Effects of high vs moderate-intensity intermittent training on functionality, resting heart rate and blood pressure of elderly women

Effects of different exercise regimens on prognosis of patients with chronic obstructive pulmonary disease: a systematic reviews and meta-analysis

INTRODUCTION

Skeletal muscle dysfunction is a significant factor contributing to exercise limitation in patients with chronic obstructive pulmonary disease (COPD). Although exercise training is often recommended to enhance patient outcomes, there continues to be ongoing debate regarding its exact effects.

OBJECTIVE

The aim of this study is to evaluate the effectiveness of endurance exercise, strength training and combined exercise on cardiorespiratory fitness (including maximal oxygen uptake, maximal minute ventilation, and the 6-minute walk test), strength of lower limbs (measured by leg press), and quality of life (using the COPD Assessment Test) in patients with COPD. By conducting a systematic review and meta-analysis of randomized controlled trials (RCTs), our objective is to provide tailored training methods and intensity recommendations for patients with COPD in order to improve their quality of life.

METHODS

The meta-analysis included 10 randomized controlled trials (RCTs) of exercise rehabilitation programs involving 180 patients with COPD that were retrieved from electronic databases (PubMed, Cochrane Library, and Embase). Two reviewers independently assessed the topical relevance, trial quality, and extracted data for the meta-analysis.

RESULTS

Meta-analysis showed that primary outcomes representing exercise endurance were elevated under different exercise interventions compared to pre-test, such as maximal oxygen uptake (VO2max (ml/kg/min)) [SMD = 0.40, 95% CI (0.15, 0.64)] and the 6-min walk test (6MWT) [MD = 33.90, 95% CI (25.25, 42.55)], and primary outcomes representing strength also increased, such as leg press (1RM) [MD = 24.59, 95% CI (16.08, 33.11)], while secondary outcomes such as assessments of life such as the COPD Assessment Test (CAT) recovered [MD = 2.51, 95% CI (2.01, 3.00)], with all differences being statistically significant (p < 0.05). However, Maximum minute ventilation (VEmax (L)) [MD = 0.91, 95%CI (3.61, 5.43)] was not statistically significant (p > 0.05) when compared with the post-test data. The sensitivity test data were stable, and the results were reliable. We subgrouped the data from different types of exercise interventions and found that different types of exercise affected the experimental results.

CONCLUSION

Exercise interventions have a positive effect on the treatment of patients with COPD, significantly improving functional capacity, aerobic capacity, and exercise tolerance, but they should be individualized and developed according to the patient's condition to achieve the best therapeutic effect.

Effects of High-Intensity Interval Training on the Parameters Related to Physical Fitness and Health of Older Adults: A Systematic Review and Meta-Analysis

BACKGROUND

As a novel and time-efficient exercise form, high-intensity interval training (HIIT) has shown great potential in improving health-related physical fitness among diverse populations. However, empirical evidence on its efficacy among the elderly has not been well summarized. This systematic review and meta-analysis aimed to determine the effect of HIIT interventions on the parameters related to physical fitness and health of older adults, including resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiorespiratory fitness (CRF), body mass index (BMI), body fat percent (BF%), waist circumference (WC), muscular endurance (ME), muscular strength (MS), muscular power (MP), balance and flexibility, compared to non-exercise and other-exercise (e.g., moderate-intensity continuous training, resistance training) conditions.

METHODS

Literature published from January 2000 to May 2023 was collected through extensive searches across eight databases and relevant review papers. Randomized controlled trials (RCTs) featuring a minimum 2-week exercise intervention for older adults (≥ 60 years) were included. The pooled effect size of Hedges'g was estimated using random-effects models in R. Meta-regression was performed for both categorical (health status, duration of training programme, and frequency) and continuous moderators (mean age, male rate, and attrition rate).

RESULTS

Forty-four eligible RCTs with 1863 participants (52.1% female; 60.5-81.2 years) were included in the quantitative analysis. Compared to non-exercise condition, HIIT significantly improved resting HR (g = -0.36, 95%CI = [-0.67, -0.05], P = 0.032), SBP (g = -0.29, 95%CI = [-0.54, -0.03], P = 0.008), CRF (g = 0.77, 95%CI = [0.51, 1.04], P < 0.001), BF% (g = -0.26, 95%CI = [-0.41, -0.11], P = 0.006), MS (g = 0.47, 95%CI = [0.23, 0.71], P = 0.004), ME (g = 0.65, 95%CI = [0.10, 1.19], P = 0.036), and balance (e.g., timed-up-and-go) (g = -0.79, 95%CI = [-1.19, -0.40], P = 0.035). Compared to other-exercise condition, HIIT significantly improved resting HR (g = -0.11, 95%CI = [-0.21, -0.01], P = 0.029), SBP (g = -0.14, 95%CI = [-0.28, -0.01], P = 0.038), and CRF (g = 0.23, 95%CI = [0.07, 0.38], P = 0.008). No significant difference was found between HIIT and non-exercise condition for DBP, BMI and WC, as well as between HIIT and other-exercise condition for DBP, BMI, BF%, WC, ME, and balance (all P > 0.05). Meta-regression indicated that mean age moderated the HIIT effect on resting HR (b = -0.02, P = 0.014; HIIT vs. other-exercise condition) and SBP (b = 0.03, P = 0.048; HIIT vs. non-exercise), and attrition rate moderated the effect on CRF (b = 0.03, P = 0.007; HIIT vs. non-exercise).

CONCLUSION

This study supports the efficacy of HIIT in improving resting HR, SBP, CRF, BF%, MS, ME and balance among older adults. More empirical evidence is needed to determine the efficacy of HIIT for MP and flexibility in this population.

TRIAL REGISTRATION

PROSPERO CRD42022316246.

Exercise intensity prescription in cardiovascular rehabilitation: bridging the gap between best evidence and clinical practice

Optimizing endurance exercise intensity prescription is crucial to maximize the clinical benefits and minimize complications for individuals at risk for or with cardiovascular disease (CVD). However, standardization remains incomplete due to variations in clinical guidelines. This review provides a practical and updated guide for health professionals on how to prescribe endurance exercise intensity for cardiovascular rehabilitation (CR) populations, addressing international guidelines, practical applicability across diverse clinical settings and resource availabilities. In the context of CR, cardiopulmonary exercise test (CPET) is considered the gold standard assessment, and prescription based on ventilatory thresholds (VTs) is the preferable methodology. In settings where this approach isn't accessible, which is frequently the case in low-resource environments, approximating VTs involves combining objective assessments-ideally, exercise tests without gas exchange analyses, but at least alternative functional tests like the 6-minute walk test-with subjective methods for adjusting prescriptions, such as Borg's ratings of perceived exertion and the Talk Test. Therefore, enhancing exercise intensity prescription and offering personalized physical activity guidance to patients at risk for or with CVD rely on aligning workouts with individual physiological changes. A tailored prescription promotes a consistent and impactful exercise routine for enhancing health outcomes, considering patient preferences and motivations. Consequently, the selection and implementation of the best possible approach should consider available resources, with an ongoing emphasis on strategies to improve the delivery quality of exercise training in the context of FITT-VP prescription model (frequency, intensity, time, type, volume, and progression).

