1
|
Dalamitros AA, Toupektsi E, Alexiou P, Nousiou S, Clemente-Suarez VJ, Tornero-Aguilera JF, Tsalis G. The Effectiveness of Water- versus Land-Based Exercise on Specific Measures of Physical Fitness in Healthy Older Adults: An Integrative Review. Healthcare (Basel) 2024; 12:221. [PMID: 38255107 PMCID: PMC10815058 DOI: 10.3390/healthcare12020221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/15/2023] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
As the population ages, maintaining an active lifestyle becomes increasingly vital to promote overall health and well-being in older individuals. Water- and land-based exercises have emerged as popular options, each offering a distinct set of benefits tailored to the unique needs of this population group. An electronic database search, including PubMed, Scopus, MEDLINE, and Web of Science, was conducted until 15 September 2023, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to investigate the effects of water-based compared to land-based exercise on selected fitness parameters in older healthy individuals. The eligibility criteria included studies with at least two groups of participants aged 60 and older, with physical fitness outcome measures. A total of ten studies met the inclusion criteria and were analyzed. While both exercise modalities may offer significant benefits, this review's findings emphasized the absence of conclusive evidence and consensus for recommending a single exercise category applicable to aquatic or land environments and providing more definite guidance to improve health-related physical fitness parameters in healthy older individuals. Finally, combining both training approaches may lead to a comprehensive array of health benefits for this age group population by also considering individual's needs, preferences, and fitness goals.
Collapse
Affiliation(s)
- Athanasios A. Dalamitros
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.T.); (P.A.); (S.N.); (G.T.)
| | - Eirini Toupektsi
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.T.); (P.A.); (S.N.); (G.T.)
| | - Panagiota Alexiou
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.T.); (P.A.); (S.N.); (G.T.)
| | - Stamatia Nousiou
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.T.); (P.A.); (S.N.); (G.T.)
| | - Vicente Javier Clemente-Suarez
- Faculty of Sports Sciences, European University of Madrid, 28670 Madrid, Spain; (V.J.C.-S.); (J.F.T.-A.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
| | | | - George Tsalis
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.T.); (P.A.); (S.N.); (G.T.)
| |
Collapse
|
2
|
Awada M, Sanaei S, Jameie M, Rahnamoun Z. Effects of cardiac rehabilitation on inflammatory biomarkers in unstable ischemic heart disease patients following percutaneous coronary intervention: a randomized controlled study. Coron Artery Dis 2024; 35:8-13. [PMID: 37990628 DOI: 10.1097/mca.0000000000001295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
INTRODUCTION Several blood inflammatory markers, such as high-sensitivity C-reactive protein (hs-CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), are linked to increased risk for cardiovascular diseases. This study aimed to evaluate these inflammatory markers after cardiac rehabilitation (CR) in patients with unstable ischemic heart disease (UIHD) who underwent successful percutaneous coronary intervention (PCI). METHODS A cohort of 115 patients with successful PCI due to UIHD enrolled in the study from January 2018 to March 2021. We used a permuted block stratified randomization technique (2 : 1 ratio). Seventy-seven patients were randomized to the CR group and 38 patients to the control group. The CR group underwent a 12-week pre-specified CR regimen. Blood samples were taken at baseline and follow-up at 12 weeks for both groups. RESULT Among the 115 patients, 33 patients were female. The mean age was (53 ± 5.55 years) in the control and (53 ± 6.09 years) in the CR group. The two groups were comparable regarding their baseline characteristics and the values of the inflammatory markers. By contrast, at 12 weeks, the inflammatory marker values were significantly lower in the CR group compared to the control group; hs-CRP: 0.11 [0.08-0.14] vs. 0.21 [0.19-0.21], P -value <0.001; NLR: 2.17 [1.42-2.43] vs. 2.26 [2.07-2.6], P -value: 0.016; PLR: 91.2821 [63.3333-103.2000] vs. 92.600 [84.6154-110.0000], P -value: 0.027. CONCLUSION CR after PCI in UIHD patients may attenuate some inflammatory markers, which might benefit cardiovascular health. Further studies are required to evaluate these findings with longer follow-up and the powered to measure major cardiovascular event rates.
