The challenges of measuring physical activity and sedentary behaviour in people with rheumatoid arthritis

The importance of sufficient moderate-to-vigorous physical activity as a key component of a healthy lifestyle is well established, as are the health risks associated with high levels of sedentary behaviour. However, many people with RA do not undertake sufficient physical activity and are highly sedentary. To start addressing this, it is important to be able to carry out an adequate assessment of the physical activity levels of individual people in order that adequate steps can be taken to promote and improve healthy lifestyles. Different methods are available to measure different aspects of physical activity in different settings. In controlled laboratory environments, respiratory gas analysis can measure the energy expenditure of different activities accurately. In free-living environments, the doubly labelled water method is the gold standard for identifying total energy expenditure over a prolonged period of time (>10 days). To assess patterns of physical activity and sedentary behaviour in daily life, objective methods with body-worn activity monitors using accelerometry are superior to self-reported questionnaire- or diary-based methods.

[Water aerobics training: selection and control of the exercise intensity using the Borg scale]

OBJECTIVE

To evaluate the opportunity of Borg scale using for applying and monitoring the aerobic training intensity in the pool as well as the relationship between the Borg scale and the heart rate (HR) in the aquatic environment.

MATERIAL AND METHODS

The study involved 11 healthy individuals (mean age 46.4±7.5 years). After a cardiopulmonary test on a treadmill and a probation lesson the training was conducted in the pool using a set of basic aerobic exercises lasting 45 minutes. During training the subjects had to maintain a load level corresponding to 12-14 points on the Borg scale. Every 10 minutes of the main training part the heart rate was calculated and the rating of perceived exertion (RPE) was determined according to the Borg scale.

RESULTS

The average heart rate in the main part of the training was 126.8±14.0 beats/min. The intensity of aerobic exercise was 82% of the maximum heart rate determined during the cardiopulmonary test and 68% of the reserve heart rate which corresponded to a high level of intensity. Between the heart rate and the Borg scale a significant correlation was found in the first period of training (r=0.67, p<0.02). At RPE 12-13 in almost ¹/₂ cases the subjects felt a subjectively lower intensity of the load than they actually performed (by heart rate) while at RPE 14 a high percentage of coincidences was observed between different measurement methods (p<0.05).

CONCLUSION

During water aerobics training the use of the Borg scale to prescribe and maintain a level of exercise allows to achieve a sufficient intensity level which is necessary to improve cardiorespiratory fitness and physical performance in order to influence risk factors for cardiovascular disease. The Borg Scale as a stand-alone method of controlling intensity when using water-based aerobic training, especially with high-intensity training should be used with caution. Further investigation is needed to determine the relation between subjective measures of exercise intensity and HR and validity of their use during water aerobics training.

Relationship between Oxygen Uptake, Heart Rate, and Perceived Effort in an Aquatic Incremental Test in Older Women

Different parameters can be used to control the intensity of aerobic exercises, a choice that should consider the population and exercise environment targeted. Therefore, our study aimed to verify the relationship between oxygen uptake (VO₂), heart rate (HR), rating of perceived exertion (RPE), and cadence during an aquatic incremental test in older women. Nine older women (64.3 ± 4.4 years) engaged in a water-based aerobic training performed an aquatic incremental test using the stationary running exercise (cadence increases of 15 b·min⁻¹ every 2 min) until participants’ volitional exhaustion. VO₂, HR, and RPE data were measured, and the percentage of peak VO₂ (%VO_2peak) and percentage of maximal HR (%HR_max) were calculated. Linear and polynomial regression analyses were performed (α = 0.05). Polynomial regressions revealed the best adjustments for all analyses. Data showed a significant relationship (p < 0.001) between %VO_2peak and %HR_max (r = 0.921), %VO_2peak and RPE (r = 0.870), and %HR_max and RPE (r = 0.878). Likewise, significant relationships between cadence (p < 0.001) and %VO_2peak (r = 0.873), %HR_max (r = 0.874), and RPE (r = 0.910) were also observed. In summary, the physiological, subjective, and mechanical variables investigated were highly associated during an aquatic incremental test to exhaustion in older women. Therefore, these different parameters can be employed to adequately prescribe water-based programs according to preference and availability.

