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

QUESTION

Is periodised circuit training delivered via a telerehabilitation model of care as effective as the same training applied face-to-face for improving pain intensity, physical function, muscle strength, pain catastrophising, body composition, intermuscular adipose tissue and muscle architecture in people with knee osteoarthritis (OA)?

DESIGN

Randomised controlled, non-inferiority trial with concealed allocation, blinded assessors and intention-to-treat analysis.

PARTICIPANTS

One hundred adults aged ≥ 40 years with knee OA and pain for ≥ 3 months, with current pain ≥ 40 mm on a 100-mm visual analogue scale (VAS).

INTERVENTION

The experimental group received 14 weeks of circuit training delivered via telerehabilitation using video recordings, followed by periodic phone calls in order to motivate and instruct participants. The control group received the same circuit training program in a face-to-face format.

OUTCOME MEASURES

The primary outcomes were pain VAS and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale, measured at 14 weeks. Secondary outcomes included objective physical function, strength, pain catastrophising and morphological measures (muscle architecture and thigh and body composition). Outcomes were measured at 14 and 26 weeks.

RESULTS

Periodised circuit training delivered via telerehabilitation had equivalent effects to face-to-face delivery for pain intensity, physical function, muscle strength, pain catastrophising, thigh composition, intermuscular adipose tissue and muscle architecture. Whole body composition did not change appreciably in either group. Adherence to the training was excellent and participants in each group reported good perceptions of their randomised intervention.

CONCLUSION

A periodised circuit training protocol can be delivered to people with knee OA in their own homes, using available technology while maintaining high levels of acceptability. More importantly, telerehabilitation appears to cause non-inferior physical and functional outcomes to face-to-face rehabilitation programs.

TRIAL REGISTRATION

RBR-662hn2.

A Metabolic Profile of Peripheral Heart Action Training

Purpose: Peripheral heart action (PHA) is a style of circuit training that alternates upper and lower body resistance exercises with minimal rest between sets. The purpose of this study was to compare the metabolic demands of PHA to traditional hypertrophy training (TRAD) and to provide between sex comparison for both types of resistance training (RT). Methods: Twenty resistance-trained individuals underwent two bouts of volume-load matched RT: PHA and TRAD. We measured oxygen uptake (VO₂), heart rate (HR), blood lactate (BL) concentration, rating of perceived exertion (RPE), excess post-exercise oxygen consumption (EPOC), and duration of each session. Results: PHA elicited significantly greater %VO₂max (p < .001), %HRmax (p < .001), RPE (p < .001), and EPOC (p < .001) compared to TRAD. PHA was also completed in less time (p < .001). Compared to TRAD, BL was significantly higher at mid-exercise (p < .001), post-exercise (p < .001), and 5-min post-exercise (p < .001) during PHA. There were no between-sex differences for BL at any time-point for TRAD. However, during PHA, BL was significantly higher for males at mid-exercise (p = .04), post-exercise (p = .02), and 5-min post-exercise (p = .002). No between-sex differences were detected for HR, VO₂, RPE, or duration for either style of RT. Conclusions: PHA is a time-effective and metabolically demanding circuit that may lead to strength and cardiorespiratory adaptations. Males produced more BL than females during PHA, but not TRAD, suggesting that they incurred more metabolic stress during the bout of circuit training.

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

BACKGROUND

Regular exercise is an effective method for reducing pain and disability in patients with knee osteoarthritis (OA), as well as improving body composition. Thus, a combination of both resistance and aerobic training (circuit training) has shown to be promising for this population. However, access to physical therapy is limited by physical distance, social isolation, and/or treatment costs. Remote rehabilitation seems to be an effective way to minimize these barriers, but the benefits are dependent on the participants' adherence to the interventions provided at a distance. The objectives of this protocol are to compare the effects of a periodized circuit training applied via telerehabilitation with the same protocol applied in the face-to-face model for individuals with knee OA.