Collapse
Affiliation(s)
- Mohamad Awada
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences
| | - Shahin Sanaei
- Department of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mana Jameie
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences
| | - Zahra Rahnamoun
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences
| |
Collapse
|
3
|
Scheer AS, I R de Oliveira B, Shah A, Jacques A, Chasland LC, Green DJ, Maiorana AJ. The effects of water-based circuit exercise training on vascular function in people with coronary heart disease. Am J Physiol Heart Circ Physiol 2023; 325:H1386-H1393. [PMID: 37830985 DOI: 10.1152/ajpheart.00468.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023]
Abstract
Impaired endothelial function in people with coronary heart disease (CHD) is associated with increased mortality. Water immersion can increase peripheral artery shear stress which may provide an additional stimulus to the endothelium during exercise. This study compared the effects of water-based circuit exercise training (WEX) and gym-based circuit exercise training (GEX) on vascular function in people with stable CHD. Participants were randomized to 12 wk of WEX (n = 20), GEX (n = 20), or a control group (usual activities; n = 12). Endothelium-dependent flow-mediated dilation (FMD) and glyceryl trinitrate-mediated dilation (GTN) of the brachial artery were assessed pre- and postintervention. FMD increased following WEX [4.0% (3.0%-5.1%) to 5.3% (4.1%-6.5%); P = 0.016], but was unchanged following GEX [4.9% (3.8%-5.9%) to 5.0% (3.8%-6.1%); P = 0.822]. There were no between-group differences in the change in FMD and no significant changes in GTN-mediated dilation percentage. Triglycerides decreased following GEX [1.2 mmol·L-1 (1.0-1.4 mmol·L-1) to 1.0 mmol·L-1 (0.8-1.3 mmol·L-1); P = 0.022], but there were no further differences in lipid profiles. WEX improved endothelial function of the brachial artery in people with stable CHD, suggesting that WEX is an effective alternative to gym-based exercise in people living with CHD, which may specifically address vascular health.NEW & NOTEWORTHY This study found that 12 wk of water-based circuit exercise training was well tolerated and improved vascular endothelial function in people with stable coronary heart disease. However, there was no effect on endothelium-independent function. Water-based exercise appears to be an effective alternative to gym-based exercise for people with coronary heart disease, which has specific benefits to vascular health and function.
Collapse
Affiliation(s)
- Anna S Scheer
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | | | - Amit Shah
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Angela Jacques
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Lauren C Chasland
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
- Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
| | - Andrew J Maiorana
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Western Australia, Australia
- Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
| |
Collapse
|
4
|
Khalafi M, Symonds ME, Sakhaei MH, Ghasemi F. The effects of exercise training on circulating adhesion molecules in adults: A systematic review and meta-analysis. PLoS One 2023; 18:e0292734. [PMID: 37831667 PMCID: PMC10575525 DOI: 10.1371/journal.pone.0292734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
INTRODUCTION The current meta-analysis investigated the effects of exercise training on circulating adhesion molecules i.e. soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in adults. METHOD PubMed, Web of Science, Scopus and Embase were searched to identify original articles, published in English languages journal from inception up to 31 August 2023 that compared the effects of exercise training with non-exercising control on sICAM-1 and sVCAM-1 in adults. Standardized mean differences (SMDs) and 95% CIs were calculated using random-effect models. RESULTS Twenty-three studies including 31 intervention arms and involving 1437 subjects were included in the meta-analysis. Exercise training effectively reduced sICAM-1 [SMD: -0.33 (95% CI -0.56 to -0.11), p = 0.004; I2 = 56.38%, p = 0.001; 23 intervention arms]. Subgroup analyses showed that sICAM-1 decreased in adults with age <60 years (p = 0.01) and BMI ≥ 27 kg/m2 (p = 0.002) and those with metabolic disorders (p = 0.004) and cardiovascular diseases (p = 0.005). In addition, aerobic (p = 0.02) and resistance training (p = 0.007) are effective in reducing sICAM-1. However, exercise training did not indicate a superior effect on sVCAM-1 [SMD: -0.12 (95% CI -0.29 to 0.05), p = 0.17; I2 = 36.29%, p = 0.04; 23 intervention arms]. CONCLUSION Our results show that exercise training reduces sICAM-1, but not for sVCAM-1, where both aerobic and resistance training is effective in reducing sICAM-1 in adults with metabolic disorders and cardiovascular diseases. TRIAL REGISTRATION The current meta-analysis was registered at www.crd.york.ac.uk/prospero with ID registration number: CRD42023410474.
