The effects of aquatic exercise on body composition and nonspecific low back pain in elderly males

The effect of aquatic training and vitamin D3 supplementation on bone metabolism in postmenopausal obese women

Purpose

Despite prevalence of studies indicating the positive effect of land-based exercise on bone metabolism, there are limited findings regarding the effect of aquatic exercise. The present study aimed to evaluate the effects of aquatic training and vitamin D3 supplementation on femur bone mineral density (BMD), serum 25(OH)D, and parathyroid hormone (PTH) in postmenopausal obese women with vitamin D insufficiency.

Methods

40 postmenopausal obese women were randomly divided into four groups of aquatic training + vitamin D3 intake group; (ATD), aquatic training with placebo intake group (AT), vitamin D3 intake group (D), and control group with placebo intake (CON). AT groups performed aerobic aquatic exercises for 8 weeks. Vitamin D3 supplementation groups consumed oral dose of 4000 IU/d for 8 weeks.

Results

The femur BMD was significantly higher in the ATD than the AT and D and CON groups; in AT it was higher than the D and CON groups. Serum 25(OH)D level in the ATD was more than AT and CON, and in the D was more than the CON and AT. PTH in the ATD group was lower compared to AT, D, and CON groups. PTH was lower in the AT and D compared to the CON.

Conclusion

In postmenopausal obese women with vitamin D insufficiency or deficiency, combining vitamin D supplementation and aquatic training was the most effective method for improving bone metabolism; Vitamin D supplementation (alone) was not sufficient to affect some of bone metabolism indices; Aquatic training could not improve serum vitamin D. By priority, ATD, AT, and D indicated better bone related metabolism indices.

Water-Based Exercise in Patients With Nonspecific Chronic Low-Back Pain: A Systematic Review With Meta-Analysis

ABSTRACT

Babiloni-Lopez, C, Fritz, N, Ramirez-Campillo, R, and Colado, JC. Water-based exercise in patients with nonspecific chronic low-back pain: a systematic review with meta-analysis. J Strength Cond Res 38(1): 206-219, 2024-This study aimed to systematically review and synthesize evidence (i.e., active [land-based training] and nonactive controls [e.g., receiving usual care]) regarding the effects of water-based training on patients with nonspecific chronic low-back pain (NSCLBP). Web of Science (WOS), PubMed (MEDLINE), EMBASE, EBSCO (SPORTDiscus; CINAHL), and PEDro were searched, with no date restrictions, until October 2021. The included studies satisfied the following criteria: (a) NSCLBP (≥12 weeks) patients, (b) water-based intervention, (c) control group (land-based trained; nonactive group), and (d) outcomes related to pain, disability, quality of life, or flexibility. The main outcome analyzed in the meta-analysis was pain intensity. Secondary outcomes included disability, body mass index, and flexibility. The random-effects model was used, and effect size (ES) values are presented with 95% confidence intervals (CIs). The impact of heterogeneity was assessed (I2 statistic), with values of <25%, 25-75%, and >75% representing low, moderate, and high levels, respectively. Alpha was set at p < 0.05. In conclusion, 15 studies (n = 524) were meta-analyzed. After intervention, pain intensity was reduced compared with nonactive controls (ES = -3.61; p < 0.001) and a similar reduction was noted when compared with land-based trained group (ES = -0.14; p = 0.359). Greater decrease in disability (ES = 2.15; p < 0.001) and greater increase in sit-and-reach (i.e., flexibility; ES = -2.44; p < 0.001) were noted after intervention compared with the nonactive group. In conclusion, water-based exercise therapy reduces pain intensity, disability, and increases flexibility in NSCLBP compared with nonactive subjects and was equally effective compared with land-based exercise to reduce pain. Favorable effects may be expected at ≤8 weeks. However, due to several methodological issues (e.g., high heterogeneity), for the improvement of most outcomes, we are unable to provide other than a weak recommendation in favor of intervention compared with control treatment.

A Korean Nationwide Cross-Sectional Study Investigating Risk Factors, Prevalence, and Characteristics of Sarcopenia in Men in Early Old Age

The present study investigated the risk factors, prevalence, and characteristics of sarcopenia among men aged 50-64 years. A total of 2868 participants were enrolled in this study. Of these, 328 individuals were classified into a sarcopenia group; the remaining 2540 were assigned to a control group. This study examined several variables, including skeletal muscle mass index, age, height, weight, body mass index, waist circumference, systolic and diastolic blood pressure, fasting glucose, triglyceride and total cholesterol levels, alcohol consumption, and tobacco use. It employed a stratified, clustered, and multistage probability sampling design. Complex sampling was used for the data analysis. The prevalence of sarcopenia was 10.25% (95% CI: 8.98-11.69). All anthropometric measures, including height, weight, BMI, and waist circumference, were significantly different between the two groups (p < 0.05). In terms of blood pressure, only systolic blood pressure (SBP) was significant (p < 0.05), and fasting glucose and triglyceride levels were risk factors for sarcopenia (p < 0.05). Tobacco use differed significantly between the two groups (p < 0.05). This study reported the specific prevalence of sarcopenia and identified its risk factors among men in early old age.

