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Mendes Zambetta R, Signini ÉDF, Ocamoto GN, Catai AM, Uliam NR, Santarnecchi E, Russo TL. Effects of weightlessness on the cardiovascular system: a systematic review and meta-analysis. Front Physiol 2024; 15:1438089. [PMID: 39129756 PMCID: PMC11310543 DOI: 10.3389/fphys.2024.1438089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 07/02/2024] [Indexed: 08/13/2024] Open
Abstract
Background: The microgravity environment has a direct impact on the cardiovascular system due to the fluid shift and weightlessness that results in cardiac dysfunction, vascular remodeling, and altered Cardiovascular autonomic modulation (CAM), deconditioning and poor performance on space activities, ultimately endangering the health of astronauts. Objective: This study aimed to identify the acute and chronic effects of microgravity and Earth analogues on cardiovascular anatomy and function and CAM. Methods: CINAHL, Cochrane Library, Scopus, Science Direct, PubMed, and Web of Science databases were searched. Outcomes were grouped into cardiovascular anatomic, functional, and autonomic alterations, and vascular remodeling. Studies were categorized as Spaceflight (SF), Chronic Simulation (CS), or Acute Simulation (AS) based on the weightlessness conditions. Meta-analysis was performed for the most frequent outcomes. Weightlessness and control groups were compared. Results: 62 articles were included with a total of 963 participants involved. The meta-analysis showed that heart rate increased in SF [Mean difference (MD) = 3.44; p = 0.01] and in CS (MD = 4.98; p < 0.0001), whereas cardiac output and stroke volume decreased in CS (MD = -0.49; p = 0.03; and MD = -12.95; p < 0.0001, respectively), and systolic arterial pressure decreased in AS (MD = -5.20; p = 0.03). According to the qualitative synthesis, jugular vein cross-sectional area (CSA) and volume were greater in all conditions, and SF had increased carotid artery CSA. Heart rate variability and baroreflex sensitivity, in general, decreased in SF and CS, whereas both increased in AS. Conclusion: This review indicates that weightlessness impairs the health of astronauts during and after spaceflight, similarly to the effects of aging and immobility, potentially increasing the risk of cardiovascular diseases. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42020215515.
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Affiliation(s)
| | - Étore De Favari Signini
- Physical Therapy Department, Federal University of São Carlos, UFSCar, São Carlos, SP, Brazil
| | - Gabriela Nagai Ocamoto
- Physical Therapy Department, Federal University of São Carlos, UFSCar, São Carlos, SP, Brazil
- Brain4care Inc., São Carlos, SP, Brazil
| | - Aparecida Maria Catai
- Physical Therapy Department, Federal University of São Carlos, UFSCar, São Carlos, SP, Brazil
| | - Nicoly Ribeiro Uliam
- Physical Therapy Department, Federal University of São Carlos, UFSCar, São Carlos, SP, Brazil
| | | | - Thiago Luiz Russo
- Physical Therapy Department, Federal University of São Carlos, UFSCar, São Carlos, SP, Brazil
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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] [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.
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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
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Weaver SRC, Rendeiro C, Lucas RAI, Cable NT, Nightingale TE, McGettrick HM, Lucas SJE. Non-pharmacological interventions for vascular health and the role of the endothelium. Eur J Appl Physiol 2022; 122:2493-2514. [PMID: 36149520 PMCID: PMC9613570 DOI: 10.1007/s00421-022-05041-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/05/2022] [Indexed: 12/11/2022]
Abstract
The most common non-pharmacological intervention for both peripheral and cerebral vascular health is regular physical activity (e.g., exercise training), which improves function across a range of exercise intensities and modalities. Numerous non-exercising approaches have also been suggested to improved vascular function, including repeated ischemic preconditioning (IPC); heat therapy such as hot water bathing and sauna; and pneumatic compression. Chronic adaptive responses have been observed across a number of these approaches, yet the precise mechanisms that underlie these effects in humans are not fully understood. Acute increases in blood flow and circulating signalling factors that induce responses in endothelial function are likely to be key moderators driving these adaptations. While the impact on circulating factors and environmental mechanisms for adaptation may vary between approaches, in essence, they all centre around acutely elevating blood flow throughout the circulation and stimulating improved endothelium-dependent vascular function and ultimately vascular health. Here, we review our current understanding of the mechanisms driving endothelial adaptation to repeated exposure to elevated blood flow, and the interplay between this response and changes in circulating factors. In addition, we will consider the limitations in our current knowledge base and how these may be best addressed through the selection of more physiologically relevant experimental models and research. Ultimately, improving our understanding of the unique impact that non-pharmacological interventions have on the vasculature will allow us to develop superior strategies to tackle declining vascular function across the lifespan, prevent avoidable vascular-related disease, and alleviate dependency on drug-based interventions.
