of dyslipidemia. The aquatic environment presents some beneficial characteristics for patients suffering from dyslipidemia. However, it is unknown which modality promotes better results. This study aims to compare the effects of water-based aerobic training (WA) and water-based resistance training (WR) on lipid profile of dyslipidemic elderly women. Methods: Sixty-nine dyslipidemic elderly women participated in this 3-arm randomized controlled clinical trial with groups in parallel. The interventions were WA, WR, and control group, with 2 weekly sessions for 10 weeks. Total cholesterol (TC), triglycerides, low-density lipoprotein, high-density lipoprotein (HDL) levels, and TC/HDL ratio, were determined before and after interventions. Results: Intention-to-treat analysis showed that WA and WR participants obtained similar decreases in TC (-10.0% and -9.6%, respectively), triglycerides (-13.4% and -15.7%, respectively), low-density lipoprotein (-16.1% and -16.9%, respectively), TC/HDL (-16.9% and -23.4%, respectively) and increases in HDL (7.6% and 16.9%, respectively). The control group maintained their TC and low-density lipoprotein levels unchanged, whereas triglycerides and TC/HDL were increased (3.6% and 11.3%, respectively), and HDL decreases 4.8%. Conclusions: WA and WR improve similarly the lipid profile of dyslipidemic elderly women, representing interesting nonpharmacological tools in the treatment of dyslipidemia.

Effects of land vs water jump exercise: Implications for exercise design targeting bone health

PURPOSE

To quantify ground reaction force (GRF), osteogenic index (OI), muscle activity, and blood lactate levels during continuous jumping performed in water and on land.

METHODS

Thirteen post-menopausal women (59.5 ± 6.8 years) performed two bouts of jumping, on land (LND) and in water at a depth of 1 m (WEX). Each 10-minute, 40-second bout consisted of 2 consecutive sets of squat, lunge, jumping jax, countermovement, and single legged jumps as intervals: 10 seconds maximal effort and 60 seconds recovery at 50% of heart rate reserve (HRR). Pre- and post-exercise lower extremity rate of perceived exertion (RPE) was recorded, and 10-µL earlobe blood samples were collected to assess lactate concentration. During exercise, data were collected for electromyography, GRF, and heart rate. Total GRF (TGRF) and total muscular activity (TMA) during each 10 seconds of jumping were measured. OI for one bout of continued jumps was determined by averaging GRF·ln (number of jumps + 1).

RESULTS

There were no differences between WEX and LND for percent HRR and RPE. TGRF, OI, TMA, and lactate concentration on LND jumps were significantly higher than WEX.

CONCLUSION

At similar cardiorespiratory and RPE levels, the lower impact loading of 10 minutes 40 seconds of interval continuous jumping exercise in 1-m depth was less osteogenic than on land. However, one daily bout of water jumping, 5 days per week resulted in a similar OI as 3 days of jumping on land. WEX might substitute or provide an adjunct to LND exercise to promote bone health.

Aquatic cycling-What do we know? A scoping review on head-out aquatic cycling

Over the past few years, aquatic cycling has become a trending fitness activity. However, the literature has not been reviewed exhaustively. Therefore, using scoping review methodology, the aim of this review was to explore the current state of the literature concerning aquatic cycling. This study specifically focused on study designs, populations and outcomes. A comprehensive search of seven databases (PubMed, MEDLINE, Cinahl, Embase, PEDro,Web of Science, WorldCat) was conducted up to 30^th September 2016. GoogleScholar, World Cat, ResearchGate, specific aquatic therapy websites and aquatic therapy journals were searched to identify additional literature. Full-text publications in English, German or Dutch were included. Studies were included when the intervention involved head-out cycling carried out in 10° to 35° Celsius water. Exclusion criteria were the use of wet suits or confounding interventions that would affect participants’ homeostasis. 63 articles were included and the study parameters of these studies were summarized. Using three grouping themes, included studies were categorised as 1) single session tests comparing aquatic versus land cycling, or 2) aquatic cycling only sessions investigating different exercise conditions and 3) aquatic cycling intervention programmes. Although the experimental conditions differed noticeably across the studies, shared characteristics were identified. Cardiovascular parameters were investigated by many of the studies with the results suggesting that the cardiac demand of aquatic cycling seems similar to land-based cycling. Only six studies evaluated the effect of aquatic cycling interventions. Therefore, future research should investigate the effects of aquatic cycling interventions, preferably in individuals that are expected to gain health benefits from aquatic cycling. Moreover, this comprehensive outline of available literature could serve as a starting point for systematic reviews or clinical studies on the effects of aquatic cycling on the cardiovascular responses.