Aquatic Exercise Impact on Pain Intensity, Disability and Quality of Life in Adults with Low Back Pain: A Systematic Review and Meta-analysis

BACKGROUND

Low back pain is a common, multifaceted disorder that directly affects diverse aspects of people's lives in terms of health, personal and social lives. A variety of pathological disorders, including low back pain, may benefit from hydrotherapy.

OBJECTIVE

This study aimed to systematically analyze the efficacy of aquatic exercise on pain intensity, disability, and quality of life among adults with low back pain.

DATA SOURCES

A systematic search was conducted in PubMed, Web of Science, Medline, and Scopus up to February 2023 for randomized controlled trials (RCTs) that which examined the impact of aquatic exercise. The most relevant articles were selected based on research criteria. The PEDro scale was applied to assess the quality of the included studies. Review Manager 5.3 was used for conducting all analyses.

STUDY SELECTION

Out of 856 articles, 14 RCTs (n = 484 participants; 257 in the experimental groups and 227 in the control groups) met our inclusion criteria.

RESULTS

Pooled results illustrated that aquatic exercises significantly reduced pain (mean differences (MD): -3.82; p < 0.00,001), improved disability (standardized mean differences (SMD): 1.65; p < 0.00,001), and improved quality of life in both the physical component score (mean difference (MD), 10.13; p < 0.00,001) and the mental component score (MD, 6.45; p < 0.0001) when compared with a control group.

CONCLUSION

The current review showed that aquatic exercise regimens were effective among adults with low back pain. High-quality clinical investigations are still needed to support the use of therapeutic aquatic exercise in a clinical setting.

Effects of aquatic exercises on physical fitness and quality of life in postmenopausal women: an updated systematic review and meta-analysis

Objective

In the present systematic review and meta-analysis, we aimed to evaluate and update the effects of aquatic exercise on physical fitness and quality of life (QoL) in postmenopausal women.

Methods

The databases Cochrane Library, PubMed, Web of Science, and MEDLINE were searched for randomized controlled trials (RCTs) on the topic from inception to July 2022. The GetData software was used to extract data from the published images. RevMan5.4 software was used for statistical analysis. Data are expressed as standardized mean difference (SMD) with 95% confidence intervals (CI). I² index was employed for heterogeneity. Egger's test was used to assess publication bias. We evaluated the methodological quality of included studies using the Physiotherapy Evidence Database scale.

Results

We included 594 participants in 16 RCTs (19 comparison groups). The results indicated that aquatic exercise can significantly improve lower limb strength (LLS), upper limb strength (ULS), agility, flexibility, and overall QoL. No significant effects were found on aerobic capacity. Subgroup-analysis results indicated that aquatic exercise only significantly improved LLS, ULS, agility, and flexibility in postmenopausal women < 65 years of age. However, aquatic exercise improves the overall QoL both in postmenopausal women < 65 years and ≥ 65 years. Aquatic resistance exercise significantly improves LLS, ULS, agility and flexibility. In addition, aquatic aerobic exercise can effectively increase LLS, and combined aquatic aerobic and resistance exercise can enhance the overall QoL.

Conclusions

Aquatic exercise can effectively improve physical fitness and overall QoL in postmenopausal women, but has limited effects on aerobic capacity; thus, it is highly recommended in postmenopausal women.

The effects of water-based exercise on body composition: A systematic review and meta-analysis

AIMS

This study aimed to investigate the effects of water-based exercise (WBE) on body composition.

METHODS

Trials published up to October 28, 2022 were searched using the PubMed, EMBASE, Web of Science, Cochrane, Scopus, and Ovid databases. Randomized controlled trials of healthy adults published in English, comparing WBE and control groups, were included. Other studies with different research designs and participants with medical diagnoses were excluded. The main outcome measures were body weight (BW), body fat mass (BFM), body fat percentage (BFP), lean mass (LM), and skeletal muscle mass (SMM).

RESULTS

Overall, 17,458 potential studies were identified. After a closer inspection, 79 full-length articles were considered for further screening. Finally, 20 studies, involving 565 participants, were included in the meta-analysis. The WBE was beneficial in reducing BW, BFM, and BFP and increasing LM and SMM. Subgroup analyses were conducted based on different exercise intensities and times per week. Moderate- or moderate-vigorous-intensity exercise helped improve body composition, while lower-intensity WBE or aquatic high-intensity interval training (HIIT) seemed less helpful. Training for <120 min/week was insufficient to improve body composition. Training for >120 min/week was associated with improvements in body composition.

CONCLUSIONS

Moderate- or moderate-vigorous-intensity WBE helps improve body composition. Adults are encouraged to exercise for >120 min/week.

The (cost-)effectiveness of combined lifestyle interventions for people with persistent low-back pain who are overweight or obese: A systematic review

INTRODUCTION

Lifestyle factors are expected to contribute to the persistence and burden of low-back pain (LBP). However, there are no systematic reviews on the (cost-)effectiveness of combined lifestyle interventions for overweight or obese people with LBP.