METHODS

This study presents a single-blinded protocol for a non-inferiority randomized controlled trial. One hundred participants diagnosed with knee OA (grades II and III Kellgren and Lawrence system), aged 40 years or more, and BMI < 30 kg/m2 will be randomly divided into two groups: telerehabilitation (TR) and face-to-face (FtF) circuit training. The FtF group will perform a 14-week periodized circuit training protocol supervised by a physical therapist, 3 times a week. The TR group will perform the same exercise protocol at home, at least 3 times a week. In addition, the TR group will be able to follow the execution and orientations of the exercises by DVD, a website, and online file sharing tools, and they will receive periodic phone calls in order to motivate, clarify, and inform some aspects of knee OA. The primary outcomes are changes in self-reported pain intensity (visual analog scale (VAS)) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)), with a primary end-point of 14 weeks and a secondary end-point of 26 weeks. Secondary outcomes include changes in other clinical outcomes, in morphological characteristics, adherence, acceptability, and treatment perspective.

DISCUSSION

A circuit training through telerehabilitation may contribute to developing early intervention in the causative and potentiating factors of the knee OA, verifying the effects of a low-cost, non-pharmacological and non-invasive treatment.

TRIAL REGISTRATION

Brazilian Registry of Clinical Trials (ReBEC) ID: RBR-662hn2. Registered on 31 March 2019. Link: http://www.ensaiosclinicos.gov.br ; Universal Trial Number (UTN) of World Health Organization: U1111-1230-9517.

EPOC Comparison Between Resistance Training and High-Intensity Interval Training in Aerobically Fit Women

Previous research has shown that various modes of exercise may elicit significant increases in resting metabolism for up to 24 hours post-exercise, but typically using untrained or moderately active subjects. The purpose of the present study was to compare excess post-exercise oxygen consumption (EPOC) between circuit-style resistance training (RT) and high-intensity interval training (HIIT) in young, aerobically fit women. During the follicular phase of the menstrual cycle, seven participants reported to the laboratory for evening and morning baseline resting metabolic rate (RMR) measurements via indirect calorimetry. Participants fasted and slept overnight in the laboratory between RMR measurements. Following the morning RMR measurement, participants were randomly assigned to complete either a total-body, circuit-style RT protocol (30 seconds of lifting at 80% 1RM:one minute rest) or treadmill HIIT (30-second run at 90% VO₂ max:one minute stationary recovery). RMR was repeated 14 and 24 hours post-exercise. All procedures were replicated during the follicular phase of the next menstrual cycle using the remaining exercise protocol. Resting VO₂ was significantly (p<0.05) higher 14 hours after RT (3.8±0.3 ml/kg/min) compared to baseline (3.4±0.3 ml/kg/min), however HIIT showed no significant change (3.7±0.3 ml/kg/min). Both RT and HIIT showed significantly higher energy expenditure 14 hours post-exercise (33±5 and 33±4 kcals/30 minutes, respectively) compared to baseline (30±3 kcal). Neither protocol sustained a RMR change at 24 hours. Based on the magnitude and duration of post-exercise energy expenditure, EPOC responses may be a worthwhile consideration when prescribing exercise for weight maintenance in young, fit women.

Effect of high-intensity circuit training on obesity indices, physical fitness, and browning factors in inactive female college students

The recently discovered myokines, irisin and fibroblast growth factor-21, have emerged beneficial for metabolic health due to their role in regulating browning. This study examined the effects of high-intensity circuit training on obesity indices, physical fitness, and irisin and fibroblast growth factor-21 levels in inactive female college students. Ten female college students performed high-intensity circuit training (jogging, stretching, squat jumps, arm walking and push-ups, lunge jumps, burpee test, mountain climbers, side steps, and crunches and side crunches exercises). The exercise program consisted of 40 min of circuit training at 60%–80% hear rate reserve and was conducted 3 times per week for 4 weeks. The body composition, physical fitness, and concentration of plasma irisin and fibroblast growth factor-21 were analyzed before and after the exercise. The body weight (P=0.001), waist circumference (P=0.003), and body fat percentage (P=0.003) decreased, while the muscular strength (handgrip strength test, P=0.030; sit-ups test, P=0.024) and cardiorespiratory fitness (P=0.001) increased after the exercise program. However, there were no significant changes in the irisin and fibroblast growth factor-21 levels. These results suggest that high-intensity circuit training could be the ideal type of exercise in inactive female college students to induce a positive change in the obesity indices and physical fitness. Further studies are needed to determine the effects of exercise on the browning factors.