Ratings of Perceived Exertion and Physiological Parameters of Muscle Metabolism in Postmenopausal Women

We compared responses from postmenopausal women living a sedentary lifestyle ( n = 15; Mean age= 59; SD = 4.2) to a single bout of water- or land-based exercise with respect to ratings of perceived exertion (RPE), lactate concentration, and muscle oxygen saturation. Each participant was randomly assigned to a single water- or land-based 50-minute bout of combined aerobic and resistance exercise. Blood samples were collected to detect pre- and post-exercise lactate concentration. Total hemoglobin, deoxidized hemoglobin, and the percentage change in the total oxygen saturation index (TSI%) of the rectus femoris were detected by means of near-infrared spectroscopy. We found similar RPE at various stages of land- and water-based exercise, and a similar change in lactate concentration in these environments (in water: 4.35 ± 1.49 mol/L; on land: 3.62 ± 1.18 mol/L). However, the reduction in HHb response was less pronounced after water-based exercise, and TSI% increased on land but decreased in water, with the magnitude of this change much higher on land. For similar RPE and lactate concentration, the oxygen saturation in the exercising muscles decreased in water, suggesting higher oxygen consumption in water than on land.

Metabolic responses to exercise on land and in water following glucose ingestion

Although aerobic exercise after a meal decreases postprandial blood glucose, the differences in glucose response between land and aquatic exercise are unclear. Thus, we examined the effect of different modes of exercise with same energy expenditure following glucose ingestion on carbohydrate metabolism. Ten healthy sedentary men (age, 22 ± 1 years) participated in this study. All subjects performed each of three exercise modes (cycling, walking and aquatic exercise) for 30 min after ingestion of a 75-g glucose solution with 1-2 weeks between trials. The exercise intensity was set at 40% of the maximum oxygen uptake that occurred during cycling. The velocity during walking and the target heart rate during aquatic exercise were predetermined in a pretest. The plasma glucose concentration at 30 min after exercise was significantly lower with aquatic exercise compared to that with cycling and walking (P<0·05). However, there were no significant differences among the three exercise modes in respiratory exchange ratio. On the other hand, serum free fatty acid concentration with aquatic exercise was significantly higher at 120 min after exercise compared with that after walking (P<0·05). These results suggest that aquatic exercise reduces postprandial blood glucose compared with both cycling and walking with the same energy expenditure. Aquatic exercise shows potential as an exercise prescription to prevent postprandial hyperglycaemia.

The Effects of Exercise on Natriuretic Peptides in Individuals without Heart Failure

Cardiac natriuretic peptides (NPs) play an important role in the regulation of energy expenditure in skeletal muscle and adipose tissue. A systematic review on the effects of exercise on NPs in patients with heart failure reported that aerobic and resistance training reduced NPs; however, the effects of exercise on NPs and the underlying mechanism of exercise-induced NP secretion in subjects without heart failure remain unknown. In athletes and young, healthy subjects, the NP concentration at rest is not elevated, but strenuous endurance exercise significantly increases NPs. The exercise-induced increase in NPs may be caused by transient myocardial wall stress, cardiomyocyte metabolic changes, or neuroendocrinological response, which may have cytoprotective and growth-regulating effects on the heart. On the other hand, in elderly, overweight/obese subjects, and patients with hypertension, NP concentrations also increase during exercise; however, NP secretion may be more susceptible to cardiac stress compared to young, healthy individuals. Recent studies have shown that NPs are associated with thermogenesis in fat tissue and oxidative capacity in skeletal muscles. NPs may also have a protective role for skeletal muscle in humans, although further studies are warranted to elucidate the physiological mechanism of exercise-induced NP secretion.

Clinical effects of phosphodiesterase 3A mutations in inherited hypertension with brachydactyly

Autosomal-dominant hypertension with brachydactyly is a salt-independent Mendelian syndrome caused by activating mutations in the gene encoding phosphodiesterase 3A. These mutations increase the protein kinase A-mediated phosphorylation of phosphodiesterase 3A resulting in enhanced cAMP-hydrolytic affinity and accelerated cell proliferation. The phosphorylated vasodilator-stimulated phosphoprotein is diminished, and parathyroid hormone-related peptide is dysregulated, potentially accounting for all phenotypic features. Untreated patients die prematurely of stroke; however, hypertension-induced target-organ damage is otherwise hardly apparent. We conducted clinical studies of vascular function, cardiac functional imaging, platelet function in affected and nonaffected persons, and cell-based assays. Large-vessel and cardiac functions indeed seem to be preserved. The platelet studies showed normal platelet function. Cell-based studies demonstrated that available phosphodiesterase 3A inhibitors suppress the mutant isoforms. However, increasing cGMP to indirectly inhibit the enzyme seemed to have particular use. Our results shed more light on phosphodiesterase 3A activation and could be relevant to the treatment of severe hypertension in the general population.