AIM

To assess whether combined lifestyle interventions are (cost-)effective for people with persistent LBP who are overweight or obese, based on a systematic review.

DESIGN

Systematic review METHOD: PubMed, Cochrane, Embase, CINAHL, PsycINFO and the Wiley/Cochrane Library were searched from database inception till January 6^th 2023. Two independent reviewers performed study selection, data-extraction and risk of bias scoring using the Cochrane RoB tool 2 and/or the Consensus Health Economic Criteria list. GRADE was used to assess the level of certainty of the evidence.

RESULTS

In total 2510 records were screened, and 4 studies on 3 original RCTs with 216 participants were included. Low certainty evidence (1 study) showed that combined lifestyle interventions were not superior to usual care for physical functioning, pain and lifestyle outcomes. Compared to usual care, moderate certainty evidence showed that healthcare (-$292, 95%CI: 872; -33), medication (-$30, 95% CI -65; -4) and absenteeism costs (-$1000, 95%CI: 3573; -210) were lower for the combined lifestyle interventions.

CONCLUSION

There is low certainty evidence from 3 studies with predominantly small sample sizes, short follow-up and low intervention adherence that combined lifestyle interventions are not superior to physical functioning, pain and lifestyle outcomes compared to usual care, but are likely to be cost-effective.

Physiological Changes and Pathological Pain Associated with Sedentary Lifestyle-Induced Body Systems Fat Accumulation and Their Modulation by Physical Exercise

A sedentary lifestyle is associated with overweight/obesity, which involves excessive fat body accumulation, triggering structural and functional changes in tissues, organs, and body systems. Research shows that this fat accumulation is responsible for several comorbidities, including cardiovascular, gastrointestinal, and metabolic dysfunctions, as well as pathological pain behaviors. These health concerns are related to the crosstalk between adipose tissue and body systems, leading to pathophysiological changes to the latter. To deal with these health issues, it has been suggested that physical exercise may reverse part of these obesity-related pathologies by modulating the cross talk between the adipose tissue and body systems. In this context, this review was carried out to provide knowledge about (i) the structural and functional changes in tissues, organs, and body systems from accumulation of fat in obesity, emphasizing the crosstalk between fat and body tissues; (ii) the crosstalk between fat and body tissues triggering pain; and (iii) the effects of physical exercise on body tissues and organs in obese and non-obese subjects, and their impact on pathological pain. This information may help one to better understand this crosstalk and the factors involved, and it could be useful in designing more specific training interventions (according to the nature of the comorbidity).

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.

Effects of Low Back Pain Exercises on Pain Symptoms and Activities of Daily Living: A Systematic Review and Meta-Analysis

Our objective in this paper was to systematically review evaluations of the effects of exercises on pain symptoms and activities of daily living (ADL) in middle-aged and elderly patients with low back pain (LBP). We searched Web of Science, PubMed, EBSCO, and China National Knowledge Internet (CNKI) databases for randomized controlled trials (RCTs) on this topic. We evaluated the methodological quality of included articles using the Physiotherapy Evidence Database (PEDro) scale, and we statistically analyzed these studies using RevMan software. We reviewed 18 RCTs (23 comparison groups) with a total of 910 participants, and our meta-analysis confirmed that exercises significantly improved both pain and ADLs measured on visual analog scales (VAS) (SMD = -0.91, 95% CI: [-1.3, -0.52], p < 0.00001) and on the Oswestry Disability Index (ODI) (SMD = -2.07, 95% CI: [-3.19, -0.96], p < 0.00001). We conclude that exercises can reduce pain severity and improve ADL capacity in middle-aged and elderly persons with LBP, confirming that exercise can serve as a medical intervention for these indivdiuals. However, given the high heterogeneity of responses among individual participants, there remains a need for further study.

Aquatic Exercise for Health Promotion: A 31-Year Bibliometric Analysis

The present study aimed to review the research literature on aquatic exercise for health promotion using bibliometric methods and CiteSpace software. The number of studies related to this topic are constantly expanding, with the USA, Brazil, and Australia the centers of this research. Most published papers fall within Sports Science, but the disciplines of Physiology, Psychology, and Rehabilitation were also found to be dominant domains for this literature. The seven most prolific authors were from Brazil or Spain. The most frequently cited references focused on sub-topics of physiology, biochemistry, physical fitness, psychological health, cardiovascular disease, and joint disease. New research trends have shifted to the promotion of cardiovascular health in clinical populations (stroke, overweight, hypertension, endothelium dysfunctional, obese, inflammation, antioxidant, heart failure). Overall, this review found that research hot spots and trends in this realm have focused on improving cardiovascular health with aquatic exercise.