Effects of conditioning on the left ventricular function of young purebred Arabian horses

The effects of conditioning on cardiac function in young horses is still unknown. For this reason, this study evaluated the left ventricular (LV) function of young horses by echocardiography after six weeks of conditioning. Fourteen untrained young purebred Arabian horses were evaluated at rest and after a stress test (ST) before and after a six-week conditioning program. There was an increase in V4 (p < 0.001) after conditioning, as well as a reduction in both heart rate (HR) at rest and peak HR during the ST (p < 0.001). There was also a reduction in internal diameter, along with an increase in interventricular septal, free wall and mean thicknesses and LV mass (p < 0.05). After the ST, the conditioned animals showed higher values of velocity time integral, stroke volume, systolic and cardiac indices, ejection (ET) and deceleration times (DT), end-diastolic volume, time to onset of radial myocardial velocity during early diastole and time to peak of transmitral flow velocity, in addition to reduced pre-ejection period (PEP), PEP/ET ratio and mean velocity of circumferential fiber shortening (p < 0.05). The conditioning protocol promoted physiological adaptations that indicate an improvement in the animals' aerobic capacity associated with an enhanced left ventricular function.

Pilot study of a high-intensity interval training program in older adults: Safety, feasibility, functional fitness and cognitive effects

Exercise can boost physical and cognitive health in older adults. However, there are a lack of accessible exercise programs that foster adherence among older adults. In this study, we aimed to establish the safety and feasibility of APEX, a new exercise program designed to optimize fitness and cognitive gains for older adults, in addition to evaluating its acute physiological effects, and assessing its possible effects on functional fitness and cognition among healthy older adults. APEX utilizes a multimodal progressive high-intensity interval training (HIIT) design, with high-intensity intervals focused on enhancing cardiovascular fitness and muscle strength, and recovery intervals that incorporate balance and mobility exercises. The APEX training was tested in healthy older adults (n=4) over the course of four weeks. Ultimately, APEX was found to be safe and feasible, with no adverse events and high adherence. Participants met heart rate targets for all of the high-intensity exercises, and all intervals had a significant difference in heart rates between high-intensity and recovery periods in linear effects models (p<0.001). Improvements in functional fitness were observed in aerobic endurance, lower body strength, and balance. The intervention was also associated with positive trends in the cognitive domains of information processing, working memory, executive control, and attention. APEX offers a promising alternative to traditional cardiovascular exercise modalities for older adults with additional benefits for functional fitness and cognition. These results encourage further testing of the APEX program in older adults and different clinical populations.

Effects of high-intensity interval training on functional performance and maximal oxygen uptake in comparison with moderate intensity continuous training in cancer patients: a systematic review and meta-analysis

INTRODUCTION

High-intensity interval training (HIIT) is an appropriate training modality to improve endurance and therefore contributes to physical performance. This review investigates the effect of HIIT on functional performance in cancer patients. We reviewed the relative peak oxygen uptake (relV̇O2PEAK) and meta-analytical compared HIIT with moderate intensity continuous training (MICT). Furthermore, we took various training parameters under consideration.

METHODS

A systematic literature search was conducted in Scopus, PubMed, and Cochrane Library databases. For the review, we included randomized controlled trials containing HIIT with cancer patients. From this, we filtered interventions with additional MICT for the meta-analysis. Outcomes of interest were various functional performance assessments and V̇O2MAX.

RESULTS

The research yielded 584 records which fit the inclusion criteria, of which 31 studies with n=1555 patients (57.4±8.6 years) could be included in the overall review and 8 studies in the meta-analysis (n=268, 59.11±5.11 years) regarding relV̇O2PEAK. Different functional outcomes were found, of which walking distance (+8.63±6.91% meters in 6-min walk test) and mobility (+2.7cm in sit and reach test) improved significantly due to HIIT. In terms of relV̇O2PEAK, the performance of cancer patients was improved by HIIT (10.68±6.48%) and MICT (7.4±4.29%). HIIT can be favored to increase relV̇O2PEAK (SMD 0.37; 95% CI 0.09-0.65; I2=0%; p=0.009). Effect sizes for relV̇O2PEAK improvements correlate moderately with total training volume (Spearman's ρ=0.49; p=0.03), whereas percentage increases do not (Spearman's ρ=0.24; p=0.14).

CONCLUSION

Functional and physical outcomes were positively altered by different HIIT protocols and forms of implementation, whereas a tendency toward more effectiveness of HIIT vs. MICT was found for relV̇O2PEAK. Future studies should include functional parameters more often, to finally allow a comparison between both training protocols in this regard.

Recreational futsal provides broad-spectrum fitness and health benefits but no blood pressure effects in men with treated hypertension - a randomised controlled trial

We determined the coadjuvant effect of a recreational futsal (RF) programme versus standard care alone (CON) in men with treated arterial hypertension (TAHT). Thirty-nine men with TAHT were randomised to RF (N = 20; 48 ± 8 years; systolic blood pressure [SBP]: 122 ± 14 mmHg) with 2-3 one-hour sessions/week for 3 months, or to CON (N = 19; 51 ± 6 years; SBP: 126 ± 13 mmHg). Participants were assessed at baseline, at 3 months, and after 1 month of training cessation (4 months). Mean training attendance was 60 ± 23%. At 3-months, there were no between-group differences in BP parameters (SBP: 0.44 mmHg; 95% CI: -5.79, 6.67). However, compared to CON, RF was effective for peak oxygen uptake (2.76 mL.min-1.kg-1; 95% CI: 0.26, 5.26), time to exhaustion (1.15 min; 95% CI: 0.59, 1.69), Yo-Yo IE1 performance (365 m; 95% CI: 175, 556), resting heart rate (RHR; -5 b.min-1; 95% CI: -10, -1), glycated haemoglobin (-0.52 mmol/L; 95% CI: -0.84, -0.19), blood glucose (-0.25 mmol/L; 95% CI: -0.44, -0.06), left femur bone mineral content (1.96 g; 95% CI: 0.29, 3.65), and postural balance (-2.3 falls; 95% CI: -3.9, -0.6). Similar findings were observed after 1-month of training cessation, except for RHR and blood glucose that returned to baseline levels in the RF group. In conclusion, RF provides broad-spectrum fitness and health benefits but no BP effects in men with TAHT.