Collapse
Affiliation(s)
- Mousa Khalafi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
| | - Michael E. Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Mohammad Hossein Sakhaei
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran
| | - Faeghe Ghasemi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran
| |
Collapse
|
5
|
Li P, Liu Z, Wan K, Wang K, Zheng C, Huang J. Effects of regular aerobic exercise on vascular function in overweight or obese older adults: A systematic review and meta-analysis. J Exerc Sci Fit 2023; 21:313-325. [PMID: 37520931 PMCID: PMC10372915 DOI: 10.1016/j.jesf.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/16/2023] [Accepted: 06/21/2023] [Indexed: 08/01/2023] Open
Abstract
Background Overweight and obese older adults have a high risk for developing cardiovascular disease. Aerobic exercise is a valuable strategy to improve vascular health, but the effects of aerobic exercise on vascular endothelial function in obese and overweight older adults remain controversial. The purpose of this meta-analysis was to investigate the effects of aerobic exercise on vascular function in obese and overweight older adults with or without comorbidity. Methods A systematic literature search for related studies published in English was conducted between January 1989 and October 30, 2022, in the PubMed, Embase, and Cochrane Library databases. A random effects model was chosen for meta-analysis, which calculated the effect sizes of control and intervention groups after exercise intervention using standardized mean differences (SMDs) corrected for Hedges' g bias and 95% confidence intervals (95% CIs). Results Twenty-six studies containing 1418 participants were included in the study. After excluding three studies contributing to higher heterogeneity by sensitivity analysis, there are small effects of regular aerobic exercise on vascular function of obese and overweight older adults, including flow-mediated dilation (FMD) [SMD = 0.21, 95% CI (0.02, 0.41), z = 2.16, df = 19, I2 = 52.2%, P = 0.031] and pulse wave velocity (PWV) [SMD = -0.24, 95% CI (-0.46, -0.02), z = 2.17, df = 10, I2 = 8.6%, P = 0.030], and no significant effect was observed on augmentation index (Aix). Subgroup analysis showed small effects of regular aerobic exercise on FMD [SMD = 0.37, 95% CI (0.13, 0.61), z = 3.05, df = 9, I2 = 52.6%, P = 0.002] in the overweight not obese subgroup (25 = BMI <30 kg/m2), but no significant effect on the obese subgroup (BMI ≥30 kg/m2). Regular aerobic exercise for more than 24 weeks improved FMD by small effect sizes [SMD = 0.48, 95% CI (0.04, 0.93), z = 2.12, df = 5, I2 = 56.4%, P = 0.034] and for more than three times per week improved FMD by moderate effect sizes [SMD = 0.55, 95% CI (0.12, 0.98), z = 2.50, df = 3, I2 = 31.1%, P = 0.012] in obese and overweight older adults with or without CVD. Conclusion In obese and overweight older adults with or without comorbidity, regular aerobic exercise for more than 24 weeks improved FMD by small effect sizes and exercise for more than three times per week improved FMD by moderate effect sizes and regular aerobic exercise reduced PWV by small effect sizes and had no influence on Aix. Taken together, it was recommended that obese and overweight older adults should adhere to regular aerobic exercise, training at least 3 times per week for better results.