Effects of Rehabilitation Exercise on Cardiovascular Risk Factors and Muscle Cross-Sectional Area in Overweight Patients with Low Back Pain

Limited studies exist on the effects of exercise therapy on obese and normal-weight patients. Herein, we investigated the effect of a 12-week rehabilitation exercise program on cardiovascular risk factors, Oswestry Disability Index (ODI), and change in the cross-sectional area (CSA) of lumbar muscles in patients with obesity and normal-weight low back pain (LBP). LBP patients were allocated to the overweight LBP group (OLG; n = 15) and normal-weight LBP group (NLG; n = 15). They performed a rehabilitation exercise program three times per week for 12 weeks. Cardiovascular risk factors, ODI score, and lumbar muscle CSA were assessed pre- and post-intervention. Body composition, body weight (p < 0.001), and body mass index (p < 0.001) significantly improved after the exercise intervention in OLG. Body fat percentage significantly decreased in both groups, but OLG (p < 0.001) showed slightly greater improvement than NLG (p = 0.034). Total cholesterol (p = 0.013) and low-density lipoprotein (p = 0.002) significantly improved in OLG. ODI score improved significantly in both groups (p = 0.000). Lumbar muscle CSA showed a significant difference in the context of the time result (p = 0.008). OLG showed a significant improvement post-intervention (p = 0.003). The rehabilitation exercise program was more beneficial on cardiovascular risk factors and change in lumbar muscle CSA in OLG, suggesting an intensive exercise intervention needed for overweight patients with LBP.

Relationship of the Pro12Ala Polymorphism on the PPARy2 Gene With the Body Composition of Practitioners of Cyclic Exercises

This study aimed to verify the association between the genotypic of the receptor gene activated by peroxisome proliferators gamma 2 (PPARy2) and the body composition and the specific indicators of adiposity in practitioners physical exercises, considering nutritional intake, age, and training load as influencing factors. It was conducted a cross-sectional study with 335 adults (47.9 ± 12.7 years, 138 men, body mass index/BMI = 27.0 ± 4.9 kg/m²), practitioners of aerobic exercises in cyclical modalities (running, walking and/or cycling, who spent 328.3 ± 193.6 kcal/day on physical training). The genotyping of the Pro12Ala polymorphism was performed using the PCR-RFLP technique and the body composition measured by bioimpedance (InBody 720). Energy expenditure was based on the compendium of physical activities and caloric intake was measured by 24 h recall questionnaire. The higher prevalence was for the Pro/Pro genotype (76.1% vs. 23.9% of Pro/Ala). Pro/Pro genotypic group showed significant higher mean values for body mass (BM) (p < 0.03 for men and p < 0.02 for women) and BMI (p < 0.00 for men and p < 0.02 for women) and %FAT (p < 0.00), waist-hip ratio (WHR) (p < 0.04), and visceral fat (VF) (p < 0.00) only in men compared to Pro/Ala. Higher frequency of Pro/Pro was observed in the category indicating BMI (p < 0.00 for men and p < 0.03 for women), WRH (p < 0.03 for men and p < 0.00 for women), and %FAT (p < 0.03) (in the latter case, only among men. It was also observed that the frequency of distribution of Pro/Ala in the eutrophic category of the BMI remained independent of all influencers, while WHR and %FAT were independent of the training load, but influenced by nutritional intake and age. In women, the frequency of Pro/Ala distribution at the lowest BMI and WHR values remained independent of all confounding variables. It is concluded that the Pro12Ala polymorphism in the PPARy2 gene consistently influences indicators of body composition and adiposity, regardless of the practitioners of physical training, but the relationship needs to be considered according to age and nutritional intake.

Efficacy of hydrotherapy treatment for the management of chronic low back pain

AIMS

The study investigated the influence of hydrotherapy method-based McKenzie and Williams among patients with non-specific low back pain (NSLBP).

METHODS

Semi-experimental pretest-posttest with a control group design trial was conducted at Health Service Center, Qazvin, Iran. Twenty-eight NSLBP patients (16 men and 12 women, age: 42.5 ± 7 years) were recruited. Hydrotherapy program developed based on McKenzie and Williams therapy was performed individually 3 days per week for 20 sessions. Therefore, the study compared a hydrotherapy group (based on McKenzie and Williams therapy) to a control group. Participants attended a hydrotherapy program under the supervision of a hydrotherapist. The Numeric Pain Rating Scale (NPRS), Roland-Morris Disability Questionnaire (RMDQ), and Straight Leg Raise Test (SLRT) were measured at the beginning, middle, and at the end of the 20 sessions to determine pain and functionality of the patient's improvement.

RESULTS

Overall, NPRS, RMDQ, and SLRT scores were improved in hydrotherapy group in the 10th session and 20th session compared with baseline (p ≤ 0.001) and control group (p ≤ 0.001). No difference in the treatment variables between the 10th session and the 20th session was observed (p > 0.05).

CONCLUSIONS

The results indicated that the NSLBP symptom was improved after 10 sessions of hydrotherapy program developed based on McKenzie and Williams therapy.