Immediate post-breakfast physical activity improves interstitial postprandial glycemia: a comparison of different activity-meal timings

The optimal timing between meal ingestion and simple physical activity for improving blood glucose control is unknown. This study compared the effects of physical activity on postprandial interstitial glucose responses when the activity was conducted either immediately before, immediately after, or 30 min after breakfast. Forty-eight adults were randomized to three separate physical activity interventions: standing still (for 30 min), walking (for 30 min), and bodyweight exercises (3 sets of 10 squats, 10 push-ups, 10 lunges, 10 sit-ups). In each intervention, 16 participants completed four trials (A to D) during which a 500 kcal mixed nutrient liquid breakfast meal was consumed. Interstitial glucose responses were recorded using continuous glucose monitoring for 2 h after the meal. The activity was completed either after the glucose monitoring period (trial A; control) or immediately before (trial B), immediately after (trial C), or 30 min after (trial D) the breakfast. Mean, coefficient of variance (CV), and area under the curve (AUC) for glucose were calculated and compared between the four trials. Walking and bodyweight exercises immediately after the meal improved mean, CV, and AUC glucose (P ≤ 0.05 vs. control), while standing immediately after the meal only improved AUC glucose (P ≤ 0.05 vs. control) and nearly improved mean glucose (P = 0.06). Mean, CV, and AUC glucose were not affected by standing, walking, or bodyweight exercise conducted immediately before, or 30 min after the meal (all P > 0.05 vs. control). Energy intake (diet records) and energy expenditure (Actigraph) were consistent throughout the studies and did not influence the findings. Low- to moderate-intensity activity should be implemented soon after eating to improve glucose control following breakfast. The type of activity appears less important than the timing. These findings will help optimize exercise-meal timing in general health guidelines. ClinicalTrials.gov Identifier: NCT03730727

The relationship of high-intensity cross-training with arterial stiffness

BACKGROUND

Central arterial stiffness is a cardiovascular risk factor that can be readily affected through engagement in physical exercise training, with resistance and aerobic exercise having disparate affects. Despite the growing popularity of high-intensity cross-training (HICT), little is currently known about the effects of this mixed modality exercise stimulus on arterial stiffness. Therefore, the purpose of this study was to characterize the arterial stiffness of habitual HICT participants vs. aerobically active and sedentary controls using a cross-sectional design.

METHODS

A total of 30 participants were recruited: 10 middle-aged long-term participants of HICT (CrossFit) and 20 age, sex, and height matched controls (10 recreationally active, 10 sedentary). Central and peripheral pulse wave velocities were measured for the carotid-femoral and femoral-dorsalis pedis arterial segments. Aerobic fitness (maximal oxygen uptake, VO_2max) was measured and typical exercise participation rates were self-reported for each group.

RESULTS

HICT participants manifested central pulse wave velocity (PWV) (5.3 ± 1.0 m/s, mean ± SD) and VO_2max (43 ± 6 mL/kg/min) values nearly identical to active controls. Both active groups had significantly better values than sedentary controls (7.1 ± 1.0 m/s, p ≤ 0.001; and 32 ± 7 mL/kg/min, p = 0.01). No differences were observed in peripheral PWV between groups.

CONCLUSION

Habitual participation in HICT exercise was not associated with increased central nor peripheral arterial stiffness. Long-term HICT participants presented with similar fitness and arterial stiffness as compared with participants who practiced traditional aerobic exercise. Compared to sedentary living, HICT may offer musculoskeletal and cardiovascular health benefits without negatively impacting arterial stiffness.