Effects of High-Intensity Functional Training (HIFT) on the Functional Capacity, Frailty, and Physical Condition of Older Adults with Mild Cognitive Impairment: A Blind Randomized Controlled Clinical Trial

Physical exercise has been established as an intervention in the integral approach for the physical, functional, and social health of older adults. The objective of this study was to determine the effects of a high-intensity functional training (HIFT) program on the physical condition and functional capacity of an elderly Colombian population with mild cognitive impairment. This research corresponds to a blind randomized controlled clinical trial. A total of 169 men and women aged over 65 years were evaluated and distributed in two groups: the experimental group that received a 12-week HIFT intervention (n = 82) and the control group (n = 87) that received general recommendations on the benefits of physical exercise. The outcome variables included physical condition, assessed using the Senior Fitness battery (SNB); Fried's frailty phenotype was applied, and gait and balance were assessed using the Tinetti scale. For the functional variables, activities of daily living, instrumental activities of daily living, and advanced activities of daily living were evaluated. All variables were measured pre- and post-intervention. Statistically significant improvements were observed in the IG for gait stability and balance (p < 0.001), as well as for independence in activities of daily living (p = 0.003), and instrumental and advanced activities (p < 0.001). Likewise, greater functionality was found when assessed with the SNB (p < 0.001), except for upper limb strength. The frailty classification did not show changes post-intervention (p = 0.170) nor in the group x time interaction. MANCOVA analysis showed that regardless of gender, health level, age, BMI, cognition, and health level, the HIFT intervention produced better results in functional capacity, balance, and gait (F = 0.173, p < 0.001, Wilks' λ = 88.231).

Moderate-Intensity Continuous Training Versus Moderate-Intensity Interval Training: Effects on Cardiometabolic Factors in Spanish Obese Adults

BACKGROUND

Excess weight and obesity are related to cardiometabolic diseases and limit physical activity. Until now, the effects of moderate-intensity continuous training (MICT) compared with moderate-intensity interval training (MIIT) in Spanish obese adults have not been analyzed.

OBJECTIVE

This study aimed to investigate the effect of MICT and MIIT together with a 1300-to-1400 caloric restrictive diet on cardiovascular disease risk factors in overweight and obese patients.

METHODS

The MICT and MIIT groups trained during 4 sessions a week for 12 weeks while performing the diet. The MICT group trained for 32 minutes per session in a cycloergometer, initially at 60% maximal oxygen uptake during the first month and increasing by 10% every 4 weeks. The MIIT group performed 4 × 4 intervals (at 60% maximal oxygen uptake and active rest at 60% maximal oxygen uptake minus 20 W), with a 10% increase every 4 weeks. The control group neither trained nor followed the restrictive diet.

RESULTS

One hundred fifty-nine obese adults participated in the study. The control group did not present any significant changes during the study. The MICT group significantly improved in all the variables (P < .05) except for high-density lipoproteins. The MIIT group improved in all the variables (P < .05) except for high-density lipoproteins and triglycerides. The MIIT group lost weight in less time than the MICT group.

CONCLUSIONS

Overweight and obese adults of both the MICT and MIIT groups decreased their risk for cardiovascular disease, although the MIIT group lost weight in a shorter amount of time.

Pre- and Postoperative Exercise Effectiveness in Mobility, Hemostatic Balance, and Prognostic Biomarkers in Hip Fracture Patients: A Study Protocol for a Randomized Controlled Trial

Hip fractures are a major health concern, particularly for older adults, as they can reduce life quality, mobility loss, and even death. Current evidence reveals that early intervention is recommended for endurance in patients with hip fractures. To our knowledge, preoperative exercise intervention in patients with hip fractures remains poorly researched, and no study has yet applied aerobic exercise preoperatively. This study aims to investigate the short-term benefits of a supervised preoperative aerobic moderate-intensity interval training (MIIT) program and the added effect of an 8-week postoperative MIIT aerobic exercise program with a portable upper extremity cycle ergometer. The work-to-recovery ratio will be 1-to-1, consisting of 120 s for each bout and four and eight rounds for the pre- and postoperative programs, respectively. The preoperative program will be delivered twice a day. A parallel group, single-blinded, randomized controlled trial (RCT) was planned to be conducted with 58 patients each in the intervention and control groups. This study has two primary purposes. First, to study the effect of a preoperative aerobic exercise program with a portable upper extremity cycle ergometer on immediate postoperative mobility. Second, to investigate the additional effect of an 8-week postoperative aerobic exercise program with a portable upper extremity cycle ergometer on the walking distance at eight weeks after surgery. This study also has several secondary objectives, such as ameliorating surgical and keeping hemostatic balance throughout exercise. This study may expand our knowledge of preoperative exercise effectiveness in hip fracture patients and enhance the current literature about early intervention benefits.

Promoting Healthy Behaviors in Older Adults to Optimize Health-Promoting Lifestyle: An Intervention Study

Introduction: Exercise intervention is the easiest and most effective way to promote human health. This study combined technology and exercise to improve the health behavior of the older adults through a physical activity intervention and to enhance a health-promoting lifestyle. Materials and methods: A quasi-experimental research method was used to openly recruit 120 healthy male and female older adults over 65 years old (average age of males: 71.6 ± 1.25 years; average age of females: 72.3 ± 1.28 years), all of whom wore smart bracelets. The participants were monitored by special personnel during the same period of walking every Monday to Friday. All participants recorded their daily steps, distance walked, and calorie consumption data for a period of 8 weeks. Results: After 8 weeks of walking, all participants showed a positive medium−high correlation of various factors between healthy behaviors and the health-promoting lifestyle scales. In the post-tests of each factor of two scales, males had the highest correlation between regular physical activity and physical activity, and females had the highest correlation between regular physical activity and social support. The variabilities in the explanatory power of the health behaviors of males and females on the health-promoting lifestyle were R2 = 70.9% (p < 0.01) and R2 = 74.1% (p < 0.01), indicating that the variables of healthy behaviors have a positive effect on health-promoting lifestyles in male and female older adults. Conclusions: Walking interventions positively affect the health behaviors of older adults and encourage health-promoting lifestyles. The value of this study is in its contribution to health promotion and public health recommendations for older adults.

Effect of High-Intensity Interval Training on Functional Movement in Older Adults: A Systematic Review and Meta-analysis

BACKGROUND

Preserving physiological functional capacity (PFC), the ability to perform the activities of daily life, and the ease with which they can be performed, in older adults, defined for this study as ≥ 50 years of age, is an important consideration for maintaining health and independence through the ageing process. Physical activity, and exercise training in particular, has been positively associated with improvement in PFC. In addition to improving aerobic and anaerobic capacity, promoting and preserving functional movement as a component of PFC is an important goal of physical activity, especially for older adults. High-intensity interval training (HIIT), an exercise protocol where repeated bouts of increased intensity are interspersed with active or passive recovery periods, has often been studied as an alternative to traditional moderate-intensity continuous training (MICT) exercise, where a continuous intensity is maintained throughout the exercise session. A large body of research has determined that both types of exercise programme are effective in improving measures of aerobic and anaerobic fitness in older adults. However, the effect of the two exercise modalities on functional movement has most often been a secondary outcome, with a range of observational techniques applied for measurement.