Collapse
Affiliation(s)
- Peilun Li
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Ziqing Liu
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Kewen Wan
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kangle Wang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Chen Zheng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Junhao Huang
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| |
Collapse
|
6
|
Wasilewski M, Vijayakumar A, Szigeti Z, Sathakaran S, Wang KW, Saporta A, Hitzig SL. Barriers and Facilitators to Delivering Inpatient Cardiac Rehabilitation: A Scoping Review. J Multidiscip Healthc 2023; 16:2361-2376. [PMID: 37605772 PMCID: PMC10440091 DOI: 10.2147/jmdh.s418803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
Objective The purpose of this scoping review was to summarize the literature on barriers and facilitators that influence the provision and uptake of inpatient cardiac rehabilitation (ICR). Methods A literature search was conducted using PsycINFO, MEDLINE, EMBASE, CINAHL and AgeLine. Studies were included if they were published in English after the year 2000 and focused on adults who were receiving some form of ICR (eg, exercise counselling and training, education for heart-healthy living). For studies meeting inclusion criteria, descriptive data on authors, year, study design, and intervention type were extracted. Results The literature search resulted in a total of 44,331 publications, of which 229 studies met inclusion criteria. ICR programs vary drastically and often focus on promoting physical exercises and patient education. Barriers and facilitators were categorized through patient, provider and system level factors. Individual characteristics and provider knowledge and efficacy were categorized as both barriers and facilitators to ICR delivery and uptake. Team functioning, lack of resources, program coordination, and inconsistencies in evaluation acted as key barriers to ICR delivery and uptake. Key facilitators that influence ICR implementation and engagement include accreditation and professional associations and patient and family-centred practices. Conclusion ICR programs can be highly effective at improving health outcomes for those living with CVDs. Our review identified several patient, provider, and system-level considerations that act as barriers and facilitators to ICR delivery and uptake. Future research should explore how to encourage health promotion knowledge amongst ICR staff and patients.
Collapse
Affiliation(s)
- Marina Wasilewski
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada
| | - Abirami Vijayakumar
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Zara Szigeti
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Sahana Sathakaran
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Adam Saporta
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Sander L Hitzig
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| |
Collapse
|
7
|
Vitez L, Bunc M, Jug B. The Effects of Exercise Training on Exercise Capacity and Vascular Function after Transcatheter Aortic Valve Implantation-A Pilot Study. J Cardiovasc Dev Dis 2023; 10:343. [PMID: 37623356 PMCID: PMC10455217 DOI: 10.3390/jcdd10080343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/05/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023] Open
Abstract
Transcatheter aortic valve implantation (TAVI) improves event-free survival in patients with severe aortic stenosis, but patients' exercise capacity remains poor after the procedure. Therefore, we sought to compare the effects of a supervised center-based exercise training program and unsupervised exercise routine on exercise capacity and vascular function in patients after TAVI. Patients were randomized to either center-based exercise training (12-24 sessions of combined aerobic and low-weight resistance training twice weekly for 8-12 weeks) or an unsupervised home-based exercise routine (initial appraisal with detailed recommendations and monthly follow-up). Exercise capacity (cardiopulmonary testing) and vascular function (ultrasonographic measurement of flow-mediated vasodilation (FMD) and arterial stiffness) were assessed at the baseline and after the study period. We included 23 patients (mean age of 81 years, 61% women), with higher-than-expected drop-out rates (41%) because of the coronavirus-19 pandemic outbreak. Exercise capacity improved over time, irrespective of the intervention group: 0.09 mL/min/kg increase in peak oxygen uptake (95% CI [0.01-0.16]; p = 0.02), 8.2 Watts increase in workload (95% CI [0.6-15.8]; p = 0.034), and 47 s increase in cumulative exercise time (95% CI [5.0-89.6]; p = 0.029). A between-group difference in change over time (treatment effect) was detected only for FMD (4.49%; 95% CI [2.35; 6.63], p < 0.001), but not for other outcome variables. Both supervised and unsupervised exercise training improve exercise capacity and vascular function in patients after TAVI, with supervised exercise training possibly yielding larger improvements in vascular function, as determined by FMD.