Effects of circuit training interventions on bone metabolism markers and bone density of old women with osteopenia

The purpose of this study is to propose an effective exercise intervention program to prevent and control osteopenia and osteoporosis that result from aging. To the end of this study, a circuit training intervention was performed for 8 weeks among participants with osteopenia who resided in Gyeonggi Province and were aged 65 and whose T-score of dual energy X-ray absorptiometry was between −1.0 and −2.5. Based on the effect of this intervention on their bone metabolism markers and bone density, the following conclusions were derived: First, it turned out that the circuit training intervention had statistically significant interactive effects on bone metabolism markers (osteocalcin and deoxypyrid-inoline) of old women with osteopenia depending on the measuring timing and groups. Second, it turned out that the circuit training intervention had statistically significant interactive effects on the bone density (T-score) depending on the measuring timing and groups. The conclusions above indicate that the circuit training intervention showed positive effects on bone metabolism markers and bone density of old women with osteopenia, being viewed as an effective intervention program applicable in order to prevent and control osteopenia and osteoporosis in line with bone density decrease.

The effects of circuit training on the indexes of sarcopenia and the risk factors of metabolic syndrome in aged obese women

The purpose of this study is to examine the effects of circuit training on the indexes of sarcopenia and the risk factors of metabolic syndrome in aged obese women. To address the goal, this author selected aged women whose body mass index was higher than 25.0 kg/m² visiting the welfare center for the aged located in Gangwon-do Province and measured the indexes of sarcopenia and the risk factors of metabolic syndrome after circuit training. Through that, this study has gained following results. First, after circuit training, aged obese women’s indexes of sarcopenia indicated statistically significant difference in terms of interaction between the measuring times and groups. Second, after circuit training, aged obese women’s risk factors of metabolic syndrome (systolic blood pressure, diastolic blood pressure, fasting blood sugar, triglycerides, high-density lipoprotein-cholesterol, and waist circumference) showed statistically significant difference in terms of interaction between the measuring times and groups. To sum up the above results, circuit training improves aged obese women’s indexes of sarcopenia and risk factors of metabolic syndrome positively, which means circuit training is found to be effective. Therefore, the circuit training intervention enhances aged obese women’s muscular and metabolic functions positively. As it helps prevent and manage the risk factors of sarcopenia and metabolic syndrome resulted from aging, it will elevate life quality in senescence.

Improvements in cognition and associations with measures of aerobic fitness and muscular power following structured exercise

OBJECTIVES

Cognition, along with aerobic and muscular fitness, declines with age. Although research has shown that resistance and aerobic exercise may improve cognition, no consensus exists supporting the use of one approach over the other. The purpose of this study was to compare the effects of steady-state, moderate-intensity treadmill training (TM) and high-velocity circuit resistance training (HVCRT) on cognition, and to examine its relationships to aerobic fitness and neuromuscular power.

METHODS

Thirty older adults were randomly assigned to one of three groups: HVCRT, TM, or control. Exercise groups attended training 3 days/wk for 12 weeks, following a 2 week adaptation period. The NIH Cognitive Toolbox was used to assess specific components of cognition and provided an overall fluid composite score (FCS). The walking response and inhibition test (WRIT) was specifically used to assess executive function (EF) and provided an accuracy (ACC), reaction time (RT) and global score (GS). Aerobic power (AP) and maximal neuromuscular power (MP) were measured pre- and post-intervention. Relationships between variables using baseline and mean change scores were assessed.

RESULTS

Significant increases were seen from baseline in ACC (MD = 14.0, SE = 4.3, p = .01, d = 1.49), GS (MD = 25.6, SE = 8.0, p = .01, d = 1.16), and AP (MD = 1.4, SE = 0.6, p = .046, d = 0.31) for HVCRT. RT showed a trend toward a significant decrease (MD = -0.03, SE = 0.016, p = .068, d = 0.32) for HVCRT. No significant within-group differences were detected for TM or CONT. Significant correlations were seen at baseline between AP and FCS, as well as other cognitive domains; but none were detected among change scores. Although no significant correlation was evident between MP and FCS or GS, there was a trend toward higher MP values being associated with higher FCS and GS scores.