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Affiliation(s)
- Samuel R C Weaver
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
| | - Catarina Rendeiro
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Rebekah A I Lucas
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - N Timothy Cable
- Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Tom E Nightingale
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Helen M McGettrick
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
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Unnikrishnan R. Aquatic exercise as an adjunct therapy for erectile dysfunction: A narrative review. ASIAN JOURNAL OF PHARMACEUTICAL RESEARCH AND HEALTH CARE 2022. [DOI: 10.4103/ajprhc.ajprhc_37_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bansal P, Kannarpady Janardan S, Shetty P. "The immediate effect of neutral spinal compress on heart rate variability in hypertensive individuals". JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:429-434. [PMID: 34420268 DOI: 10.1515/jcim-2021-0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/09/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Hypertension (HTN) is considered as chronic medical condition. Because of the increased complications associated with the conventional medicine, the effects of naturopathic modalities were emphasized to prevent and minimize those adverse effects. This study was done to assess the immediate effect of neutral spinal compress on heart rate variability and blood pressure and thereby to substantiate the clinical understanding of its effect in hypertensive individuals. METHODS Hundred hypertensive individuals were recruited for the study. Subjects were assessed for Blood Pressure (BP) and Heart Rate Variability (HRV) before and immediately after the intervention of 20 min. RESULTS Result shows significant reduction in mean Heart Rate (HR) (p<0.001), Low Frequency (LF) (p<0.001), Low Frequency/High Frequency (LF/HF) (p<0.001), Systolic blood pressure (SBP) (p<0.001) and Diastolic blood pressure (DBP) (p<0.001) and significant increase in mean R-R interval (Mean RR) (p<0.001) and High frequency (HF) (p<0.001) components of Heart Rate Variability after neutral spinal compress intervention. CONCLUSIONS The results of the study reported that full neutral spinal compress reduces the sympathetic tone and shifts the Sympatho-vagal balance in favor of parasympathetic dominance and hence it can be concluded that neutral spinal compress can be effectively used in the management of hypertension. TRIAL REGISTRATION Clinical Trial Registry- India (CTRI); CTRI Reg. No- CTRI/2020/01/022639.