Exergaming and Aquatic Exercises Affect Lung Function and Weight Loss in Obese Children

We investigated the effect of exergames and aquatic exercises on lung function and weight loss in obese children. Sixty-one obese male primary-school children were randomly allocated to video game, aquatic exercise, and control groups. Lung functions and anthropometric variables were measured before and after the intervention and after one month (follow-up). In the video game group, an Xbox Kinect game was played for 60 min during three sessions a week. The aquatic aerobic exercise was performed three times per week and consisted of a warm-up, main exercises, and a cool down phase. For the video game group, there was a significant reduction in body weight between (i) pre- and (ii) post-intervention and follow-up. In the aquatic exercise group, there was a significant reduction in body weight between pre- and post-intervention and between pre-intervention and follow-up. Both exercise groups improved the waist/hip ratio index compared to the control group. Forced vital capacity was significantly improved in the follow-up of the video game group and the aquatic exercise group compared to the control group. A significant improvement was found in forced expiratory volume in the first second at post-intervention and follow-up in the video game and the aquatic exercise groups. Exergames and aquatic exercises improved weight loss and lung function in obese children.

Comparative effects of water- and land-based combined exercise training in hypertensive older adults

OBJECTIVES

A randomized controlled trial was designed to compare water- and land-based combined (aerobic and resistance) exercise training programs on cardiometabolic parameters, functional fitness, and quality-of-life (QoL) in hypertensive older adults.

METHODS

Fifty-three participants were divided into three groups: 1) land-based exercise group (LET, n=17), 2) water-based exercise group (WET, n=16), and 3) control group (CON, n=20). All programs comprised of a 12-week supervised training program (three 1-hr sessions per week), followed by a 12-week self-supervised training program. Blood pressure (BP), glutathione peroxidase (GPx), total nitrite/nitrate (NOx-), malondialdehyde (MDA), high-sensitive C-reactive protein (hs-CRP), blood lipids, functional fitness, and QoL were assessed before and after each period.

RESULTS

Following the supervised period, systolic BP, rate-pressure product, GPx, NOx-, MDA, hs-CRP concentrations, physical and psychological domains, and overall QoL significantly improved in both training groups. Only the WET improved LDL-C and lipoprotein combine index. Meanwhile, the 30s chair-stand test and 2-min step test improved only in the LET. Succeeding the self-supervised period, systolic BP and NOx- concentration significantly improved in both training groups. Notwithstanding, the 30s chair-standing and arm curl tests improved only in the LET.

CONCLUSIONS

Both training programs rendered ameliorated systolic BP, antioxidant capacity and inflammation, muscular strength, aerobic endurance and QoL with a higher progression in the LET. Nevertheless, metabolic variables were greater improved in the WET. Additionally, due to greater exercise participation, the WET program may be a useful tool in motivating hypertensive older adults to continuously exercise on their own.

Effect of water exercise in blood pressure and sleep quality of hypertensive adults

BACKGROUND

Together with ageing there is an increase in blood pressure levels. However, physical activity is one of the most recommended strategies for preventing the increase of blood pressure. Water exercise involves numerous advantages, one of which is the comfort proportioned by water temperature. The aim of this study was to evaluate the effects of a water exercise program on blood pressure, physical fitness, quality of sleep and the likelihood of having sleep apnea (SA) in hypertensive adults.

METHODS

We evaluated 21 sedentary hypertensive subjects of both sexes. The water exercise was conducted over 13 weeks, three times/week, 50 min/day. Resting blood pressure, height, body weight, waist and hip circumference, functional capability, as well as sleep quality and the likelihood of having sleep apnea were evaluated before and after the experimental period.

RESULTS

There was a significant decrease in systolic and mean blood pressure. Significant increases in strength, muscular and aerobic endurance, coordination, agility, dynamic balance and flexibility were also seen. In addition, a reduction in the likelihood of sleep apnea was identified, despite a deterioration in sleep quality.

CONCLUSIONS

Water exercise was effective in reducing systolic blood pressure, in improving functional capacity variables, and in reducing probability of sleep apnea in hypertensive subjects, however it promoted worsening of sleep quality.

Comparison of Subjective Workout Intensities between Aquatic and Land-based Running in Healthy Young Males: A Pilot Study

Background and objectives: Aquatic exercises have demonstrated several advantages over land-based exercise, but only a few studies have compared the workout intensities and efficiencies in a stage-specific manner. This study aimed to investigate workout intensity during aquatic and land-based running, based on the rating of perceived exertion (RPE). Materials and Methods: Twenty healthy young male subjects underwent a land-based running test (LRT) and an aquatic running test (ART), in the form of a cardiopulmonary exercise treadmill test and a shallow-water running test. The seven stages of the ART were composed of 3 minutes each of the Bruce protocol performed during the LRT. In the ART, the participants were instructed to run in a swimming pool with matching RPE to that obtained at each stage of the LRT. Results: Heart rate (HR) during both LRT and ART exhibited a linear relationship (r = 0.997 and 0.996, respectively; p < 0.001). During the initial and middle period, HR was higher in the ART than in the LRT. However, in the final period, HR was higher in the LRT than in the ART. Conclusions: In aquatic exercises based on the RPE obtained from the LRT, HR exhibited a linear relationship in both the ART and the LRT. The ART appears to increase cardiac loading more efficiently in the initial period and does not increase cardiac loading abruptly at a later period. Although there is no precise, objective, controlled parameter to compare the ART and the LRT, the RPE may be used as a convenient measurement for workout intensity in aquatic running.