OBJECTIVES

The primary objective of this research is to systematically review and meta-analyse published studies of HIIT interventions that measured functional movement in older adults to conclude if HIIT is effective for improving functional movement. A secondary objective is to determine if there are significant differences between HIIT and MICT effect on functional movement.

METHODS

A search strategy of terms locating studies of HIIT interventions, functional movement outcome measures, and older adult population samples was executed on seven digital databases. Randomized and pair-matched trials of > 2 weeks were considered for inclusion. Studies of participants with neurological impairment or studies using combined exercise modality were rejected. Standardized mean difference for functional movement outcome measures was calculated. A meta-analysis of the included studies and subgroups was performed along with study quality (risk of bias and publication bias) evaluation.

RESULTS

A total of 18 studies were included in random effects model pooled analysis. Subgroup analysis of HIIT versus MICT on functional movement showed a trivial effect in favour of HIIT (ES 0.13, 95% CI [-0.06, 0.33] p = 0.18) and did not achieve statistical significance. However, HIIT showed a medium, statistically significant favourable effect on functional movement versus non-intervention control (ES = 0.60 95% CI [0.24, 0.95] p = 0.001). Further subgroups analysis using singular and multiple functional movement outcome measures showed similar results.

CONCLUSION

This meta-analysis indicates that HIIT interventions in older adults may be effective at promoting improvements in functional movement, though it is unclear whether HIIT is superior to MICT.

Application and progress of blood flow restriction training in improving muscle mass and strength in the elderly

As an emerging training method, blood flow restriction training has been proved to promote the growth of muscle mass and strength. In recent years, it has been gradually applied in different populations. However, there are few studies on how blood flow restriction training affects muscle mass and strength in the elderly. The relevant literature is compiled and summarized in this study. Through the comparison of blood flow restriction training with traditional training methods and its application in the elderly, it shows that blood flow restriction training can effectively increase muscle mass and strength, prevent muscle atrophy, improve cardiopulmonary function, facilitate injury and postoperative rehabilitation, and intervene in related degenerative diseases as a training method suitable for the elderly,. The main mechanism of blood flow restriction training promoting muscle mass and strength growth is metabolic stress response, including muscle fiber recruitment, protein synthesis signal pathway activation, hormone secretion, etc., and is also related to cell swelling caused by pressure. At present, although the application of blood flow restriction training in the elderly population is increasing, there is a lack of personalized programs. In the future, more research on the dose effect and safety of blood flow restriction training is needed to develop more accurate personalized training programs.

Monitoring training load in youth soccer players: effects of a six-week preparatory training program and the association between external and internal loads

This study examined the effects of a six-week preparatory training program on physical performance and physiological adaptations in junior soccer players. Additionally, we investigated whether a relationship existed between external and internal loads. Youth soccer players (aged 16 years old) from a youth football academy participated in six weeks of pre-conditioning training. Wireless Polar Team Pro and Polar heart rate sensors (H10) were used to monitor physical performance indicators (sprint and acceleration scores, covered distance, maximum and average speed and duration), physiological responses (maximum and average heart rate [HR] and R-R interval, time in HR zones 4+5, and heart rate variability [HRV]), and training load score. Additionally, muscle status and rating of perceived exertion (RPE) scores were measured using digital questionnaires. Significant increases were observed in the majority of physical performance indicators [i.e., sprints (p = 0.015, ES = 1.02), acceleration (p = 0.014, ES = 1), total distance (p = 0.02, ES = 0.87), as well as maximum speed (p = 0.02, ES = 0.87)]. A trend towards improvement was observed in the remaining performance indicators (i.e., distance/min and avg speed; ES = 0.6), training load (ES = 0.2), muscle status (ES = 0.3)), and all physiological responses parameters (ES = 0.1 to 0.6). Significant correlations were found between the majority of external load parameters (i.e., performance indicators) and objective (i.e., physiological responses) and subjective (i.e., RPE, muscle status) internal load parameters (p < 0.001). The highest number of moderate-large correlations were registered between performance indicators and time in HR zone 4+5 (0.58 < r < 0.82), training load (0.53 < r < 0.83), average HR (0.50 < r < 0.87), maximal HR (0.51 < r < 0.54) and average R-R interval (0.58 < r < 0.76). HR zone 4+5, average and maximal HR, average R-R interval, and training load score may help control training parameters and reduce the risk of under- or over-training in youth soccer players. However, these conclusions should be confirmed and replicated in future studies with more diverse subject populations.

Effects of a multicomponent physical exercise programme on perceived health-related quality of life and on depressive symptoms in older adults living in long-term nursing homes

Objectives

This study aimed to investigate the impact of a multicomponent exercise programme on perceived health-related quality of life (HRQoL) and depressive symptomatology in older people living in a long-term nursing home (LTNH).

Methods

A quasi-experimental study was conducted. Forty-one older people were conveniently selected from the largest LTNH in the Basque Country. The participants were assigned to either an intervention group (n = 21) or a control group (n = 20). The intervention group participated in 50-min moderate intensity multicomponent physical exercise sessions (strength and balance, three sessions a week for 3 months). The control group participants continued their usual activities in the LTNH. Assessments were completed at baseline and reassessed after the 12-week intervention by the same nurse researchers who filled out the questionnaires: the 36-item Short Form Survey (SF-36) and the Geriatric Depression Scale (GDS).

Results

Thirty-eight participants completed the study (19 participants in each group). In the SF-36 parameters, physical functioning increase in the intervention group tends with a mean increase of 11.06 units (a 17.2% increase over the pre). In the role-emotional, the increase in the intervention group is with a mean increase of 5.27 units (a 29.1% increase over the pre) (P < 0.05). In social functioning, the increase in the control group is significant with a mean increase of 13.16 units (a 15.4% increase over the pre) (P < 0.05). There are no significant changes in the rest of the parameters, there are no differences between groups in the evolutionary pattern either.

Conclusions

As for the effects of the multicomponent exercise programme on HRQoL and depressive symptomatology, no statistically significant effects were obtained in the outcome data among older adults living in LTNHs. An increase in the sample size could confirm the trends obtained. The results may help inform the design of future studies.

The Technology Acceptance Model and Older Adults' Exercise Intentions-A Systematic Literature Review

Aging is a global phenomenon, and the use of exercise technology by older adults can help them to prevent disease, achieve good health, and ultimately achieve successful aging. In the past, there literature compilation studies have been conducted on sports technology and young people or on the use of technology by the older adults; however, no studies have determined the attitudes of older adults toward sports technology. This review applied a systematic literature analysis to determine the factors that correlate the technology acceptance model with the older population's exercise attitudes. A total of 10 studies were identified as contributing to the use of exercise technology by older adults. The main findings of this review are that, of the 28 factors identified in the 10 studies, only 18 were identified as factors influencing older adults' use of sports technology in the technology acceptance model (TAM). Among these, fifteen factors affected intention, four factors affected perceived ease of use, three factors affected perceived usefulness, and two factors affected attitudes. Finally, discussing the related factors affecting TAM allows us to provide suggestions for future research directions.