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Affiliation(s)
- Poornima Bansal
- Department of Clinical Naturopathy, SDM College of Naturopathy and Yogic Sciences Affiliated to Rajiv Gandhi University of Health and Sciences, Bangalore, Karnataka, India
| | - Sujatha Kannarpady Janardan
- Department of Clinical Naturopathy, SDM College of Naturopathy and Yogic Sciences Affiliated to Rajiv Gandhi University of Health and Sciences, Bangalore, Karnataka, India
| | - Prashanth Shetty
- SDM College of Naturopathy and Yogic Sciences Affiliated to Rajiv Gandhi University of Health and Sciences, Bangalore, Karnataka, India
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Cold-Water Effects on Energy Balance in Healthy Women During Aqua-Cycling. Int J Sport Nutr Exerc Metab 2021; 31:236-243. [PMID: 33588379 DOI: 10.1123/ijsnem.2020-0177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND While the popularity of aquatic physical activities continues to grow among women, the effects on energy expenditure (EE) and appetite control remain unknown. The objective of this study was to examine the effect of water temperature during aqua-cycling session on EE, rate of perceived exertion, energy intake, appetite sensations, and food reward in healthy premenopausal women. METHODS Participants completed three experimental sessions, in the postprandial condition, in a randomized order: a land control session (CON), an aqua-cycling session in 18 °C (EXO18), and an aqua-cycling session in 27 °C (EXO27). The EE, food intake, appetite sensations, and food reward were investigated for each condition. RESULTS EXO18 induced a significant increase in EE (p < .001) and oxygen consumption (p < .01) compared with EXO27. The carbohydrate oxidation was higher in EXO18 session compared with EXO27 and CON (p < .05 and p < .001, respectively). While fat oxidation was higher in exercise sessions compared with CONT (p < .01), no difference was observed between EXO18 and EXO27. Exercise sessions did not alter absolute energy intake session but induced a decrease in relative energy intake (p < .001) and in hunger, desire to eat, and prospective food consumption compared with CON (p < .001). The authors also show here that cold-water exposure can increase EE while rate of perceived exertion is lower at the end of exercise session compared with same exercise at 27 °C (p < .05). CONCLUSION An exposure to a moderately cold-water during aqua-cycling is an efficient strategy to promote increased EE and decreased hunger, which may be effective for energy balance management in healthy premenopausal women.
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Amirova L, Navasiolava N, Rukavishvikov I, Gauquelin-Koch G, Gharib C, Kozlovskaya I, Custaud MA, Tomilovskaya E. Cardiovascular System Under Simulated Weightlessness: Head-Down Bed Rest vs. Dry Immersion. Front Physiol 2020; 11:395. [PMID: 32508663 PMCID: PMC7248392 DOI: 10.3389/fphys.2020.00395] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/02/2020] [Indexed: 12/19/2022] Open
Abstract
Background The most applicable human models of weightlessness are −6° head-down bed rest (HDBR) and head-out dry immersion (DI). A detailed experimental comparison of cardiovascular responses in both models has not yet been carried out, in spite of numerous studies having been performed in each of the models separately. Objectives We compared changes in central hemodynamics, autonomic regulation, plasma volume, and water balance induced by −6° HDBR and DI. Methods Eleven subjects participated in a 21-day HDBR and 12 subjects in a 3-day DI. During exposure, measurements of the water balance, blood pressure, and heart rate were performed daily. Plasma volume evolution was assessed by the Dill–Costill method. In order to assess orthostatic tolerance time (OTT), central hemodynamic responses to orthostatic stimuli, and autonomous regulation, the 80° lower body negative pressure–tilt test was conducted before and right after both exposures. Results For most of the studied parameters, the changes were co-directional, although they differed in their extent. The changes in systolic blood pressure and total peripheral resistance after HDBR were more pronounced than those after DI. The OTT was decreased in both groups: to 14.2 ± 3.1 min (vs. 27.9 ± 2.5 min before exposure) in the group of 21-day HDBR and to 8.7 ± 2.1 min (vs. 27.7 ± 1.2 min before exposure) in the group of 3-day DI. Conclusions In general, cardiovascular changes during the 21-day HDBR and 3-day DI were co-directional. In some cases, changes in the parameters after 3-day DI exceeded changes after the 21-day HDBR, while in other cases the opposite was true. Significantly stronger effects of DI on cardiovascular function may be due to hypovolemia and support unloading (supportlessness).