Collapse
Affiliation(s)
- Luka Vitez
- Department of Cardiology, Division of Internal Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Matjaž Bunc
- Department of Cardiology, Division of Internal Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Borut Jug
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Department of Vascular Diseases, Division of Internal Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| |
Collapse
|
8
|
Guimarães ALA, Gomes-Neto M, Conceição LSR, Saquetto MB, Gois CO, Carvalho VO. Water-Based Exercises on Peak Oxygen Consumption, Exercise Time, and Muscle Strength in Patients with Coronary Artery Disease: A Systematic Review with Meta-Analysis. Cardiovasc Ther 2023; 2023:4305474. [PMID: 37404774 PMCID: PMC10317579 DOI: 10.1155/2023/4305474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/03/2023] [Accepted: 06/05/2023] [Indexed: 07/06/2023] Open
Abstract
Background There is a growing use of water-based exercises in cardiac rehabilitation programs. However, there is little data concerning the effects of water-based exercise on the exercise capacity of coronary artery disease (CAD) patients. Objective To perform a systematic review to investigate the effects of water-based exercise on peak oxygen consumption, exercise time, and muscle strength in patients with CAD. Methods Five databases were searched to find randomized controlled trials that evaluated the effects of water-based exercise for coronary artery disease patients. Mean differences (MD) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I2 test. Results Eight studies were included. Water-based exercise resulted in an improvement in peak VO2 of 3.4 mL/kg/min (95% CI, 2.3 to 4.5; I2 = 0%; 5 studies, N = 167), exercise time of 0.6 (95% CI, 0.1 to 1.1; I2 = 0%; 3 studies, N = 69), and total body strength of 32.2 kg (95% CI, 23.9 to 40.7; I2 = 3%; 3 studies, N = 69) when compared to no exercising controls. Water-based exercise resulted in an improvement in peak VO2 of 3.1 mL/kg/min (95% CI, 1.4 to 4.7; I2 = 13%; 2 studies, N = 74), when compared to the plus land exercise group. No significant difference in peak VO2 was found for participants in the water-based exercise plus land exercise group compared with the land exercise group. Conclusions Water-based exercise may improve exercise capacity and should be considered as an alternative method in the rehabilitation of patients with CAD.
Collapse
Affiliation(s)
- Alana Lalucha Andrade Guimarães
- The GrEAt Group (Grupo de Estudos em Atividade Física), Brazil
- Physical Therapy Department, Federal University of Sergipe, Brazil
- Post-Graduate Program in Health Sciences, Federal University of Sergipe, Brazil
| | - Mansueto Gomes-Neto
- The GrEAt Group (Grupo de Estudos em Atividade Física), Brazil
- Physical Therapy Department, Federal University of Bahia, Brazil
| | - Lino Sérgio Rocha Conceição
- The GrEAt Group (Grupo de Estudos em Atividade Física), Brazil
- Physical Therapy Department, Federal University of Sergipe, Brazil
| | - Micheli Bernardone Saquetto
- The GrEAt Group (Grupo de Estudos em Atividade Física), Brazil
- Physical Therapy Department, Federal University of Bahia, Brazil
| | - Caroline Oliveira Gois
- The GrEAt Group (Grupo de Estudos em Atividade Física), Brazil
- Physical Therapy Department, Federal University of Sergipe, Brazil
- Post-Graduate Program in Health Sciences, Federal University of Sergipe, Brazil
| | - Vitor Oliveira Carvalho
- The GrEAt Group (Grupo de Estudos em Atividade Física), Brazil
- Physical Therapy Department, Federal University of Sergipe, Brazil
- Post-Graduate Program in Health Sciences, Federal University of Sergipe, Brazil
| |
Collapse
|
9
|
Tartibian B, Azadpour N, Eslami R, Khayat SMA. Home-based exercise alters pulmonary function and cellular stress markers in overweight middle-aged men during covid-19 Home quarantine. BMC Sports Sci Med Rehabil 2023; 15:61. [PMID: 37081518 PMCID: PMC10116448 DOI: 10.1186/s13102-023-00673-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 04/13/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND This study aimed to investigate the effects of a combined home-based exercise program on potential indicators of severe coronavirus disease 2019 (COVID-19) in overweight middle-aged men during home quarantine caused by COVID-19. METHODS Forty men (aged 45-64 years) were assigned to the exercise (EXE, n = 20) or control (CON, n = 20) groups. A 6-week combined program was carried out three days/week, starting at 20 min per session at 50% maximal heart rate (HRmax) and advancing to 45 min at 70% HRmax. Pulmonary functional and cellular stress biomarkers were measured before and after the training program. Analysis of the covariance (ANCOVA) was used for comparison between the two groups considering the baseline values. RESULTS Thirty-six participants (EXE, n = 17; CON, n = 19) completed the research protocol. The EXE group showed post-training improvements in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, Vital capacity (VC), and Forced expiratory flow at 25-75% (FEF25-75) compared to the CON group (P < 0. 05). Further, the plasma levels of fibrinogen, Interleukin (IL)-6, Interleukin (IL)-1β, D-dimer, and angiotensin (Ang II) decreased in the EXE group compared to the CON group (P < 0. 05). After six weeks of the training program, leukocyte counts increased in the EXE group compared to the CON group (P < 0. 05). There was a significant positive correlation between body mass index (BMI) with cardiovascular and inflammatory biomarkers other than white blood cells (WBC) in the EXE group (P < 0.05). CONCLUSIONS The findings suggest that combined home-based exercise during home quarantine improves risk factors for severe COVID-19 in overweight middle-aged men. These improvements were further correlated with changes in BMI. Future research is required to confirm the findings of this study.