Effects of the intensity of interval training on aerobic fitness, body composition and resting metabolic rate of women with overweight or obesity: A randomized trial

BACKGROUND: Moderate-intensity interval training (MIIT) may be a viable exercise format for improving body composition, aerobic fitness, and health-related variables. OBJECTIVES: This randomized trial aimed to analyze the effect of MIIT or high-intensity interval training (HIIT) on aerobic fitness, body composition variables, and resting metabolic rate (RMR) in women with overweight or obesity. METHODS: 31 sedentary adult women with overweight or obesity performed 7 weeks × 3 weekly sessions of either HIIT or MIIT. Physical and physiological tests were applied before and after training. RESULTS: In both analyses (intention-to-treat and by adherence to the training), aerobic fitness showed a time effect (p= 0.041 and p= 0.015), but without differences between groups (p> 0.05). No group (HIIT vs. MIIT), time (pre vs. post), or interaction effects (group vs. time) were found for RMR, body composition markers (fat mass, body fat percentage, lean mass), or body mass index – BMI (p> 0.05). In addition, MIIT induced a relatively high drop-out rate. CONCLUSIONS: This study suggested that the short-term (7-weeks) interval exercise training was effective for increasing aerobic fitness, and moderate-intensity intervals were as effective as high-intensity intervals. However, neither training format was effective for changing RMR, body composition variables, or BMI of women with overweight or obesity. Clinical trial ID: RBR-9jd7b7.

A need to reconsider the rehabilitation protocol in patients with idiopathic Parkinson’s disease: Review analysis

Idiopathic Parkinson’s disease is the second most debilitating and progressive neurodegenerative disease affecting the functional activities in day-to-day life. The motor and non-motor symptoms have shown to be a huge functional loss for the subject which has led to compromise their independence. There are varieties of treatment programs proposed as pharmacological, surgical, rehabilitation, allied therapies but none have proven to be the disease modifying treatments in managing the symptoms of Parkinson’s disease patients. Research has shown that discontinuity in the treatment and diminished effects of treatments have drained care givers physically, emotionally, and financially.  In this study we explore the available physiotherapy treatment strategies highlighting the research gaps in articles (n=36). The articles were taken from the databases such as PubMed, Science Direct and Google Scholar by considering the inclusion and exclusion criteria. Though the present research has shown to be significant in improving the motor and non-motor symptoms there are still unanswered questions on the rehabilitation protocols whether they can modify the disease and improve the quality of life among Parkinson’s disease in long term. Exercise have proven to be beneficial, cost effective and low risk which improves the overall health and independence of the patient,  however, the mechanism involved are less understood.

The Effect of Self-Selected Exercise Workloads on Perceived Enjoyment and Self-Efficacy in Sedentary Adults

Self-selected workloads are shown to be more enjoyable than researcher-selected workloads. In addition, it is unclear if sedentary adults find aerobic interval or continuous exercise more pleasant. Therefore, the primary purpose of this study was to determine the effects of two acute bouts (interval vs. continuous) of self-selected moderate-intensity treadmill exercises on perceived enjoyment and self-efficacy towards exercise in a sedentary cohort. Methods: Sixteen sedentary adults completed two 30 min bouts of moderate-intensity treadmill activity, one interval and one continuous. Participants blindly (could not see speed, grade, and heart rate) selected their own treadmill workload with guidance from the Borg RPE 6-20 scale. Post-exercise self-efficacy and perceived enjoyment were assessed using the Self-Efficacy for Exercise Scale and the Physical Activity Enjoyment Scale, respectively. Exercise workloads using treadmill speed and grade and exercise heart rate were compared between trials. Results: No significant differences were found between conditions for self-selected workloads (p = 0.62), self-efficacy (p = 0.58), perceived enjoyment (p = 0.41), and heart rate (p = 0.12). Discussion: Sedentary individuals reported no difference in self-efficacy or perceived exercise enjoyment. Participants were, however, adequate in self-selecting their own intensities with RPE guidance as there were no differences in the workloads across conditions. These results suggest that when able to self-select moderate-intensity exercise workloads, sedentary individuals equally enjoy both interval and continuous exercise.

Lightweight neural network based model for real-time precise HR monitoring during high intensity workout using consumer smartwatches

Mobile and wearable electronics is one of the rapidly developing areas of high technologies, which regularly appear new devices that offer new features for monitoring our health, level of physical exertion and everyday activity. From the point of view of medicine and sports, usually wearable devices are used to solve one of two tasks: round-the-clock continuous heart rate monitoring, and the control of the heart rate during workout. One of the drawbacks of such devices is the calculation errors that are caused by the motion artifacts. The most critical of them are those that arise in some cases when performing high-intensity training's, which are conjugate with intense hands movements, such as sprint running or boxing. In addition, limited resources of wearable devices do not always allow usage of very complex algorithms for processing certain events. In our work, an ultra-lightweight framework for a precise real-time heart rate monitoring during the high intensity physical exercises is developed. The model is a combination of a digital signal processing and deep convolutional and recurrent neural networks approaches. From the personalization point of view, the effect of anthropometric parameters has been studied. The model shows an average mean absolute error of 2.4±2.8 bpm during 5 fold cross-validation on an internal dataset, 2.9±3.4 bpm when evaluated on 12 IEEE SPC subjects, and 4.8±5.3 bpm when evaluated on 24 subjects from Wonkwang University dataset. Such results exceed the current state of the art solutions both in terms of the achieved accuracy of heart rate estimation and consumed computational resources. Clinical relevance- This work aims to provide a robust and lightweight neural network based framework for a real time heart rate estimation during high intensity physical exercises.

Equipment-free, unsupervised high intensity interval training elicits significant improvements in the physiological resilience of older adults

Background

Reduced cardiorespiratory fitness (CRF) is an independent risk factor for dependency, cognitive impairment and premature mortality. High-intensity interval training (HIIT) is a proven time-efficient stimulus for improving both CRF and other facets of cardiometabolic health also known to decline with advancing age. However, the efficacy of equipment-free, unsupervised HIIT to improve the physiological resilience of older adults is not known.

Methods

Thirty independent, community-dwelling older adults (71(SD: 5) years) were randomised to 4 weeks (12 sessions) equipment-free, supervised (in the laboratory (L-HIIT)) or unsupervised (at home (H-HIIT)) HIIT, or a no-intervention control (CON). HIIT involved 5, 1-minute intervals of a bodyweight exercise each interspersed with 90-seconds recovery. CRF, exercise tolerance, blood pressure (BP), body composition, muscle architecture, circulating lipids and glucose tolerance were assessed at baseline and after the intervention period.

