The effect of 12 weeks of water-aerobics on health status and physical fitness: An ecological approach

Impacts of a Prescribed Physical Activity Program for People with Chronic Diseases Living in Community Settings in France

BACKGROUND

Sedentary behavior and physical inactivity are modifiable risk factors at the forefront of prevention and health promotion strategies. The health benefits of physical activity (PA) have been widely demonstrated in chronic diseases and have led to the prescription of adapted PA. To date, French scientific data are insufficient to evaluate the effectiveness of prescribing adapted PA. This study aimed (1) to evaluate the effectiveness of a community-based program and (2) to identify patient characteristics at inclusion that could be associated with improved post-program anthropometric data.

METHODS

Our sample was composed of 113 participants with a chronic disease (83.18% women) with a mean age of 55.4 ± 13.9 years. Participants benefited from an 8-week adapted PA program. All participants were evaluated at the beginning and end of the program by anthropometric measurements, a subjective measure of the level of PA and a measure of physical condition.

RESULTS

Almost 86% of the participants were overweight and two-thirds were obese. Statistical analyses showed a significant improvement in physical condition, expressed by a better cardiorespiratory endurance (up to +14% for a 2 min walk test; MT0 = 78.1 m vs. MT1 = 89 m; p < 0.001 with a 2 min walk test), improved flexibility (+12.5%; MT0 = 2.4 vs. MT1 = 2.7; p < 0.001), and increased muscle strength in the lower limbs (+22.7%; MT0 = 11.9 vs. MT1 = 14.6; p < 0.001). The level of physical activity increased significantly for all participants (57.52% of inactive individuals at T0 vs. 5.31% at T1; p = 0.004). Correlational analyses revealed that the decrease in BMI and weight throughout the program correlated positively with age (r = 0.252 and p = 0.007, and r = 0.247 and p = 0.008, respectively) and negatively with BMI from baseline (r = -0.271; p = 0.004).

CONCLUSIONS

The key points of this community-based PA program are the following: (1) It improves participants' physical condition. (2) It improves anthropometric parameters. (3) It modifies physical activity behavior. Furthermore, in the context of the program set up specifically for this purpose, it would appear that elderly and overweight people are more likely to exhibit beneficial effects on anthropometric parameters than younger participants or those with a high level of obesity. However, these results need to be confirmed by a long-term evaluation of the effectiveness of such devices.

Duration of Water-Based Exercise on Hemodynamic and Sleep Quality: An of Hypertensives and Normotensives Subanalysis

Purpose: This study aimed to determine whether a better hemodynamic profile and a better sleep quality are associated with the duration of physical exercise in the water; secondly, it aims to determine whether better sleep quality is associated with a more favorable hemodynamic profile. Methods: 97 subjects (85 women, age 59.46 ± 10.62) were included in the study. Groups were divided into normotensive (n = 46) and hypertensive individuals, (n = 51) duration of water aerobics (1-6 (n = 18), 7-11 (n = 11), 12-35 (n = 26), and > 36 months (n = 42), respectively), and sleep quality (Good, Poor, and Sleep Disordered). The peripheral (brachial), central (through applanation tonometry), and arterial blood pressure were assessed, and the Pittsburgh Sleep Quality Index questionnaire was collected. Results: We found that the groups practicing water-based exercise for a more extended period (>6 months) did not present improved pressure values and sleep quality. The best (though still weak) relationship between the water-based exercise time and the sleep quality values occurred between the group of 7-11 exercising for over 36 months (r = - 0.29 for both). When multivariate regression analysis was performed, there was interaction between AIx@75bpm and sleep quality score, as well as between AIx@75bpm and the age of subjects (p = .006 and 0.003, respectively). Conclusion: The data from the present study reported that subjects who participated for a longer time in the water aerobics training protocol had no additional hemodynamic and sleep quality benefits compared to volunteers with shorter duration groups (<6 months).