Collapse
Affiliation(s)
- Bakhtyar Tartibian
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Allameh Tabataba'i University, Tehran, Iran.
| | - Noushin Azadpour
- Department of Physiotherapy, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Rasoul Eslami
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Sirwan Mohammad Amini Khayat
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Urmia University, Urmia, Iran
| |
Collapse
|
10
|
Jug B, Vasić D, Novaković M, Avbelj V, Rupert L, Kšela J. The Effect of Aquatic Exercise Training on Heart Rate Variability in Patients with Coronary Artery Disease. J Cardiovasc Dev Dis 2022; 9:251. [PMID: 36005415 PMCID: PMC9409327 DOI: 10.3390/jcdd9080251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Aquatic exercise training is a relatively understudied exercise modality in patients with CAD; with the present study, we sought to compare the impact of short-term 14-day water- and land-based exercise training on heart rate variability (HRV). (2) Methods: We randomized 90 patients after a recent CAD event (myocardial infarction and/or revascularization within 2 months prior to inclusion) to either (i) water-based or (ii) land-based exercise training (14 days, two 30 min sessions daily), or (iii) controls. Before and after the intervention period, all participants underwent 20 min 12-channel high-resolution ECG recordings with off-line HRV analysis, including conventional linear time- and frequency-domain analysis (using the Welch method for fast-Fourier transformation), and preselected non-linear analysis (Poincaré plot-derived parameters, sample entropy, and the short-term scaling exponent α1 obtained by detrended fluctuation analysis). (3) Results: Eighty-nine patients completed the study (mean age 60 ± 8 years; 20 % women). We did not detect significant differences in baseline- or age-adjusted end-of-study HRV parameters, but aquatic exercise training was associated with a significant increase in the linear LF/HF parameter (from 2.6 [1.2–4.0] to 3.0 [2.1–5.5], p = 0.046) and the non-linear α1 parameter (from 1.2 [1.1–1.4] to 1.3 [1.2–1.5], p = 0.043). (4) Conclusions: Our results have shown that a short-term 14-day aquatic exercise training program improves selected HRV parameters, suggesting this mode of exercise is safe and may be beneficial in patients with CAD.
Collapse
|
11
|
Manresa-Rocamora A, Ribeiro F, Casanova-Lizón A, Flatt AA, Sarabia JM, Moya-Ramón M. Cardiac Rehabilitation Improves Endothelial Function in Coronary Artery Disease Patients. Int J Sports Med 2022; 43:905-920. [PMID: 35468652 DOI: 10.1055/a-1717-1798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Exercise-based cardiac rehabilitation may be an effective non-pharmacological intervention for improving endothelial function in coronary artery disease patients. Therefore, this systematic review with meta-analysis aimed to (a) estimate the training-induced effect on endothelial and vascular smooth muscle function, assessed by flow-mediated dilation and nitroglycerin-mediated dilation, respectively, in coronary artery disease patients; and to (b) study the influence of potential trial-level variables (i. e. study and intervention characteristics) on the training-induced effect on endothelial and vascular smooth muscle function. Electronic searches were performed in Pubmed, Scopus, and Embase up to February 2021. Random-effects models of standardised mean change were estimated. Heterogeneity analyses were performed by using the Chi 2 test and I 2 index. Our results showed that exercise-based cardiac rehabilitation significantly enhanced flow-mediated dilation (1.04 [95% confidence interval=0.76 to 1.31]) but did not significantly change nitroglycerin-mediated dilation (0.05 [95% confidence interval=-0.03 to 0.13]). Heterogeneity testing reached statistical significance (p<.001) with high inconsistency for flow-mediated dilation (I 2 =92%). Nevertheless, none of the analysed variables influenced the training-induced effect on flow-mediated dilation. Exercise-based cardiac rehabilitation seems to be an effective therapeutic strategy for improving endothelial-dependent dilation in coronary artery disease patients, which may aid in the prevention of cardiovascular events.