Results

When compared to the control group, both HIIT protocols improved the primary outcome of CRF ((via anaerobic threshold) mean difference, L-HIIT: +2.27, H-HIIT: +2.29, both p < 0.01) in addition to exercise tolerance, systolic BP, total cholesterol, non-HDL cholesterol and m. vastus lateralis pennation angle, to the same extent. There was no improvement in these parameters in CON. There was no change in diastolic BP, glucose tolerance, whole-body composition or HDL cholesterol in any of the groups.

Conclusions

This is the first study to show that short-term, time-efficient, equipment-free, HIIT is able to elicit improvements in the CRF of older adults irrespective of supervision status. Unsupervised HIIT may offer a novel approach to improve the physiological resilience of older adults, combating age-associated physiological decline, the rise of inactivity and the additional challenges currently posed by the COVID-19 pandemic.

Trial registration

This study was registered at clinicaltrials.gov and coded: NCT03473990.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03208-y.

Impact of high-intensity interval training on cardio-metabolic health outcomes and mitochondrial function in older adults: a review

Exercise being a potent stimulator of mitochondrial biogenesis, there is a need to investigate the effects of high-intensity interval training (HIIT) among older adults. This review explores and summarizes the impact of HIIT on mitochondria and various cardio-metabolic health outcomes among older adults, healthy and with comorbid conditions. Electronic databases were scrutinized for literature using permutations of keywords related to (i) Elderly population (ii) HIIT (iii) Mitochondria, cell organelles, and (iv) cardio-metabolic health outcomes. Twenty-one studies that met the inclusion criteria are included in this review. HIIT is an innovative therapeutic modality in preserving mitochondrial quality with age and serves to be a viable, safe, and beneficial exercise alternative in both ill and healthy older adults.

Effects of an individualized and progressive multicomponent exercise program on blood pressure, cardiorespiratory fitness, and body composition in long-term care residents: Randomized controlled trial

This study analyzed the effects of an individualized and progressive multicomponent exercise program on blood pressure, cardiorespiratory fitness, and body composition in long-term care residents. This was a single-blind, multicenter, randomized controlled trial performed in 10 long-term care settings and involved 112 participants. Participants were randomly assigned to a control group or an intervention group. The control group participated in routine activities; the intervention group participated in a six-month individualized and progressive multicomponent exercise program focused on strength, balance, and walking recommendations. The intervention group maintained peak VO₂, oxygen saturation, and resting heart rate, while the control group showed a significant decrease in peak VO₂ and oxygen saturation and an increase in resting heart rate throughout the six-month period. Individualized and progressive multicomponent exercise programs comprising strength, balance, and walking recommendations appear to be effective in preventing cardiorespiratory fitness decline in older adults living in long-term care settings.

High-intensity interval training reduces blood pressure in older adults: A systematic review and meta-analysis

BACKGROUND/OBJECTIVES

The current systematic review and meta-analysis evaluated the effects of High-Intensity Interval Training (HIIT) on blood pressure (BP) in older adults and compared the efficacy of HIIT versus moderate-intensity continuous training (MICT).

METHODS

Search was conducted using the databases at PubMed, Scopus, Cochrane Library and EMBASE, for randomized trials comparing the chronic effects (≥4 weeks) of HIIT versus MICT or control group (non-exercise) on BP in older adults (≥60 years) with or without hypertension.

RESULTS

A total of 10 articles (n = 266 participants) were included in this meta-analysis. HIIT were associated with reductions in systolic BP (MD -7.36; 95%CI -11.80 to -2.92; P < 0.01; I² = 24%) and diastolic BP (MD -5.48; 95%CI -8.71 to -2.25; P < 0.01; I² = 40%) versus control group. No differences were found between HIIT and MICT in systolic BP (MD -2.09; 95%CI -9.76 to 5.58; P = 0.59; I² = 0%) and diastolic BP (MD -1.00; 95%CI -6.01 to 4.01; P = 0.69; I² = 0%).

CONCLUSION

HIIT reduces BP in older adults. Additionally, HIIT and MICT provided comparable reductions on BP in this population.

Effect of physical exercise cessation on strength, functional, metabolic and structural outcomes in older adults: a protocol for systematic review and meta-analysis

INTRODUCTION

There is not a doubt that tailored exercise is an effective non-pharmacological approach for preventing, mitigating and even reversing ageing-related alterations. However, older adults are likely to experience prolonged periods of inactivity and training cessation periods as a consequence of falls or hospitalisation. Although recent evidence supports that exercise could have a protective effect and help in recovering, there is to date a lack of consensus about what kind of physical exercise prescription and training duration would produce better outcomes after training cessation periods. The current study will determine the effects that available exercise prescriptions produced in older adults in preserving physical conditioning following inactivity periods.

METHODS AND ANALYSIS

A systematic search of the literature will be conducted in three databases, namely PubMed, Scopus and Web of Science, from inception to 1 February 2021. Only randomised controlled trials written in English or Spanish will be eligible. No year of publication restriction will be applied. Eligible studies will contain information on population (older adults over 60 years old), intervention (inactivity period, exercise programme their duration), comparator (treatment as usual or waiting list) and outcomes (strength, functional capacity, metabolic health and skeletal muscle structure). Two independent reviewers will (1) search, screen and select studies, (2) extract data about their main characteristics and (3) evaluate their methodological and reporting quality. When disagreements emerge, the reviewers will discuss to reach a consensus. We plan to conduct meta-analysis to quantitatively synthesise the effects under study.

ETHICS AND DISSEMINATION

As systematic reviews use publicly available data, no formal ethical review and approval are needed. Findings will be published in a peer-reviewed journal(s) and presented at conferences.

PROSPERO REGISTRATION NUMBER

CRD42021235092.

The Effects of High-Intensity Interval Training (HIIT) on Fall Risk Factors in Healthy Older Adults: A Systematic Review

High-intensity interval training (HIIT) improves functional capacity, muscle power and physical performance in older adults with and without comorbidities. The aim of this study was to explore the effectiveness of HIIT as a method for reducing major fall risk factors (balance, muscle strength and physical activity) in older adults. A systematic literature search was conducted following the PRISMA guidelines. A computerized search was conducted using electronic databases (PubMed, CINAHL, Cochrane Library, APA PsycInfo, Web of Science, Scopus, PEDro, and AgeLine) published up to July 2021. Eleven papers (9 studies) of moderate quality (mean of 5.5 in Pedro scale) involving 328 healthy older adults met the inclusion criteria. Studies were characterized by high heterogeneity in terms of methodology, HIIT modality and protocol, subject characteristics, and outcome measures. Results indicate that HIIT cannot be recommended as a single modality for fall prevention in older adults due to insufficient data and no consensus among the studies. HIIT appears to be a safe and well-tolerated supplement to proven fall prevention programs, due to its effects on lower limb strength reflected in functional performance tests, and on dynamic balance and subjective balance perception. However, caution is warranted following HIIT, especially after the first session, due to possible temporary instability.