Vertical Ground Reaction Force During a Water-Based Exercise Performed by Elderly Women: Equipment Use Effects

Purpose: The present study aimed to compare the vertical ground reaction force responses during the performance of the stationary running water-based exercise with and without equipment at different cadences by elderly women. Method: Nineteen elderly women (age: 68.6 ± 5.0 years; body mass: 69.0 ± 9.5 kg; height: 154.9 ± 5.6 cm) completed one session consisting of the performance of the water-based stationary running with elbow flexion and extension immersed to the xiphoid process depth. The exercise was performed in three conditions, without equipment, with water-floating and with water-resistance equipment, at three cadences (80 b·min^-1, 100 b·min^-1 and maximal) in a randomized order. Peak and impulse of vertical ground reaction force were collected during the exercise using an underwater force plate. Repeated measures two-way ANOVA was used (α = 0.05). Results: Peak vertical ground reaction force (p < .001) and impulse (p ≤ 0.002) resulted in lower values for the water-floating use (0.42-0.48 BW and 0.07-0.13 N.s/BW) in comparison to the water-resistance equipment use (0.46-0.60 BW and 0.09-0.16 N.s/BW) and to the non-use of equipment (0.45-0.60 BW and 0.07-0.17 N.s/BW), except for the impulse at the maximal cadence. In addition, peak vertical ground reaction force at 80 b·min^-1 (p = .002) and impulse at the maximal cadence (p < .001) showed lower values compared to the other cadences. Conclusion: The use of water-floating equipment minimizes the vertical ground reaction force during the stationary running water-based exercise performed by elderly women regardless of the cadence.

Kinematic Comparison of Aquatic- and Land-Based Stationary Exercises in Overweight and Normal Weight Children

PURPOSE

This study examined lower extremity kinematics in healthy weight (HW) and overweight (OW) children during water- and land-based stationary exercises (stationary running, frontal kick, and butt kick) at light submaximal intensity.

METHODS

Participants included OW (N = 10; body fat percentage: 34.97 [8.60]) and HW (N = 15; body fat percentage: 18.33 [4.87]) children, aged 10 to 13 years. Spatiotemporal data, lower extremity joint kinematics, and rating of perceived exertion (RPE) were collected during water- and land-based stationary exercises. Repeated measures analysis of variance compared kinematic variables and RPE between groups and environments. A polygon area function compared coordination patterns between environments.

RESULTS

RPE responses were significantly greater in OW than HW children on land (13.6 [0.7] vs 11.6 [0.7]; P < .001), whereas the RPE responses were similar between groups in water (11.2 [0.7] vs 11.1 [0.8]; P > .05). OW children were significantly more upright than HW children during land-based exercise, whereas there were no differences observed between groups during aquatic-based exercise. The duration of stance and swing phases, angular velocity, and cadence were significantly lower in water than on land.

CONCLUSION

Compared with HW children, OW children performed stationary exercises in a more upright posture on land, with higher RPE. However, these differences diminished in water. Aquatic-based exercise may be effective in minimizing the effects of excess mass on OW children's ability to complete physical activity.

Horizontal ground reaction forces to stationary running performed in the water and on dry land at different physiological intensities

The aim of the present study was to compare the peak anterior-posterior (Fy) and medio-lateral (Fx) ground reaction forces (GRFs) of women performing stationary running at different intensities in aquatic and dry land environments. Fourteen young women performed the stationary running exercise at three cadences (first ventilatory threshold, second ventilatory threshold and maximum effort, as determined during exercise in water) in aquatic and dry land environments. Two-way repeated measures ANOVA was used to analyse the data (α = .05). As a result, significantly lower peak Fy anterior, Fy posterior, Fx medial and Fx lateral values were observed for the aquatic environment, except for the Fy posterior at the first ventilatory threshold. Significant differences were observed between cadences in the peak Fy anterior, Fy posterior, Fx medial and Fx lateral values, with higher values for the cadence corresponding to maximum effort compared to the first ventilatory threshold, except for the Fy posterior and Fx medial in the aquatic environment. The results indicate that the horizontal GRFs are reduced in the aquatic environment and depend on the intensity of stationary running exercise performance.

Rating of Perceived Exertion and Physiological Responses in Water-Based Exercise

The aim of the present study was to relate the overall rating of perceived exertion (RPE-overall) with cardiorespiratory and neuromuscular variables during stationary running with the elbow flexion/extension performed with water-floating equipment. The sample consisted of eleven women that performed the water-based exercise at submaximal cadences. The heart rate, oxygen uptake, ventilation, and electromyographic signal (EMG) from biceps brachii (%EMG BB), triceps brachii (%EMG TB), biceps femoris (%EMG BF) and rectus femoris (%EMG RF) muscles were measured during the exercise, and the overall RPE was measured immediately following its completion. The Pearson product-moment linear correlation was used to investigate associations between the variables analyzed in the present study. Significant relationships were observed between the RPE-overall and all the cardiorespiratory variables, with the r values ranging from 0.60 to 0.70 (p<0.05). In addition, the RPE-overall showed a significant (p<0.05) relationship with %EMG BB (r=0.55) and %EMG BF (r=0.50). These results suggest an association between the RPE-overall with all cardiorespiratory and two neuromuscular variables during the execution of a water-based aerobic exercise using water-floating equipment.