Collapse
Affiliation(s)
- Agustín Manresa-Rocamora
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain.,Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain
| | - Fernando Ribeiro
- School of Health Sciences and Institute of Biomedicine- iBiMED, Universidade de Aveiro, Aveiro, Portugal
| | - Antonio Casanova-Lizón
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain
| | - Andrew A Flatt
- Health Sciences and Kinesiology, Georgia Southern University - Armstrong Campus, Savannah, United States
| | - José Manuel Sarabia
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain.,Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain
| | - Manuel Moya-Ramón
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain.,Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain
| |
Collapse
|
12
|
Sakellariou XM, Papafaklis MI, Domouzoglou EM, Katsouras CS, Michalis LK, Naka KK. Exercise-mediated adaptations in vascular function and structure: Beneficial effects in coronary artery disease. World J Cardiol 2021; 13:399-415. [PMID: 34621486 PMCID: PMC8462042 DOI: 10.4330/wjc.v13.i9.399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/30/2021] [Accepted: 07/21/2021] [Indexed: 02/06/2023] Open
Abstract
Exercise exerts direct effects on the vasculature via the impact of hemodynamic forces on the endothelium, thereby leading to functional and structural adaptations that lower cardiovascular risk. The patterns of blood flow and endothelial shear stress during exercise lead to atheroprotective hemodynamic stimuli on the endothelium and contribute to adaptations in vascular function and structure. The structural adaptations observed in arterial lumen dimensions after prolonged exercise supplant the need for acute functional vasodilatation in case of an increase in endothelial shear stress due to repeated exercise bouts. In contrast, wall thickness is affected by rather systemic factors, such as transmural pressure modulated during exercise by generalized changes in blood pressure. Several mechanisms have been proposed to explain the exercise-induced benefits in patients with coronary artery disease (CAD). They include decreased progression of coronary plaques in CAD, recruitment of collaterals, enhanced blood rheological properties, improvement of vascular smooth muscle cell and endothelial function, and coronary blood flow. This review describes how exercise via alterations in hemodynamic factors influences vascular function and structure which contributes to cardiovascular risk reduction, and highlights which mechanisms are involved in the positive effects of exercise on CAD.