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Affiliation(s)
- Liubov Amirova
- Laboratory of Gravitational Physiology of the Sensorimotor System, Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia.,Laboratoire MITOVASC, UMR Institut National de la Santé et de la Recherche Médicale 1083, Centre National de la Recherche Scientifique 6015, Université d'Angers, Angers, France
| | - Nastassia Navasiolava
- Laboratoire MITOVASC, UMR Institut National de la Santé et de la Recherche Médicale 1083, Centre National de la Recherche Scientifique 6015, Université d'Angers, Angers, France
| | - Ilya Rukavishvikov
- Laboratory of Gravitational Physiology of the Sensorimotor System, Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | | | - Claude Gharib
- Institut NeuroMyogène, Université Claude Bernard Lyon 1, Lyon, France
| | - Inessa Kozlovskaya
- Laboratory of Gravitational Physiology of the Sensorimotor System, Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Marc-Antoine Custaud
- Laboratoire MITOVASC, UMR Institut National de la Santé et de la Recherche Médicale 1083, Centre National de la Recherche Scientifique 6015, Université d'Angers, Angers, France.,Centre de Recherche Clinique, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Elena Tomilovskaya
- Laboratory of Gravitational Physiology of the Sensorimotor System, Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
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Autonomic cardiovascular adaptations to acute head-out water immersion, head-down tilt and supine position. Eur J Appl Physiol 2019; 120:337-347. [PMID: 31813043 DOI: 10.1007/s00421-019-04278-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 11/30/2019] [Indexed: 01/21/2023]
Abstract
PURPOSE Thermoneutral head-out water immersion (WI) and 6° head-down tilt (HDT) have been considered as suitable models to increase central blood volume and simulate autonomic cardiovascular adaptations to microgravity, swimming or scuba diving. However, any differences in autonomic cardiovascular adaptations are still unclear. In this study, we hypothesized that WI induces a higher activation of arterial baroreceptors and the parasympathetic system. METHODS Ten healthy men underwent 30 min of WI, HDT, and a supine position (SP). RR intervals (RRI) and blood pressure (BP) were continuously monitored. High frequency power (HF), low frequency power (LF) and LF/HF ratio were calculated to study sympathetic and parasympathetic activities, and a spontaneous baroreflex method was used to study arterial baroreflex sensitivity (aBRS). Lung transfer of nitric oxide and carbon monoxide (TLNO/TLCO), vital capacity and alveolar volume (Vc/VA) were measured to study central blood redistribution. RESULTS We observed (1) a similar increase in RRI and decrease in BP; (2) a similar increase in HF power during all experimental conditions, whereas LF increased after; (3) a similar rise in aBRS; (4) a similar increase in Vc/VA and decrease in TLNO/TLCO in all experimental conditions. CONCLUSIONS These results showed a cardiac parasympathetic dominance to the same extent, underpinned by a similar arterial baroreflex activation during WI and HDT as well as control SP. Future studies may address their association with cold or hyperoxia to assess their ability to replicate autonomic cardiovascular adaptations to microgravity, swimming or scuba diving.
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Vasić D, Novaković M, Božič Mijovski M, Barbič Žagar B, Jug B. Short-Term Water- and Land-Based Exercise Training Comparably Improve Exercise Capacity and Vascular Function in Patients After a Recent Coronary Event: A Pilot Randomized Controlled Trial. Front Physiol 2019; 10:903. [PMID: 31379605 PMCID: PMC6646683 DOI: 10.3389/fphys.2019.00903] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 06/28/2019] [Indexed: 12/11/2022] Open
Abstract
Background We hypothesized that a 2-week twice daily aquatic endurance plus calisthenics exercise training program: (i) increases aerobic exercise capacity (peak oxygen uptake/ V ˙ O2peak), (ii) improves endothelium-dependent flow-mediated vasodilation (FMD), and (iii) reduces circulating markers of low-grade inflammation and hemostasis, as compared to land-based endurance plus calisthenics exercise training or no exercise in patients undergoing short-term residential cardiac rehabilitation after a recent coronary artery disease (CAD) event. Methods Patients with a recent myocardial infarction or revascularization procedure were randomized into two interventional groups and a control