Obesity and parasympathetic reactivation of the heart following exercise testing in young male adults: a pilot study

BACKGROUND

In elderly people, obesity may induce changes in the autonomic nervous system via alteration of the balance between the sympathetic and parasympathetic nervous systems. Little is known about obesity and parasympathetic reactivation following exercise testing, particularly in young people in Saudi Arabia, and its relationship with body composition parameters.

OBJECTIVES

Compare parasympathetic reactivation using heart rate recovery (HRR) following the exercise test between young obese and nonobese people and explore the association between body composition parameters with HRR.

DESIGNS

Cross-sectional study.

SETTING

University research lab.

PATIENTS AND METHODS

Twenty-seven young male college students underwent anthropometric measurements and treadmill exercise testing, during which the heart rate was monitored via 12-lead electro-cardiography. Participants were divided into a group (n=15) with high body fat percentage (>30%), and a group (n=12) with a normal body fat percentage (<30%) to compare multiple parameters including HRR, which was defined as the absolute change from heart rate (HR) peak during exercise to 1-minute post-HR peak.

MAIN OUTCOME MEASURES

HRR, body mass index, waist-to-hip ratio, fat percentage, and trunk fat. SAMPLE SIZE AND CHARACTERISTICS: n=27, mean (SD) age=22.4 (0.98) years, range 21-25 years.

RESULTS

There was no significant difference in HRR between the groups (32.20 [13.42] bpm for high body fat percentage vs 35.42 [13.35] bpm for normal body fat percentage) ( P=.54). We found a non-significant inverse correlations of HRR with BMI (r=-0.18, P=.37), WHR (r=-0.04, P=.86), fat percentage (r=-0.18, P=.38) and trunk fat (r=-0.23, P=.25).

CONCLUSION

HRR was preserved in our young obese people and was not different from nonobese people. Furthermore, it seems that obese people with higher body composition parameters may have slower HRR, or slower recovery indicating poorer parasympathetic reactivation.

LIMITATIONS

Need a larger sample to confirm the findings of this pilot study.

CONFLICT OF INTEREST

None.

The effect of aquatic exercise program on low-back pain disability in obese women

Low-back pain (LBP) is one of the most current causes to reduce work performance, limit daily activities and raising health cost, and it is in-creasing as obesity growing as a public health concern. While obese LBP people cannot avoid weight load on the spine in any exercise, they can easily carry out exercise in water. This study aimed to investigate the effect of aquatic exercise on LBP disability among obese women. In this study, a total of 39 women with body mass index (BMI)≥27 kg/m² who suffering from nonspecific chronic LBP were purposively selected. They randomly assigned in two groups; aquatic and control. The aquatic group carried out aquatic exercise, twice per week, 60 min per session, for 12 weeks. LBP disability was measured using modified Oswestry questionnaire with ten sections; pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, traveling, and employment. Results showed no significant difference in age, weight, BMI, waist to hip ratio, and percentage of body fat in both groups. An analyzing of multivariate analysis of covariance revealed that there was significant improvement on pain intensity, personal care, sitting, standing, sleeping, employment and total disability score in aquatic group, while there was no significant difference in lifting, walking, social life, and traveling abilities after 12 weeks between the groups. As a conclusion, this progressive aquatic exercise was a convenience and effective intervention program to reduce pain intensity, and improve personal care, sitting, standing, sleeping, and employment abilities in obese LBP women.

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.

Effect of Time-of-Day-Exercise in Group Settings on Level of Mood and Depression of Former Elite Male Athletes

Since the prevalence of depression is high among athletes at the end of their athletic career, the purpose of this study was to investigate the effect of time-of-day-exercise in group settings on the level of the mood and depression of former elite male athletes.Out of 187 volunteers referring to the sports counseling clinic, 71 retired male athletes who had a national championship record were randomly divided into two morning and evening exercise groups. The inclusion criteria were severe depression (high score in the Beck Depression Inventory-II), the age range of 50 to 60 years, the absence of metabolic syndrome, and the body mass index (BMI) between 28 and 35. All body composition variables were measured using body composition analysis (In Body 320; Korea). The second stage was the collection of data after three months (completion of the training protocol). After data collection, independent and dependent t-tests were used to analyze the data. The results indicated that both groups had a significant improvement in depression compared to the pre-test (p ≤ 0.05), while there was no significant difference between the two groups (p ≥ 0.05). The overall conclusion is that exercise at different times of the morning or evening can improve the psychological state and reduce depression.