Maximal and ventilatory thresholds of oxygen uptake and rating of perceived exertion responses to water aerobic exercises

This study aimed to compare the V[Combining Dot Above]O2max and first and second ventilatory threshold (1stVT and 2ndVT) V[Combining Dot Above]O2 values and rating of perceived exertion (RPE) responses of treadmill running (TR) with those of 3 water aerobic exercises: stationary running (SR), jumping jack (JJ), and forward kick (FK). Nine women (22.89 ± 1.81 years, 1.66 ± 0.07 m, 58.46 ± 4.19 kg) performed 1 maximal test session for each of the 4 exercise protocols in a randomized order to determine the V[Combining Dot Above]O2max and V[Combining Dot Above]O2 values and RPE responses corresponding with the 1stVT and 2ndVT. V[Combining Dot Above]O2 values were also expressed as a percentage of V[Combining Dot Above]O2max (%V[Combining Dot Above]O2max). A repeated measures analysis of variance and Bonferroni's post hoc test were used, with α = 0.05 denoting statistical significance. The analyses showed that the V[Combining Dot Above]O2 responses were significantly higher for TR than for the other exercises at all effort intensities (V[Combining Dot Above]O2max: p < 0.001; 1stVT and 2ndVT V[Combining Dot Above]O2: p < 0.001), followed by intermediate responses for SR and FK and lower responses for JJ. However, no significant differences between exercises for values of %V[Combining Dot Above]O2max (1stVT: p = 0.099; 2ndVT: p = 0.131) and RPE (1stVT: p = 0.275; 2ndVT: p = 0.477) were found at submaximal intensities, indicating that it is possible to achieve and maintain the same training intensity with these exercises during a typical water fitness lesson. Moreover, the RPE values obtained for the 1stVT and 2ndVT can make the prescription of intensity for these water exercises for young women more simple and practical.

Aerobic capacity reference data in 3816 healthy men and women 20-90 years

Purpose

To provide a large reference material on aerobic fitness and exercise physiology data in a healthy population of Norwegian men and women aged 20–90 years.

Methods

Maximal and sub maximal levels of VO₂, heart rate, oxygen pulse, and rating of perceived exertion (Borg scale: 6–20) were measured in 1929 men and 1881 women during treadmill running.

Results

The highest VO_2max and maximal heart rate among men and women were observed in the youngest age group (20–29 years) and was 54.4±8.4 mL·kg⁻¹·min⁻¹ and 43.0±7.7 mL·kg⁻¹·min⁻¹ (sex differences, p<0.001) and 196±10 beats·min⁻¹ and 194±9 beats·min⁻¹ (sex differences, p<0.05), respectively, with a subsequent reduction of approximately 3.5 mL·kg⁻¹·min⁻¹ and 6 beats·min⁻¹ per decade. The highest oxygen pulses were observed in the 3 youngest age groups (20–29 years, 30–39 years, 40–49 years) among men and women; 22.3 mL·beat⁻¹±3.6 and 14.7 mL·beat⁻¹±2.7 (sex differences, p<0.001), respectively, with no significant difference between these age groups. After the age of 50 we observed an 8% reduction per decade among both sexes. Borg scores appear to give a good estimate of the relative exercise intensity, although observing a slightly different relationship than reported in previous reference material from small populations.

Conclusion

This is the largest European reference material of objectively measured parameters of aerobic fitness and exercise-physiology in healthy men and women aged 20–90 years, forming the basis for an easily accessible, valid and understandable tool for improved training prescription in healthy men and women.

Consumo de oxigênio e índice de esforço percebido em diferentes ritmos de execução na hidroginástica

O objetivo do estudo foi correlacionar o consumo de oxigênio (VO2) e o percentual do VO2 máximo (%VO2máx) com o índice de esforço percebido (IEP) e comparar essas variáveis entre exercícios de hidroginástica executados no meio aquático em diferentes ritmos de execução. Seis mulheres realizaram quatro sessões de testes, uma no meio terrestre (teste de esforço máximo) e três no meio aquático, cada uma com a execução de um exercício de hidroginástica: corrida estacionária, deslize lateral e chute frontal até 45°. Cada exercício aquático foi realizado em três ritmos de execução, 80, 100 e 120bpm, durante 6 min (intervalo de 30 min). Para todas as variáveis, não foram observadas diferenças significativas entre os três exercícios, todavia, as mesmas apresentaram diferenças significativas entre os ritmos, indicando que com o aumento do ritmo, o esforço para executar os exercícios foi intensificado. Correlações significativas foram observadas entre VO2 e IEP e entre %VO2máx e IEP. Logo, baseado nessas associações, sugere-se que a prescrição da intensidade dos exercícios analisados possa ser feita através do IEP durante aulas de hidroginástica.