CONCLUSIONS

Our results support the use of HVCRT over TM for improving cognition in older persons, although the precise mechanisms that underlie this association remain unclear.

Effects of Circuit Training According to the Feedback Type on Psychological and Physical Health of Workers with Social Anxiety Disorder

BACKGROUND

The effects of circuit training was investigated according to the feedback type on the psychological (social anxiety, anxiety, positive emotion) health and physical (body composition, physical fitness) health of social anxiety disorder workers.

METHODS

Sixty male workers in H Company in Seoul, South Korea with social anxiety disorder were divided into four groups (positive, negative, mixed, no feedback) by conducting a circuit training program in sport center of H company during 3 times per week, total 8 weeks from Feb 1st to Mar 31st, 2017. The results of the pre-test and post-test were analyzed as follows.

RESULTS

1) In effect of social anxiety, there were significant differences in the positive, negative, and mixed feedback groups. 2) In the effect of anxiety, there were significant differences in the positive, negative, and mixed feedback groups. 3) In the effect of positive emotion, there were significant differences in the positive, negative, mixed, and no feedback groups. 4) In the effect of body composition, body fat mass and body fat percentage have significant differences in the positive, negative, mixed, and no feedback groups. And fat free mass has significant differences in the positive and mixed feedback groups. 5) In the effect of physical fitness, grip strength, wall squat, bending forward have significant differences in positive, negative, mixed, and no feedback groups.

CONCLUSION

The circuit training program improves the social anxiety disorder and positively affects the psychological health and physical health of participants. To participate in continuous exercise, personal training should be accompanied by the correct feedback of the leader.

Effect of circuit training on body composition, physical fitness, and metabolic syndrome risk factors in obese female college students

The purpose of this study was to investigate the effect of a 12-week circuit training program on health-related physical fitness and metabolic syndrome risk factors in obese female college students. Twenty subjects with over 30% of accumulated body fat voluntarily participated and were randomly allocated to the control group (n=10) or circuit training group (n=10). The circuit training program consisted of 10 types of resistance and aerobic exercise and was performed 3 times per week for 12 weeks. Health-related physical fitness and metabolic syndrome risk factors were analyzed to elucidate the effect of the circuit training. Significant differences between groups were determined with two-way repeated analysis of variance and paired t-test. As a result of this study, body weight, % body fat, and body mass index in the circuit training group was significantly decreased compared to the control group. All health-related physical fitness indicators such as back strength, sit-up, sit-and-reach, and 1,600 m running time showed relative effects between groups or over time. Among the metabolic syndrome risk factors, waist measurement, triglyceride, and total cholesterol were significantly decreased but blood glucose, high-density lipo-protein cholesterol and low-density lipoprotein cholesterol did not show any significant difference. Therefore, the present data suggested that circuit training for 12 weeks may be effective in improving physical fitness and preventing metabolic diseases.

Usefulness of circuit training at home for improving bone mass and muscle mass while losing fat mass in undergraduate female students

Background

The purpose of this study was to determine whether or not circuit training at home affects the calcaneus quantitative ultrasound status as well as other indices of body composition among undergraduate female students.

Methods

Forty-one adolescents were recruited (18.5 ± 0.6 years old). The stiffness index of the calcaneus, broadband ultrasound attenuation of the calcaneus, speed of sound of the calcaneus, and body frame index. This was a three-month intervention study, so the measurements were conducted at baseline, 2 months later, and 3 months later while the subjects underwent circuit training at home. The subjects were divided into two groups: namely, the exercising group and non-exercising group.