Comparison of respiratory muscle strength in individuals performing continuous and noncontinuous walking exercises in water after the 6-week program

This study aimed to compare respiratory muscle strength in individuals performing continuous and noncontinuous walking exercises in water after the 6-week program. Twenty-nine healthy men were randomly divided into a continuous group (CG, n=14) and a noncontinuous group (NG, n=15). Firstly, both groups executed the 6-week program which set them to walk for 30 min, 4 times per week, over 6 weeks in a pool with the adjusted intensity that their walking speed increased the heart rate to 60% of the predicted maximum. After the 6-week program, participants in the CG continued the water-walking program for 4 weeks while those in the NG discontinued the water-walking program. In both groups, respiratory muscle strength evaluated by maximum inspiratory pressure (PImax) and maximum expiratory pressure (PEmax) increased significantly after the 6-week program compared with pre-exercise value. Compared to the value after the 6-week program, PEmax increased significantly in the CG after 10 weeks (P<0.05), but the PImax showed no significant change. Compared to the value after the 6-week program, after 10 weeks, in the NG, PEmax decreased significantly, with a considerable decrease after 9 and 10 weeks compared to the CG (P<0.05). The PImax in the NG significantly decreased after 10 weeks from the value observed after the 6-week program. We demonstrated that 6 weeks of walking in water at 60% of the predicted maximum heart rate enhances PImax and PEmax, and that PImax and PEmax decrease in 4 weeks without a water-walking program.

The effect of aquatic high-intensity interval training on aerobic performance, strength and body composition in a non-athletic population: systematic review and meta-analysis

Objective:

In a non-athletic population, to (1) investigate the effectiveness of high-intensity interval training in an aquatic environment (A-HIIT) on aerobic performance, strength, and body composition and (2) report on safety of this approach.

Method:

A systematic search was undertaken of six databases until May 2018. Trials were eligible for inclusion if they compared the effect of A-HIIT in a non-athletic population with a control group that received no exercise training. Data were extracted independently by two reviewers and meta-analyses were undertaken using a random effects model to produce standardized mean difference (SMD) and 95% confidence intervals (CIs). Risk of bias was assessed using Cochrane’s risk of bias tool. All studies were graded using Physiotherapy Evidence Database (PEDro) and Consensus for Exercise Reporting Template (CERT) scales to determine quality of reporting.

Results:

Eight studies reported over 13 papers met study criteria ( n = 377). Compared with a control group, those who completed a program of A-HIIT demonstrated greater aerobic performance (SMD 0.69 (95% CI 0.39–0.98); I2 = 0%; n = 191) and lower limb muscle strength (SMD 0.30 (95% CI 0.04–0.56); I2 = 0%; n = 237). No differences were seen in measures of body composition or the number of adverse events. All studies were at risk of performance bias. The (mean ± SD) PEDro and CERT scores were 4.9 ± 1.5 and 15.1 ± 2.1, respectively.

Conclusion:

In a non-athletic population, A-HIIT was safe and may have improved aerobic performance and lower limb strength. The exercise interventions were well described and monitoring and reporting of exercise intensity in water was feasible.

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

The main purpose of the present study was to verify the effects of a 12-week water aerobics program in a real-life context on health indicators and physical fitness in adults and older adults. Fifteen volunteers (58.80 ± 14.32 years old) were part of an experimental group (Exercise), and eight volunteers (59.00 ± 12.26 years old) were part of the control group (Control). The Exercise performed 45 min of water aerobics twice a week for 12 weeks; no physical exercise was permitted for the Control during the same period. The evaluations were performed the week before (pre-training) and after the training program (post-training). The primary outcomes were the strength and cardiorespiratory fitness variables and the secondary outcomes included body anthropometry, lipid profile and blood pressure. Adjusted analysis for age and baseline values showed no differences between Exercise and Control in post-training moment. However, there was a moderated tendency for increased explosive strength of the upper limbs (ηp2 = 0.17), reduced body fat (ηp2 = 0.17), reduced systolic blood pressure (ηp2 = 0.14) and triglycerides (ηp2 = 0.19) in Exercise. Within groups changes showed that the training program caused an increase mainly in explosive strength in the upper limbs (0.26 m, 95% CI, 0.03, 0.49; ES = 0.63) In addition, there was a significant decrease in fat mass (-0.89%, 95% CI, -1.74, -0.03; ES = 0.61) and in the systolic blood pressure (-0.83 mmHg, -1.46, -0.19; ES = 0.71). Nonetheless, no significant changes were observed for the lipid profile. These results suggest that 12 weeks of water aerobics performed twice a week in a real-life context seem to benefit the explosive strength, body composition, and blood pressure of adults and older adults but is insufficient to alter cardiorespiratory fitness and lipid profiles.