group. The interventional groups underwent supervised aerobic endurance plus calisthenics exercise training either in thermo-neutral water or on land at moderate intensity (60-80% of the peak heart rate achieved during symptom-limited graded exercise testing) for 30 min twice daily for 2 weeks (i.e., 24 sessions). The control group was deferred from supervised exercise training for the 2-week duration of the intervention, but was advised low-to-moderate intensity physical activity at home while waiting. At baseline and after the intervention period, all participants underwent estimation of aerobic exercise capacity, brachial artery flow-mediated dilatation (FMD, measured ultrasonographically at rest and during reactive hyperemia after 4.5 min of forearm cuff inflation), markers of cardiac dysfunction (NT-proBNP), inflammation (hsCRP, IL-6, IL-8, IL-10), cell adhesion (ICAM, P-selectin), and hemostasis (fibrinogen, D-dimer). Results A total of 89 patients (mean age 59.9 ± 8.2 years, 77.5% males, V ˙ O2peak at baseline 14.8 ± 3.5 ml kg-1 min-1) completed the study. Both exercise modalities were safe (no significant adverse events recorded) and associated with a significant improvement in V ˙ O2peak as compared to controls: age and baseline V ˙ O2peak-adjusted end-of-study V ˙ O2peak increased to 16.7 (95% CI 16.0-17.4) ml kg-1 min-1 with land-based training (p < 0.001 for change from baseline) and to 18.6 (95% CI 17.9-19.3) ml kg-1 min-1 with water-based training (p < 0.001 for change from baseline), but not in controls (14.9 ml kg-1 min-1; 95% CI 14.2-15.6; p = 0.775 for change from baseline). FMD also increased in both intervention groups (from 5.5 to 8.8%, p < 0.001 with land-based, and from 7.2 to 9.2%, p < 0.001 with water-based training, respectively), as compared to controls (p for change 0.629). No significant changes were detected in biomarkers of inflammation, cell adhesion or hemostasis, whereas levels of NT-proBNP (marker of cardiac dysfunction) decreased in the water-based training group (p = 0.07 vs. controls). Conclusion Endurance plus calisthenics exercise training in thermo-neutral water is safe, and improves aerobic exercise capacity and vascular function in patients undergoing short-term residential cardiac rehabilitation after a recent CAD event. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT02831829.
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Affiliation(s)
- Danijela Vasić
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Terme Krka, Šmarješke Toplice, Slovenia
| | - Marko Novaković
- Department of Vascular Diseases, University Medical Center, Ljubljana, Slovenia
| | - Mojca Božič Mijovski
- Laboratory for Haemostasis and Atherothrombosis, Department of Vascular Diseases, University Medical Center, Ljubljana, Slovenia
| | | | - Borut Jug
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Vascular Diseases, University Medical Center, Ljubljana, Slovenia
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Zamunér AR, Andrade CP, Arca EA, Avila MA. Impact of water therapy on pain management in patients with fibromyalgia: current perspectives. J Pain Res 2019; 12:1971-2007. [PMID: 31308729 PMCID: PMC6613198 DOI: 10.2147/jpr.s161494] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 05/20/2019] [Indexed: 11/23/2022] Open
Abstract
Exercise-related interventions have been recommended as one of the main components in the management of fibromyalgia syndrome (FMS). Water therapy, which combines water's physical properties and exercise benefits, has proven effective in improving the clinical symptoms of FMS, especially pain, considered the hallmark of this syndrome. However, to our knowledge, the mechanisms underlying water therapy effects on pain are still scarcely explored in the literature. Therefore, this narrative review aimed to present the current perspectives on water therapy and the physiological basis for the mechanisms supporting its use for pain management in patients with FMS. Furthermore, the effects of water therapy on the musculoskeletal, neuromuscular, cardiovascular, respiratory, and neuroendocrine systems and inflammation are also addressed. Taking into account the aspects reviewed herein, water therapy is recommended as a nonpharmacologic therapeutic approach in the management of FMS patients, improving pain, fatigue, and quality of life. Future studies should focus on clarifying whether mechanisms and long-lasting effects are superior to other types of nonpharmacological interventions, as well as the economic and societal impacts that this intervention may present.