Effectiveness of aquatic exercise in the treatment of inflammatory arthritis: systematic review

Spondyloarthritis and rheumatoid arthritis are classified as inflammatory arthritis and represent a significant source of pain and disability. Non-pharmacological intervention with physical exercise is among the therapeutic approaches most used by health professionals. This study aimed to investigate the effectiveness of aquatic exercise in the treatment of inflammatory arthritis. The review was registered on the PROSPERO (CRD42020189602). The databases (PubMed, PEDro, Web of Science, and SciELO) were searched for studies involving adults with inflammatory arthritis and subjected to rehabilitation with aquatic exercise compared to any other control group, from the year 2010 to March 2022. Pain, disease activity, and physical function were regarded as primary outcomes. Two reviewers completed the eligibility screening and data extraction, and disagreements were resolved by a third reviewer. The methodological quality was assessed using the PEDro scale. A total of 5254 studies were identified, and nine articles were included, totalling 604 participants. Regarding pain, two studies showed that aquatic exercise was superior to home exercise. One study showed that disease activity was significantly improved in the aquatic group compared to the land-based exercise and the control groups (no exercise). Two studies reported that therapy containing aquatic exercise was able to improve physical function. Overall, the studies included in this review indicate that aquatic exercise is effective in treating pain, disease activity, and physical function in individuals with inflammatory arthritis. However, further studies carrying stronger evidence should be conducted to determine whether the treatment with aquatic exercise is superior to other types of therapies.

Benefits of aquatic exercise in adults with and without chronic disease-A systematic review with meta-analysis

Aquatic exercise is being increasingly recommended for healthy individuals as well as people with some special health conditions. A systematic review with meta-analysis was performed to synthesize and analyze data on the effects of water-based training (WT) programs on health status and physical fitness of healthy adults and adults with diseases to develop useful recommendations for health and sports professionals. We searched three databases (PubMed, Web of Science, and Scopus) up to June 2021 for randomized trials that examined WT in adults. A total of 62 studies were included, of which 26 involved only healthy individuals and 36 focused on adults with chronic diseases. In the healthy group, the effects of WT on strength, balance, and cardiorespiratory fitness were beneficial, indicating the usefulness of performing WT for at least 12 weeks (2-3x/week, 46-65 min/session). Among adults with diseases, improvements were observed in patients with fibromyalgia (in balance and cardiorespiratory fitness), bone diseases (pain, balance, flexibility, and strength), coronary artery disease (strength and anthropometry), hypertension (quality of life), stroke (quality of life), diabetes (balance and quality of life), multiple sclerosis (quality of life and balance), and Parkinson's disease (pain, gait, cardiorespiratory fitness, and quality of life). Research is required to determine the effects of WT on patients with heart disease, especially coronary artery disease. In adults with chronic disease, benefits in physical fitness and/or other health-related measures were mainly observed after 8-16 weeks of training. WT is an effective physical activity when the intention is to enhance health and physical fitness in healthy adults and adults with chronic diseases.

Study of Anthropometric and Body Composition Variables in the Overweight/Obese, Sedentary Elderly Men Using WATERinMOTION Aqua Training: A cross-Sectional Study

Background: The effect of aqua training on human body composition still causes inconsistency. Objectives: This study was set to identify the effects of WATERinMOTION (WiM) as a water-based exercise on anthropometric and body composition variables without dietetic supervision in overweight/obese, sedentary elderly men. Methods: Participants (n = 70; age: 70.5 ± 4.4 years) derived by purposive and accessible selection were randomly distributed to either a one-month WiM aqua training group (n = 35, two weekly sessions each included 55 minutes on WiM aqua training) or a control group (n = 35, at the same time in sitting state). Anthropometric measures (height, weight, and waist circumference [WC]) and body composition variables (body mass index [BMI], fat mass [FM], total body water [TBW], and free fat mass [FFM]) were evaluated pre/post-study. Results: Upon analysis, statistically significant changes (P ≤ 0.05) were set on weight, BMI, and FM by comparing pre/post study for the WiM group. Furthermore, comparing groups at post disclosed a significant change in anthropometric measures (weight and WC) and body composition variables (BMI, FM, TBW, and FFM). Conclusions: A short-run, non-diet-supervised WiM program suggests supporting a loss in weight, FM, and BMI in overweight/obese, sedentary elderly men.