Does continuous endurance exercise in water elicit a higher release of ANP and BNP and a higher plasma concentration of FFAs in pre-obese and obese men than high intensity intermittent endurance exercise? - study protocol for a randomized controlled trial

Background

Atrial natriuretic peptides (ANP) and Brain natriuretic peptides (BNP) stimulate fat cell plasma membrane receptors. They are potent lipolytic agents on isolated fat cells from subcutaneous adipose tissue. The physiological effects of continuous endurance exercise on ANP release and plasma free fatty acids (FFA) concentrations have been well described. The enhancement of fat metabolism using high intensity intermittent exercise protocols has been assessed in more recent investigations. The combined effects of endurance exercise and water immersion on ANP and FFA plasma concentration and the magnitude of excess post-exercise oxygen consumption (EPOC) might be further enhanced by choosing the most effective exercise protocol. Exercise modalities may play a significant role in the future prevention and treatment of obesity.

Methods/design

The two testing trials will be performed according to a randomized and cross-over design. Twenty healthy sedentary pre-obese and obese class-1 men will be scrutinized with regard to their metabolic responses to continuous exercise in water and to high intensity endurance exercise in water. Both trials will be matched for energy expenditure. After preliminary testing, the tests will be conducted as repeated measurements. The two different exercise protocols will be compared. The aims of the study are to investigate (1) whether continuous endurance exercise or high intensity intermittent endurance exercise in water elicits both a higher release of ANP and BNP and a higher plasma concentration of glycerol and (2) to determine whether continuous endurance exercise in water or a high intensity intermittent endurance exercise in water would lead to a more pronounced short term (two hours) EPOC effect.

Discussion

If our hypothesis would be confirmed, the most effective exercise protocol based on the combined effects of high intensity endurance exercise and water immersion on ANP and BNP release and glycerol plasma concentrations can be identified. Moreover, the magnitude of the EPOC effect can be augmented. Our study would provide a major contribution for creating optimized exercise modalities in the prevention and treatment of obesity.

Trial registration

Current controlled trials, ISRCTN95488515

Effect of ambient temperature during acute aerobic exercise on short-term appetite, energy intake, and plasma acylated ghrelin in recreationally active males

Ambient temperature during exercise may affect energy intake regulation. Compared with a temperate (20 °C) environment, 1 h of running followed by 6 h of rest tended to decrease energy intake from 2 ad libitum meals in a hot (30 °C) environment but increase energy intake in a cool (10 °C) environment (p = 0.08). Core temperature changes did not appear to mediate this trend; whether acylated ghrelin is involved is unclear. Further research is warranted to clarify these findings.

Training in MS: influence of two different endurance training protocols (aquatic versus overland) on cytokine and neurotrophin concentrations during three week randomized controlled trial

BACKGROUND

The influences of exercising on cytokine response, fatigue and cardiorespiratory values are important aspects of rehabilitation in persons with multiple sclerosis (PwMS). Exercise performed within these programs is often practised in water but the effects of immersion on PwMS have not been systematically investigated.

OBJECTIVE

The objective of this study is to determine differences in cytokine and neurotrophin concentrations, fatigue and cardiorespiratory values in response to 3 week endurance training conducted on a cycle ergometer or an aquatic bike.

METHODS

A randomized controlled clinical trial was conducted in 60 MS patients (Expanded Disability Status Scale range 1.0-6.5). Resting serum levels of brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), Interleukin-6, soluble receptor of IL-6 and tumor necrosis factor alpha, and concentrations in response to cardiopulmonary exercise test (CPET), fatigue and cardiorespiratory values were determined at entry and discharge. Subjects performed daily 30 minute training at 60% of VO₂max.

RESULTS

Cytokines and neurotrophins showed no significant differences between groups over the training intervention. Within the water group BDNF resting and post-CPET concentrations (p<0.05) showed a significant increase and NGF tended to increase after the training intervention. Short-term effects on BDNF (CEPT) tended to increase at the start and significantly thereafter (p<0.05). No changes occurred in the land group. Other cytokines and fatigue scores remained unchanged over the training period. Cardiorespiratory values improved significantly over time within both groups.

CONCLUSION

This study indicates that aquatic training activates BDNF regulation and can be an effective training method during rehabilitation in PwMS.