Results

In the exercising group, broadband ultrasound attenuation of the calcaneus was higher 2 months later (p = 0.033) as well as 3 months later (p = 0.036), and the speed of sound of the calcaneus was higher 3 months later (p = 0.018). In addition, the muscle mass was strongly positively correlated with the calcaneus QUS-SOS (p = 0.004), while the body fat percentage was a strongly negatively correlated with the calcaneus QUS-BUA (p = 0.043). In the non-exercising group, the stiffness index of the calcaneus was higher 2 months later (p = 0.002) as well as 3 months later (p = 0.002). Furthermore, the body percentage was strongly positively correlated with the calcaneus QUS-SI (p = 0.009).

Conclusions

These findings suggest that the calcaneus quantitative ultrasound status and muscle mass while losing fat mass may be improved by means of a simple exercise regimen within a short period among undergraduate female students.

Circuit training enhances function in patients undergoing total knee arthroplasty: a retrospective cohort study

Background

The number of patients receiving total knee arthroplasty (TKA) has been rising every year due to the aging population and the obesity epidemic. Post-operative rehabilitation is important for the outcome of TKA.

Methods

A series of 34 patients who underwent primary unilateral TKA was retrospectively collected and divided into either exercise group (n = 16) and control group (n = 18). The exercise group underwent a 24-week course of circuit training beginning 3 months after total knee arthroplasty (TKA). The effect of circuit training on TKA patients in terms of motion analysis, muscle strength testing, Knee injury and Osteoarthritis Outcomes Score (KOOS) questionnaire and patient-reported outcome measurement Short-Form Health Survey (SF-36) at the pre-operation, pre-exercise, mid-exercise, and post-exercise.

Results

Motion analysis revealed the stride length, step velocity, and excursion of active knee range of motion significantly improved in the exercise group when compared to those in the control group. KOOS questionnaire showed a greater improvement in pain, ADL, and total scores in the exercise group. The SF-36 questionnaire revealed a significant improvement in general health, bodily pain, social function, and physical components score in the exercise group.

Conclusions

The post-operative circuit training intervention can facilitate recovery of knee function and decrease the degree of pain in the TKA and might be considered a useful adjunct rehabilitative modality. The ultimate influence of circuit training on TKA needs further a prospective randomized clinical trial study and long-term investigation.

Trial registration

NCT02928562

Improving Exercise Adherence and Physical Measures in English-Speaking Latina Women

BACKGROUND

Epidemiological data have established that lack of physical activity increases risk factors for chronic diseases. Data also suggests that physical activity participation is lowest in minority women, particularly Latinas, and that the nature of the exercise and attitudes toward exercise may influence exercise adherence. The purpose of this study was to determine the effect of hypertrophy training (HT) or power training (PT) used concomitantly with evaluative conditioning (EC) or neutral conditioning (NC) on exercise adherence as well as in physical and psychosocial variables in Latina women. EC is a behavioral method using paired stimuli to develop and strengthen new associations in memory.

METHODS

Two hundred thirty-one English-speaking Latina women (mean ± SD, age 36.8 ± 15.9 years) were randomly assigned to standard HT or high-speed circuit PT and then further stratified to receive EC or NC.

RESULTS

One hundred forty-two Latina women completed pre- and posttesting. For HT, EC produced significantly greater exercise time across the training period than NC. HT and PT both significantly improved all physical, functional, and psychosocial variables, with exception of leg extension and usual gait speed (p < 0.05).

CONCLUSION

EC can positively impact exercise adherence during HT in Latina women; while body composition, neuromuscular, and functional performances can be increased using HT and PT independent of psychological conditioning.

Clinical application of circuit training for subacute stroke patients: a preliminary study

[Purpose] To investigate how task-oriented circuit training for the recovery motor control of the lower-extremity, balance and walking endurance could be clinically applied to subacute stroke inpatient group therapy. [Subjects and Methods] Twenty subacute stroke patients were randomly assigned to the intervention group (n=10) or the control group (n=10). The intervention consisted of a structured, progressive, inpatient circuit training program focused on mobility and gait training as well as physical fitness training that was performed for 90 minutes, 5 days a week for 4 weeks. The control group received individual physiotherapy of neurodevelopmental treatment for 60 minutes, 5 days a week for 4 weeks. Outcome measures were lower-extremity motor control, balance, gait endurance and activities of daily living before and after 4 weeks. [Results] There were no significant differences at baseline between the two groups. After 4 weeks, both groups showed significant improvements in all outcome measures, but there were no significant differences between the two groups during the invention period. [Conclusion] In spite of the small sample size, these findings suggest that task-oriented circuit training might be used as a cost-effective and alternative method of individual physiotherapy for the motor recovery of lower-extremity, balance and walking endurance of subacute stroke patients.