Community-Dwelling Older Adults and Physical Activity Recommendations: Patterns of Aerobic, Strengthening, and Balance Activities

Though it is known that most older adults do not meet the recommended physical activity (PA) guidelines, little is known regarding their participation in balance activities or the full guidelines. Therefore, we sought to describe PA patterns among 1,352 community-dwelling older adult participants of the Adult Changes in Thought study, a longitudinal cohort study exploring dementia-related risk factors. We used a modified version of the Community Healthy Activities Model Program for Seniors questionnaire to explore PA performed and classify participants as meeting or not meeting the full guidelines or any component of the guidelines. Logistic regression was used to identify factors associated with meeting PA guidelines. Despite performing 10 hr of weekly PA, only 11% of participants met the full guidelines. Older age, greater body mass index, needing assistance with instrumental daily activities, and heart disease were associated with decreased odds of meeting PA guidelines. These results can guide interventions that address PA among older adults.

Weight-Loss Parameters and Quality of Life in Obese Aged Women Using WATERinMOTION

Background: There are controversial studies on weight loss, cardiometabolic markers, and quality of life (QOL) in obese aged women participating in water sports. Objectives: This study aimed to determine the effects of the WATERinMOTION exercise program accompanied with no diet on the inactive obese aged women’s weight, cardiometabolic markers, and QOL. Methods: Sixty-four inactive obese aged women were recruited to participate in this cross-sectional study at the Ukrainian Sports Center, Kyiv, 2019. They were randomly assigned into two Case (n = 32, with the WATERinMOTION aquatics exercise program) and control (n = 32, held in a sitting position simultaneously) groups using the convenient sampling method. The two programs were run twice a week (55 minutes each time) and lasted for one month. Moreover, anthropometric indices (weight, height, waist circumference), cardiometabolic markers (blood lipid markers and glycaemia), QOL (SF-36 questionnaire), and dietary monitoring were assessed before and after the intervention. Results: The groups did not differ significantly regarding each of the analyzed variables prior to the intervention. Comparing pre-and post-intervention results revealed significant weight loss (-1.3, P = 0.004) and average BMI (-0.4, P = 0.002) in the case group. Moreover, a significant variation was revealed only in terms of weight after the intervention (P = 0.001). Regarding QOL, improvements in health status, vitality, and social aspects were significant in the case group after the intervention. Conclusions: The present study suggests that the WATERinMOTION program accompanied with no diet has a positive effect on weight loss, waist circumference, and metabolic profiles in obese aged women. However, the improvement in the QOL should not be neglected.

Functional preparedness of women of the first period of mature age under the influence of aquafitness training

Purpose: to identify the features of the impact of aquafitness training on aerobic and anaerobic productivity of women 25-35 years. Material and methods: The study involved women aged 25-35 in the number of 41 people. For 24 weeks, the subjects were training in an aquafitness program. Training sessions of aquafitness were aerobic and strength. Anaerobic alactate productivity of the organism was determined by the Wingate anaerobic test WAnT 10. Anaerobic lactate productivity of the organism was determined by the Wingate anaerobic test WAnT 30 and bicycle ergometric test by the method of A. Shogy, G. Cherebetin. The threshold of anaerobic metabolism was determined by bicycle ergometric test F. Conconi et al. in the modification of  Yu.M. Furman. The aerobic productivity of the organism was investigated according to the Vo2 max index determined by the method of V.L. Karpman. Absolute and relative indicators were determined for all tests. Results: Aquafitness is an effective means of correcting the indicators of functional preparedness. The combination of strength and aerobic training in the aquafitness program provides an increase in aerobic productivity, anaerobic lactatic productivity and anaerobic alactatic productivity. Under the influence of training according to the aquafitness program, an increase in all indicators of functional preparedness was revealed. The power of anaerobic alactate productivity of the organism determined by the relative indicator WAnT 10 increased with a statistically significant difference on the level (t = 5.07; p = 0.000). The power of anaerobic lactate productivity of the organism determined by the relative indicator WAnT 30 increased with a statistically significant difference on the level (t=4,68; p=0,000). The power of aerobic productivity of the organism determined by the relative indicator VO2 max increased with a statistically significant difference on the level (t=2,77; p=0,007). Conclusions: Aquafitness is an effective means of correcting the indicators of functional preparedness. The combination of strength and aerobic training in the aquafitness program provides an increase in aerobic productivity, anaerobic lactatic productivity and anaerobic alactatic productivity.  