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Affiliation(s)
| | | | - Eduardo Aguilar Arca
- Departamento de Fisioterapia, Universidade do Sagrado Coração, Bauru, São Paulo, Brasil
| | - Mariana Arias Avila
- Departamento de Fisioterapia e Programa de Pós-Graduação em Fisioterapia, Universidade Federal de São Carlos, São Carlos, São Paulo, Brasil
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The Thermal Effects of Water Immersion on Health Outcomes: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071280. [PMID: 30974799 PMCID: PMC6479732 DOI: 10.3390/ijerph16071280] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 01/02/2023]
Abstract
Hydrotherapy is widely used for the treatment and rehabilitation of patients, but it can also be applied to prevent diseases in healthy people. This review investigates the health effects of water immersion, a form of hydrotherapy, and the mechanisms by which the properties of water elicit such an effect. We searched PubMed, EMBASE, Cochrane Library, and CINAHL to identify relevant articles, of which 13 met the inclusion criteria. Various factors of water immersion were investigated in the 13 selected articles, including water temperature, immersion height, and application area. With respect to health effects, warm and cold water immersion affects the cardiovascular and neuromuscular systems, respectively. Nine articles focused on the effects of warm water immersion, explaining its thermal effect in relation to changes in disease-related serum substance levels and hemodynamic changes. While the sample population in most studies comprised young adults, two articles applied partial water immersion to the legs of elderly subjects to assess its effect on sleep. Because the water immersion protocols applied in the 13 articles were inconsistent, the health benefits could not be clearly explained. However, we expect the present findings to be beneficial for providing research guidelines for studies on the application of water immersion.
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Binkley HM, Rudd LE. Head-Out Aquatic Exercise for Generally Healthy Postmenopausal Women: A Systematic Review. J Phys Act Health 2018; 16:1-22. [PMID: 30501546 DOI: 10.1123/jpah.2017-0598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Aquatic exercise (AE) is a method for exercise and rehabilitation to enhance function for various clients. OBJECTIVES Investigate the effects of head-out AE interventions on the physiological and psychological outcomes of healthy postmenopausal women of age 50-70 years. SEARCH STRATEGIES Databases searched included Scopus, ScienceDirect, ResearchGate, PubMed/MEDLINE, PEDro, CINAHL, The Cochrane Library, Nursing & Allied Health Collection: Comprehensive, JSTOR, and OTSeeker.com, through January 2015. Search Criteria: Randomized controlled trial and quasi-randomized controlled trial studies. DATA COLLECTION AND ANALYSIS Two researchers scanned studies based on inclusion and exclusion criteria. Studies included were critically appraised using the Physiotherapy Evidence Database scale (PEDro scale). RESULTS A total of 15 studies including postmenopausal women and head-out AE intervention were reviewed. Considerable variation existed in the interventions and assessments. Outcome measures showed anthropometric measures (body mass index, circumference, skinfolds, and body fat) were inconclusive; upper and lower body strength improved; flexibility improved; all functional movements (short-distance walk, long-distance walk/run, power, agility, balance and falls) improved; bone density improved; biochemical and hormonal variables were inconclusive; and quality of life outcomes improved. CONCLUSIONS Head-out AE appears to be an effective training and conditioning method for postmenopausal women to improve strength, flexibility, functional movements, bone density, and quality of life.
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Hashimoto Y, Okamoto T. Acute effects of walking in water on vascular endothelial function and heart rate variability in healthy young men. Clin Exp Hypertens 2018; 41:452-459. [PMID: 30141976 DOI: 10.1080/10641963.2018.1506468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIM Aquatic exercise might improve endothelial function due to hydrostatic pressure increasing blood flow and causing shear stress to the endothelium. However, the acute effect of aerobic exercise in water on endothelial function is unclear. The present study compares the acute effect of aerobic exercise at moderate intensity in water and on land on endothelial function. METHODS Nine healthy young men walked on a treadmill for 30 min while immersed in water up to the xiphoid at 30.0 ± 0.2°C and on land at an intensity equivalent to 60% heart rate reserve in a crossover trial. Brachial artery flow-mediated dilation (FMD) was measured at baseline and at 30 and 60 min after exercise. Autonomic nervous activity was compared among conditions at the heart rate variability (HRV) during exercise. RESULTS FMD significantly decreased at 30 min after exercise on land trial (p < 0.05), but did not change after the aquatic trial. However, FMD was significantly higher after aquatic trial than land trial (p < 0.05) at 30 and 60 min after exercise, whereas heart rate, blood pressure, and HRV did not significantly differ between them. CONCLUSION These findings demonstrate that aerobic exercise in water suppressed the decrease in FMD compared with that on land, regardless of autonomic nervous activity.