Effects of endurance, circuit, and relaxing training on cardiovascular risk factors in hypertensive elderly patients

Recommendations for prevention of cardiovascular diseases (CVDs) risk factors among older adults highlighted the importance of exercise-based interventions, including endurance training (ET). However, the evidence of efficacy of other interventions based on short-bouts of exercise (circuit training, CT), and the practice of breath-control and meditation (relaxing training, RT) is growing. The aim of this study was to elucidate if CT or RT are equally effective in CVD risk factors reduction compared to ET. To this purpose, in 40 elderly participants, with clinically diagnosed grade 1 hypertension, resting blood pressure, blood glucose, and cholesterol levels, peak oxygen uptake ([Formula: see text]), mechanical efficiency and quality of life were evaluated before and after 12 weeks of ET, CT, and RT treatments. Resting blood pressure reduced significantly in all groups by ∼11 %. In ET, blood cholesterol levels (-18 %), [Formula: see text] (+8 %), mechanical efficiency (+9 %), and quality of life scores (+36 %) ameliorated. In CT blood glucose levels (-11 %), [Formula: see text] (+7 %) and quality of life scores (+35 %) were bettered. Conversely, in RT, the lower blood pressure went along only with an improvement in the mental component of quality of life (+42 %). ET and CT were both appropriate interventions to reduce CVDs risk factors, because blood pressure reduction was accompanied by decreases in blood glucose and cholesterol levels, increases in [Formula: see text], mechanical efficiency, and quality of life. Although RT influenced only blood pressure and quality of life, this approach would be an attractive alternative for old individuals unable or reluctant to carry out ET or CT.

Effects of vitamin D supplementation and circuit training on indices of obesity and insulin resistance in T2D and vitamin D deficient elderly women

PURPOSE

The purpose of this study was to investigate the effects of vitamin D supplementation and circuit training on body composition, abdominal fat, blood lipids, and insulin resistance in T2D and vitamin D deficient elderly women.

METHODS

Fifty-two elderly women were randomly assigned to either the vitamin D supplementation with circuit training group (D+T: n = 15), the circuit training group (T: n = 13), the vitamin D supplementation group (D: n = 11), or the control group (CON: n = 13). The subjects in D took vitamin D supplements at 1,200 IU per day for 12 weeks; the subjects in T exercised 3 to 4 times per week, 25 to 40 minutes per session for 12 weeks; and the subjects in D+T participated in both treatments. Subjects in CON were asked to maintain normal daily life pattern for the duration of the study. Body composition, abdominal fat, blood lipids, and surrogate indices for insulin resistance were measured at pre- and post-test and the data were compared among the four groups and between two tests by utilizing two-way ANOVA with repeated measures. The main results of the present study were as follows:

RESULTS

1) Body weight, fat mass, percent body fat, and BMI decreased significantly in T, whereas there were no significant changes in the variables in D and CON. Lean body mass showed no significant changes in all groups. 2) TFA and SFA decreased significantly in T, whereas there were no significant changes in the variables in D and CON. The other abdominal fat related variables showed no significant changes in all groups. 3) TC, TG, HDL-C, and LDL-C showed improvements in T, whereas there were no significant changes in the variables in D and CON. 4) Fasting glucose, fasting insulin, and HOMA-IR tended to be lower in D+T.

CONCLUSION

It was concluded that the 12 weeks of vitamin D supplementation and circuit training would have positive effects on abdominal fat and blood lipid profiles in T2D and vitamin D deficient elderly women. Vitamin D supplementation was especially effective when it was complemented with exercise training.