Exercise to Reduce Anthracycline-Mediated Cardiovascular Complications in Breast Cancer Survivors

While developments in cancer therapeutics have greatly reduced morbidity and mortality in females with breast cancer, it comes at a cost of an increased risk of cardiovascular complications. In particular, anthracyclines, like doxorubicin, which are a mainstay of current chemotherapy regimens, are associated with dose-dependent cardiotoxicity. Exercise has been widely accepted as an effective intervention in reducing cardiovascular risk in a variety of different clinical conditions. However, the benefits of exercise in anthracycline-mediated cardiotoxicity are not clearly understood. First, this review discusses the pre-clinical studies which have elucidated the cardioprotective mechanisms of aerobic and resistance exercise in improving cardiovascular function in the setting of anthracycline treatment. Next, it aims to summarize the results of aerobic and resistance exercise clinical trials conducted in females with breast cancer who received anthracycline-based chemotherapy. The review further discusses the current exercise guidelines for women undergoing chemotherapy and contraindications for exercise. Finally, the review addresses gaps in research, specifically the need for further clinical trials to establish a recommended exercise prescription within this patient population.

High Intensity Interval Training (HIIT) as a Potential Countermeasure for Phenotypic Characteristics of Sarcopenia: A Scoping Review

Background: Sarcopenia is defined as a progressive and generalized loss of skeletal muscle quantity and function associated predominantly with aging. Physical activity appears the most promising intervention to attenuate sarcopenia, yet physical activity guidelines are rarely met. In recent years high intensity interval training (HIIT) has garnered interested in athletic populations, clinical populations, and general population alike. There is emerging evidence of the efficacy of HIIT in the young old (i.e. seventh decade of life), yet data concerning the oldest old (i.e., ninth decade of life onwards), and those diagnosed with sarcopenic are sparse.

Objectives: In this scoping review of the literature, we aggregated information regarding HIIT as a potential intervention to attenuate phenotypic characteristics of sarcopenia.

Eligibility Criteria: Original investigations concerning the impact of HIIT on muscle function, muscle quantity or quality, and physical performance in older individuals (mean age ≥60 years of age) were considered.

Sources of Evidence: Five electronic databases (Medline, EMBASE, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials [CENTRAL]) were searched.

Methods: A scoping review was conducted using the Arksey and O'Malley methodological framework (2005). Review selection and characterization were performed by two independent reviewers using pretested forms.

Results: Authors reviewed 1,063 titles and abstracts for inclusion with 74 selected for full text review. Thirty-two studies were analyzed. Twenty-seven studies had a mean participant age in the 60s, two in the 70s, and three in the 80s. There were 20 studies which examined the effect of HIIT on muscle function, 22 which examined muscle quantity, and 12 which examined physical performance. HIIT was generally effective in Improving muscle function and physical performance compared to non-exercised controls, moderate intensity continuous training, or pre-HIIT (study design-dependent), with more ambiguity concerning muscle quantity.

Conclusions: Most studies presented herein utilized outcome measures defined by the European Working Group on Sarcopenia in Older People (EWGSOP). However, there are too few studies investigating any form of HIIT in the oldest old (i.e., ≥80 years of age), or those already sarcopenic. Therefore, more intervention studies are needed in this population.

High-Intensity Interval Training in Older Adults: a Scoping Review

High-intensity interval training (HIIT) is an increasingly popular form of aerobic exercise which includes bouts of high-intensity exercise interspersed with periods of rest. The health benefits, risks, and optimal design of HIIT are still unclear. Further, most research on HIIT has been done in young and middle-aged adults, and as such, the tolerability and effects in senior populations are less well-known. The purpose of this scoping review was to characterize HIIT research that has been done in older adults including protocols, feasibility, and safety and to identify gaps in the current knowledge. Five databases were searched with variations of the terms, "high-intensity interval training" and "older adults" for experimental or quasi-experimental studies published in or after 2009. Studies were included if they had a treatment group with a mean age of 65 years or older who did HIIT, exclusively. Of 4644 papers identified, 69 met the inclusion criteria. The average duration of training was 7.9 (7.0) weeks (mean [SD]) and protocols ranged widely. The average sample size was 47.0 (65.2) subjects (mean [SD]). Healthy populations were the most studied group (n = 30), followed by subjects with cardiovascular (n = 12) or cardiac disease (n = 9), metabolic dysfunction (n = 8), and others (n = 10). The most common primary outcomes included changes in cardiorespiratory fitness (such as VO2peak) as well as feasibility and safety of the protocols as measured by the number of participant dropouts, adverse events, and compliance rate. HIIT protocols were diverse but were generally well-tolerated and may confer many health advantages to older adults. Larger studies and more research in clinical populations most representative of older adults are needed to further evaluate the clinical effects of HIIT in these groups.

Four Weeks of Detraining Induced by COVID-19 Reverse Cardiac Improvements from Eight Weeks of Fitness-Dance Training in Older Adults with Mild Cognitive Impairment

Physical training is considered as a low-cost intervention to generate cardioprotective benefits and to promote physical and mental health, while reducing the severity of acute respiratory infection symptoms in older adults. However, lockdown measures during COVID-19 have limited people's opportunity to exercise regularly. The aim of this study was to investigate the effect of eight weeks of Fitness and Dance training, followed by four weeks of COVID-19-induced detraining, on cardiac adaptations and physical performance indicators in older adults with mild cognitive impairment (MCI). Twelve older adults (6 males and 6 females) with MCI (age, 73 ± 4.4 y; body mass, 75.3 ± 6.4 kg; height, 172 ± 8 cm; MMSE score: 24-27) participated in eight weeks of a combined Fitness-Dance training intervention (two sessions/week) followed by four weeks of training cessation induced by COVID-19 lockdowns. Wireless Polar Team Pro and Polar heart rate sensors (H10) were used to monitor covered distance, speed, heart rate (HR min, avg and max), time in HR zone 1 to 5, strenuousness (load score), beat-to-beat interval (max RR and avg RR) and heart rate variability (HRV-RMSSD). One-way ANOVA was used to analyze the data of the three test sessions (T1: first training session, T2: last training session of the eight-week training program, and T3: first training session after the four-week training cessation). Statistical analysis showed that eight weeks of combined Fitness-Dance training induced beneficial cardiac adaptations by decreasing HR (HR min, HR avg and HR max) with p < 0.001, ES = 0.5-0.6 and Δ = -7 to-9 bpm, and increasing HRV related responses (max and avg RR and RMSSD), with p < 0.01 and ES = 0.4. Consequently, participants spent more time in comfortable HR zones (e.g., p < 0.0005; ES = 0.7; Δ = 25% for HR zone 1) and showed reduced strenuousness (p = 0.02, Δ = -15% for load score), despite the higher covered total distance and average speed (p < 0.01; ES = 0.4). However, these changes were reversed after only four weeks of COVID-19 induced detraining, with values of all parameters returning to their baseline levels. In conclusion, eight weeks of combined Fitness-Dance training seems to be an efficient strategy to promote cardioprotective benefits in older adults with MCI. Importantly, to maintain these health benefits, training has to be continued and detraining periods should be reduced. During a pandemic, home-based exercise programs may provide an effective and efficient alternative of physical training.