Collapse
Affiliation(s)
- Xenofon M Sakellariou
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
| | - Michail I Papafaklis
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Eleni M Domouzoglou
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- Department of Pediatrics, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Christos S Katsouras
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Lampros K Michalis
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Katerina K Naka
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| |
Collapse
|
13
|
Klonizakis M, Hunt BE, Woodward A. The Association Between Cardiovascular Function, Measured as FMD and CVC, and Long-Term Aquatic Exercise in Older Adults (ACELA Study): A Cross-Sectional Study. Front Physiol 2020; 11:603435. [PMID: 33312129 PMCID: PMC7703693 DOI: 10.3389/fphys.2020.603435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 10/26/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction Cardiovascular aging is implicated in the development of cardiovascular disease (CVD). Aquatic exercise is being considered as a co-adjuvant form of rehabilitation, but there is limited evidence for its cardiovascular risk-reduction properties for older people. Our study aimed to address this by exploring the cardiovascular effects of long-term aquatic exercise in older adults in comparison to those who are either inactive or engaged in land-based/mixed training by measurement of micro- and macro-circulation. Flow Mediated Dilatation (FMD) was the primary outcome. Methods This was a pragmatic, 4-group, cross-sectional study. Eighty normotensive adults constituted four (n = 20) groups. The Aqua group (aged 63.7 ± 7 years) and Land group (aged 65 ± 6 years) consisted of participants engaged in aquatic and land-based training, respectively. The mixed group (Mix) (aged 66 ± 6 years) consisted of participants engaged in both land-based and aquatic training. Self-reported training consisted of ≥2/week for ≥6 months (mean sessions/week = 4 ± 1, 4 ± 1, and 5 ± 2 for each group, respectively). The sedentary group (Sed) (aged 63 ± 6 years) consisted of people who were sedentary for ≥6 months (mean sessions/week 0 ± 0). The primary outcome was %FMD. Secondary outcomes included raw cutaneous vascular conductance (CVC) and CVC max. Results Statistically significant differences (%FMD, raw CVC variables other than baseline) were found between each of the exercise groups (Aqua, Land, Mix) and the sedentary group (Sed) (i.e., 11.2 (4.2) vs. 5.0 (2.3); p < 0.0005, between the Aqua group and Sed group, for %FMD). No specific advantage could be attributed to any one of the exercise groups. Conclusion We reported improvements in NO-mediated endothelial function at micro- and macro-circulatory levels, observing no differences between exercise modes. Our findings provide evidence for the role of aquatic exercise as a "shield" against CVD in older populations.
Collapse
Affiliation(s)
- Markos Klonizakis
- Lifestyle, Exercise and Nutrition Improvement Research Group, Sheffield Hallam University, Sheffield, United Kingdom.,Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, United Kingdom
| | - Beatrice E Hunt
- Lifestyle, Exercise and Nutrition Improvement Research Group, Sheffield Hallam University, Sheffield, United Kingdom
| | - Amie Woodward
- Lifestyle, Exercise and Nutrition Improvement Research Group, Sheffield Hallam University, Sheffield, United Kingdom.,Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, United Kingdom
| |
Collapse
|
14
|
McDaniel BB, Naquin MR, Sirikul B, Kraemer RR. Five Weeks of Aquatic-Calisthenic High Intensity Interval Training Improves Cardiorespiratory Fitness and Body Composition in Sedentary Young Adults. J Sports Sci Med 2020; 19:187-194. [PMID: 32132842 PMCID: PMC7039013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 01/08/2020] [Indexed: 06/10/2023]
Abstract
Aquatic exercise may be better tolerated by sedentary, overweight individuals than land-based exercise. The purpose of the present study was to determine the effects of five weeks of aquatic high-intensity interval training (AHIIT) using standard calisthenic pool exercises, on cardiorespiratory fitness and body composition in sedentary young adults. Eleven college-age participants (9 women, 2 men) completed 15 exercise sessions that included three sessions per week for five weeks. Each session consisted of a five-minute warm-up period, 25 minutes of exercise, and a five-minute cool down. A training progression based upon standard progression principals from a pilot study was implemented. The exercises consisted of 25 exercise intervals lasting 10-30 seconds in duration, utilizing combinations of 8-12 different exercises. Twenty-two standard aquatic upper body, lower body, and full body aerobic exercises, most of which utilized aquatic dumbbells or hand paddles, were performed in an AHIIT protocol during each exercise session. Reductions in body composition (32.6 to 30.6% fat), submaximal (169 to 165 b·min-1) and peak heart rate (199 to 192 b·min-1), submaximal VO2 (21.7 to 19.3 ml·kg-1·min-1 and peak VO2 (30.5 to 31.95 ml·kg-1·min-1) occurred from pre- to post-program. This is the first study to determine the effectiveness of standard aquatic calisthenic exercises used in an AHIIT protocol. Improvements in cardiorespiratory fitness and exercise economy as well as body composition were observed in these sedentary individuals.
Collapse
Affiliation(s)
- Brittany B McDaniel
- Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, LA, USA
| | - Mildred R Naquin
- Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, LA, USA
| | - Bovorn Sirikul
- Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, LA, USA
| | - Robert R Kraemer
- Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, LA, USA
| |
Collapse
|