Effect of gender, cadence, and water immersion on ground reaction forces during stationary running

STUDY DESIGN

Controlled laboratory study.

OBJECTIVES

To analyze the vertical and anteroposterior components of the ground reaction force during stationary running performed in water and on dry land, focusing on the effect of gender, level of immersion, and cadence.

BACKGROUND

Stationary running, as a fundamental component of aquatic rehabilitation and training protocols, is little explored in the literature with regard to biomechanical variables, which makes it difficult to determine and control the mechanical load acting on the individuals.

METHODS

Twenty-two subjects performed 1 minute of stationary running on land, immersed to the hip, and immersed to the chest at 3 different cadences: 90 steps per minute, 110 steps per minute, and 130 steps per minute. Force data were acquired with a force plate, and the variables were vertical peak (Fy), loading rate (LR), anterior peak (Fx anterior), and posterior peak (Fx posterior). Data were normalized to subjects' body weight (BW) and analyzed using repeated-measures analysis of variance.

RESULTS

Fy ranged from 0.98 to 2.11 BW, LR ranged from 5.38 to 11.52 BW/s, Fx anterior ranged from 0.07 to 0.14 BW, and Fx posterior ranged from 0.06 to 0.09 BW. The gender factor had no effect on the variables analyzed. A significant interaction between level of immersion and cadence was observed for Fy, Fx anterior, and Fx posterior. On dry land, Fy increased with increasing cadence, whereas in water this effect was seen only between 90 steps per minute and the 2 higher cadences. The higher the level of immersion, the lower the magnitude of Fy. LR was reduced under both water conditions and increased with increasing cadence, regardless of the level of immersion.

CONCLUSION

Ground reaction forces during stationary running are similar between genders. Fy and LR are lower in water, though the values are increased at higher cadences.

Deep-water running: a practical review of the literature with an emphasis on biomechanics

Deep-water running (DWR) is used as an adjunct to training and conditioning, and as an injury-rehabilitation technique. It is important for the physician or sports medicine practitioner to focus on the underlying physics and biomechanics of running in water in order to better produce the desired physiological, metabolic, and psychological outcomes. Deep-water running maximal heart rate and oxygen consumption values have been consistently shown to be lower than those found during treadmill running. However, recent evidence reveals that there is less of a difference between these maximal values relative to treadmill running and DWR with increased DWR experience. Submaximal values have been shown to be strikingly similar. The skill level of DWR technique, psychological comfort, perception of work, muscular recruitment patterns, and running kinematics are all affected by the physics (ie, temperature, buoyancy, hydrostatic pressure, specific gravity, and drag) of running in water. Therefore, the relationship between the biomechanics and the corollary practical physiological indicators of workload found in DWR must be factored into the appropriate prescription of training and conditioning workloads and rehabilitation protocols.

Comparison of physiological and perceptual responses between continuous and intermittent cycling

The present study tested the hypothesis that the exercise protocol (continuous vs. intermittent) would affect the physiological response and the perception of effort during aquatic cycling. Each protocol was divided on four stages. Heart rate, arterial blood pressure, blood lactate concentration, central and peripheral rate of perceived exertion were collected in both protocols in aquatic cycling in 10 women (values are mean ± SD): age=32.8 ± 4.8 years; height=1.62 ± 0.05 cm; body mass=61.60 ± 5.19 kg; estimated body fat=27.13 ± 4.92%. Protocols were compared through two way ANOVA with Scheffé’s post-hoc test and the test of Mann- Whitney for rate of perceived exertion with α=0.05. No systematic and consistent differences in heart rate, arterial blood pressure, double product and blood lactate concentration were found between protocols. On the other hand, central rate of perceived exertion was significantly higher at stage four during continuous protocol compared with intermittent protocol (p=0.01), while the peripheral rate of perceived exertion presented higher values at stages three (p=0.02) and four (p=0.00) in the continuous protocol when compared to the results found in intermittent protocol. These findings suggest that although the aquatic cycling induces similar physiologic demands in both protocols, the rate of perceived exertion may vary according to the continuous vs. intermittent nature of the exercise.