Impact of the COVID-19 pandemic on phase 2 cardiac rehabilitation patients in Japan

This study aimed to clarify the effects of the interruption of cardiac rehabilitation (CR) and refraining from going outside due to the COVID-19 pandemic on hemodynamic response and rating of perceived exertion (RPE) during exercise including differences by age in phase 2 CR outpatients. Among 76 outpatients participating in consecutive phase 2 CR in both periods from March to April and June to July 2020, which were before and after CR interruption, respectively, at Sanda City Hospital were enrolled. The inclusion criterion was outpatients whose CR was interrupted due to COVID-19. We compared the data of hemodynamic response and RPE during exercise on the last day before interruption and the first day after interruption when aerobic exercise was performed at the same exercise intensity in the  < 75 years group and  ≥ 75 years group. Fifty-three patients were enrolled in the final analysis. Post-CR interruption, peak heart rate increased significantly (p = 0.009) in the  < 75 years group, whereas in the  ≥ 75 years group, weight and body mass index decreased significantly (p = 0.009, 0.011, respectively) and Borg scale scores for both dyspnea and lower extremities fatigue worsened significantly (both, p < 0.001). CR interruption and refraining from going outside due to the COVID-19 pandemic affected the hemodynamic response, RPE during exercise and body weight in phase 2 CR outpatients. In particular, patients aged  ≥ 75 years appeared to be placed at an increased risk of frailty.

Low-volume high-intensity interval training improves cardiometabolic health, work ability and well-being in severely obese individuals: a randomized-controlled trial sub-study

BACKGROUND

Obesity is associated with impaired health and lower work ability. Increased physical activity is a cornerstone in the treatment of obesity and related risk factors. Recently, high-intensity interval training (HIIT) has emerged as a popular exercise option. However, data regarding the effects on cardiometabolic health, perceived work ability and well-being in severely obese individuals are lacking.

METHODS

Sixty-five obese individuals with sedentary occupation (48.7 ± 9.9 years, BMI: 39.6 ± 7.1 kg/m2) were randomly allocated to an extremely time-efficient HIIT (5 × 1 min at 80-95% maximal heart rate on cycle ergometers, 2×/week for 12 weeks) or an inactive control group (CON). Both groups received nutritional counseling to support weight loss. Primary outcome was maximal oxygen uptake (VO2max), secondary outcomes were cardiometabolic risk indices, body composition, work ability index (WAI), quality of life (QoL, EQ-5D-5L-questionnaire) and perceived stress (PSQ-questionnaire).

RESULTS

Mean body weight reduction was 5.3 kg [95% confidence interval (95% CI) - 7.3 to - 3.3 kg] in the HIIT group (P < 0.001) and 3.7 kg (95% CI - 5.3 to - 2.1 kg) in CON (P < 0.001), respectively. Only the HIIT group showed significant (P < 0.001) changes in VO2max [+ 3.5 mL/kg/min (95% CI 2.5 to 4.6 mL/kg/min)], waist circumference [-7.5 cm (95% CI - 9.8 to - 5.1 kg)], mean arterial blood pressure [- 11 mmHg (95% CI - 14 to - 8 mmHg)], WAI [+ 3.0 points (95% CI 1.7 to 4.3 points)] and QoL [+ 10% (95% CI 5 to 16%)]. In CON, none of these parameters improved significantly.

CONCLUSIONS

Low-volume HIIT may induce significant improvements in cardiometabolic health, especially VO2max, WAI and well-being in obese individuals after only 12 weeks. Our results underpin the wide range of benefits on health and subjective measures through exercise that go well beyond simple weight loss through dietary restriction alone.

TRIAL REGISTRATION

ClinicalTrials.gov Id: NCT03306069. Registered 10 October 2017, https://clinicaltrials.gov/ct2/show/NCT03306069 .

H″IT″ting the Barriers for Exercising during Social Isolation

Aerobic exercise is traditionally recommended to improve general health and prevent many non-communicable diseases. However, the measures adopted to control the novel Coronavirus (COVID-19) outbreak culminated with closing of exercise facilities and fitness centers and, as a primary consequence, impaired aerobic exercise practice. This contributed to an increase in risk factors associated with physical inactivity such as insulin resistance, high blood pressure, low-grade inflammation, weight gain, and mental health problems. The scenario is worrisome, and it is important to propose alternatives for exercise practice during the COVID-19 pandemic. Interval training (IT) emerges as an exercise mode that might be feasible, low-cost, and potentially safe to be performed in many different places. IT consists of interspersing relative brief bouts of high-intensity exercise with recovery periods and promotes similar or greater health benefits when compared to moderate-intensity continuous exercise. Among the different types of IT, sprint interval training and "Tabata protocols" might be particularly useful during social isolation. These protocols can be controlled and performed without the need of complex equipment and can be adapted to different places, including domestic environments. In this article, we present variations of IT as possible alternatives to cope physical inactivity during COVID-19 pandemics with a focus on its practical applications. The protocols suggested can be performed without the need of specialized equipment or facilities, in a time-efficient manner, and aiming to prevent detraining or even improve physical fitness and general health.

Effects of exercise cessation on adipose tissue physiological markers related to fat regain: A systematic review

Tissues usually super compensate during the period that follow physical exercise. Although this is widely accepted for muscle and glycogen, the compensatory effect is not usually applied to fat tissues. Notwithstanding, evidence for this has been present since the 1970s when it was first suggested that the increased lipogenic activity in response to training might be an adaptation that enables to restore an energy reserve that can be used in times of need. In this context, the present review aimed to summarize information about the effect of detraining on fat metabolism and the physiological responses associated with fat regain. A systematic search on PubMed and Scielo was performed using "training cessation," "detraining," "exercise detraining," and "exercise cessation" combined with "fat tissue," "adipose tissue," "adipose metabolism," and "fat metabolism," as descriptors. From 377 results, 25 were included in this review, 12 humans and 13 rodents, resulting in a sample of 6772 humans and 613 animals. The analysis provided evidence for fat super compensation, as well as differences in humans and rodents, among different protocols and possible mechanisms for fat gain after exercise cessation. In summary, exercise cessation appears to increase the ability of the adipose tissue to store energy. However, caution should be taken, especially regarding conclusions based on investigations on humans, considering the multiple factors that could affect fat metabolism.