The Association Between Cardiovascular Function, Measured as FMD and CVC, and Long-Term Aquatic Exercise in Older Adults (ACELA Study): A Cross-Sectional Study

Introduction

Cardiovascular aging is implicated in the development of cardiovascular disease (CVD). Aquatic exercise is being considered as a co-adjuvant form of rehabilitation, but there is limited evidence for its cardiovascular risk-reduction properties for older people. Our study aimed to address this by exploring the cardiovascular effects of long-term aquatic exercise in older adults in comparison to those who are either inactive or engaged in land-based/mixed training by measurement of micro- and macro-circulation. Flow Mediated Dilatation (FMD) was the primary outcome.

Methods

This was a pragmatic, 4-group, cross-sectional study. Eighty normotensive adults constituted four (n = 20) groups. The Aqua group (aged 63.7 ± 7 years) and Land group (aged 65 ± 6 years) consisted of participants engaged in aquatic and land-based training, respectively. The mixed group (Mix) (aged 66 ± 6 years) consisted of participants engaged in both land-based and aquatic training. Self-reported training consisted of ≥2/week for ≥6 months (mean sessions/week = 4 ± 1, 4 ± 1, and 5 ± 2 for each group, respectively). The sedentary group (Sed) (aged 63 ± 6 years) consisted of people who were sedentary for ≥6 months (mean sessions/week 0 ± 0). The primary outcome was %FMD. Secondary outcomes included raw cutaneous vascular conductance (CVC) and CVC max.

Results

Statistically significant differences (%FMD, raw CVC variables other than baseline) were found between each of the exercise groups (Aqua, Land, Mix) and the sedentary group (Sed) (i.e., 11.2 (4.2) vs. 5.0 (2.3); p < 0.0005, between the Aqua group and Sed group, for %FMD). No specific advantage could be attributed to any one of the exercise groups.

Conclusion

We reported improvements in NO-mediated endothelial function at micro- and macro-circulatory levels, observing no differences between exercise modes. Our findings provide evidence for the role of aquatic exercise as a "shield" against CVD in older populations.

Kinetic Analysis of Water Fitness Exercises: Contributions for Strength Development

The evaluation of propulsive forces in water allows the selection of the most appropriate strategies to develop strength during water fitness sessions. The aim of this study was threefold: (i) to analyze the rate of force production; (ii) to analyze the rate of force variation; and (iii) to compare limbs' symmetry in two water fitness exercises. Twenty-two young health subjects (age: 21.23 ± 1.51 years old, body mass: 67.04 ± 9.31 kg, and height: 166.36 ± 8.01 cm) performed incremental protocols of horizontal adduction (HA) and rocking horse (RHadd), from 105 until 150 b·min-1. Data acquisition required an isokinetic dynamometer and a differential pressure system that allowed the assessment of (a) isometric peak force of dominant upper limb (IsometricFD); (b) propulsive peak force of dominant upper limb (PropulsiveFD); and (c) propulsive peak force of nondominant upper limb (PropulsiveFND). Significant differences were found in the rate of force production (RateFD) between the majority cadences in both exercises. The RateFD reached ~68% of the force in dry-land conditions, and lower cadences promoted a higher rate of force variation (ΔForce). Most actions were asymmetric, except for the HA at 135 b·min-1. In conclusion, the musical cadence of 135 b·min-1 seems to elicit a desired rate of force production with a symmetric motion in both exercises.

Effect of 12-Week Swimming Training on Body Composition in Young Women

Background: Systematic physical activity can permanently prevent disadvantageous developments in the human body. This is very important especially for women, for whom the maintenance of a lean body in good shape is sometimes a primary consideration. However, in most cases, this activity is taken randomly and does not produce the desired effects such as reducing body fat. The purpose of the study was to evaluate changes in female body composition induced by 12 weeks of swimming training compared to sedentary controls. Methods: Training sessions occurred three times per week (60 min/session). Height, body mass, and waist/hip circumference and waist/hips ratio (WHR) were measured. Body cell mass (BCM), total body water (TBW), extracellular (ECW) and intracellular water (ICW), fat mass (FM), lean mass (FFM), and muscle mass (MM) were measured using bioelectrical impedance (pre/post). Results: Training elicited decreases in hip circumference and increase in WHR. No changes were recorded in BCM, TBW, ECW, ICW, FM, FFM, and MM. Controls experienced decreases in values of BCM, ICW, and MM and increases in ECW. Conclusion: The applied swimming training did not significantly affect the body composition parameters. Inactivity also triggered a tendency toward unhealthy movement of water from the intracellular to extracellular space.