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Affiliation(s)
- Yuto Hashimoto
- a Department of Health and Sport Science , Nippon Sport Science University , Tokyo , Japan
| | - Takanobu Okamoto
- b Department of Exercise Physiology , Nippon Sport Science University , Tokyo , Japan
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Simmons EE, Bergeron ER, Florian JP. The impact of repetitive long-duration water immersion on vascular function. PLoS One 2017; 12:e0181673. [PMID: 28750006 PMCID: PMC5531465 DOI: 10.1371/journal.pone.0181673] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 07/04/2017] [Indexed: 01/11/2023] Open
Abstract
While physiological responses to water immersion (WI) are well-studied, the vascular responses after WI are less understood. Fifteen male subjects performed six-hour resting thermoneutral water immersions (WI) at 1.35 atmospheres absolute for four consecutive days, with follow-up on the fifth day. Measurements included peripheral endothelial function and augmentation index (PAT, peripheral arterial tonometry), beat-to-beat blood pressure (BP, photoplethysmography), heart rate (HR), and plasma volume (PV) calculated from changes in hemoglobin and hematocrit. The reactive hyperemia index (RHI), a marker of peripheral endothelial function, increased with repeated immersions (p = 0.008). By WI2 and WI3, RHI increased 12% and 16%, respectively, compared to WI1 values, but no significant differences were detected between WI4 and WI1 for either measure. Absolute augmentation index (AI) increased by an average of 33% (p<0.001) and AI normalized for HR (AI@75) by 11% (p = 0.12) following each WI. PV decreased significantly by 13.2% following WI and remained 6.8% lower at follow-up compared to pre-WI. Systolic blood pressure significantly decreased by an average of 2.5% following each WI (p = 0.012). Compared to pre-WI HR, average post-WI HR decreased 4.3% lower (p<0.001), but increased overall by 8.2% over the course of repeated WI (p<0.001). Total peripheral resistance increased by an average of 13.1% following WI (p = 0.003). Thus, peripheral endothelial function increases after two days of WI, and PAT-derived measures of arterial stiffness increase transiently post-WI. Additionally, BP and PAT-derived endothelial function diverge from their usual associations with arterial stiffness (i.e. augmentation index) in the context of WI.
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Affiliation(s)
- Erin E. Simmons
- Navy Experimental Diving Unit, Panama City, Florida, United States of America
| | | | - John P. Florian
- Navy Experimental Diving Unit, Panama City, Florida, United States of America
- * E-mail:
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The Relative Efficacy of Land-Based and Water-Based Exercise Training on Macro- and Microvascular Functions in Older Patients With Type 2 Diabetes. J Aging Phys Act 2017; 25:446-452. [DOI: 10.1123/japa.2016-0193] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Microvascular and macrovascular dysfunction plays an important role in the pathogenesis of diabetic vascular disease. Twenty-nine older patients with type 2 diabetes were randomly assigned into the land-based (LB; n = 14) or water-based (WB; n = 15) groups. Both groups completed supervised aerobic cycling exercises three times per week for 12 weeks. The WB group performed cycling exercise training in warm water (36 °C) immersed to the hip level. After 12 weeks, blood glucose concentration and insulin resistance did not change but hemoglobin A1c levels decreased (P < .05) in both groups. Plasma nitric oxide concentrations increased (P < .05) in both groups. Flow-mediated dilation in the popliteal artery increased and arterial stiffness decreased (P < .05) in both exercise groups. Indices of microvascular reactivity improved (P < .05) only in the WB group. The benefits of warm water-based training were similar in general, and superior in some measures, to the more established land-based cycling exercise.
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