Biomechanical Comparison of Countermovement Jumps Performed on Land and in Water: Age Effects

Context:The aquatic environment provides a low-impact alternative to land-based exercise and rehabilitation in older adults.Objective:Evaluate the biomechanics of older adults and young adults performing jumping movements on land and in water.Design and Setting:Cross-sectional, mixed-factorial experiment; adjustable-depth pool at sports medicine research facility.Participants:Fifty-six young adults (age = 22.0 [3.9] y) and 12 healthy older adults (age = 57.3 [4.4] y).Interventions:Each participant performed 6 maximal effort countermovement jumps: 3 jumps were performed on land, and 3 other jumps were performed with participants immersed in chest-deep water.Main Outcome Measures:Using data from the amortization and propulsive phases of jumping, the authors computed the following kinetic and kinematic measures: peak and mean mechanical power, peak force, amortization time and rate, unweighting and propulsive times, and lower-extremity segment kinematics.Results:Mechanical power outputs were greater in younger adults (peak: 7322 [4035] W) versus older adults (peak: 5661.65 [2639.86] W) and for jumps performed in water (peak: 9387 [3981] W) versus on land (peak: 4545.84 [1356.53] W). Peak dorsiflexion velocities were greater for jumps performed in water (66 [34] deg/s) versus on land (4 [7] deg/s). The amortization rate was 26% greater in water versus on land. The amortization time was 20% longer in older adults versus young adults.Conclusions:Countermovement jumps performed in water are mechanically specific from those performed on land. Older adults jumped with longer unweighting times and increased mechanical power in water. These results suggest that aquatic-based exercise and rehabilitation programs that feature jumping movements may benefit older adults.

The effect of balance exercises and computerized cognitive training on psychomotor performance in elderly

[Purpose] The purpose of this study was to investigate the effect of balance and computerized cognitive training on psychomotor performance in elderly females. [Subjects and Methods] Twentynine elderly females with the mean age of 63–71 years old were applied voluntarily and randomly allocated to four groups: balance training (3 d/wk for 12 wk), balance training with computerized cognitive training (3 d/wk for 12 wk), computerized cognitive training group and control group. Psychomotor performance of all subjects was measured by Vienna Test System which was a computerized psychological assessment tool. Determination test (DT) and Visual Pursuit Test (VPT) were used as indexes of psychomotor performance. [Results] The results suggested that DT and VPT were significantly improved in all experimental groups with greater improvement in the balance supplemented with computerized cognitive training group. [Conclusion] Balance training and computerized cognitive are highly recommended in elderly with the aim of increasing cognitive performance.

The influence of Aqua Power aerobics on body mass reduction in middle-aged, overweight women

Objectives

This study aims to evaluate the effects of Aqua Power exercises on the body composition and cardiovascular response in middle- aged, overweight women after a six-month intervention.

Patients and methods

Between November 2013 and May 2014, a total of 37 middle-aged, overweight women (mean age 42.6 years, range 36 to 57 years) participated in the Aqua Power aerobic sessions twice per week for six months. The body composition was evaluated using the near-infrared method. The heart rate was self-controlled by the participant during the exercise.

Results

The majority of the body composition elements decreased after six months of the Aqua Power aerobic training. The heart rate values decreased in the females after the intervention period.

Conclusion

Aqua Power aerobics can be recommended for middle-aged females for the treatment of overweight and in the process of cardiopulmonary fitness improvement.

Metabolic responses to exercise on land and in water following glucose ingestion

Although aerobic exercise after a meal decreases postprandial blood glucose, the differences in glucose response between land and aquatic exercise are unclear. Thus, we examined the effect of different modes of exercise with same energy expenditure following glucose ingestion on carbohydrate metabolism. Ten healthy sedentary men (age, 22 ± 1 years) participated in this study. All subjects performed each of three exercise modes (cycling, walking and aquatic exercise) for 30 min after ingestion of a 75-g glucose solution with 1-2 weeks between trials. The exercise intensity was set at 40% of the maximum oxygen uptake that occurred during cycling. The velocity during walking and the target heart rate during aquatic exercise were predetermined in a pretest. The plasma glucose concentration at 30 min after exercise was significantly lower with aquatic exercise compared to that with cycling and walking (P<0·05). However, there were no significant differences among the three exercise modes in respiratory exchange ratio. On the other hand, serum free fatty acid concentration with aquatic exercise was significantly higher at 120 min after exercise compared with that after walking (P<0·05). These results suggest that aquatic exercise reduces postprandial blood glucose compared with both cycling and walking with the same energy expenditure. Aquatic exercise shows potential as an exercise prescription to prevent postprandial hyperglycaemia.

Exercise Benefits for Chronic Low Back Pain in Overweight and Obese Individuals

Overweight and obese individuals with chronic low back pain (LBP) struggle with the combined physical challenges of physical activity and pain interference during daily life; perceived disability increases, pain symptoms worsen, and performance of functional tasks and quality of life (QOL) decline. Consistent participation in exercise programs positively affects several factors including musculoskeletal pain, perceptions of disability due to pain, functional ability, QOL, and body composition. It is not yet clear, however, what differential effects occur among different easily accessible exercise modalities in the overweight-obese population with chronic LBP. This narrative review synopsizes available randomized and controlled, or controlled and comparative, studies of easily accessible exercise programs on pain severity, QOL, and other outcomes, such as physical function or body composition change, in overweight-obese persons with chronic LBP. We identified 16 studies (N = 1,351) of various exercise programs (aerobic exercise [AX], resistance exercise [RX], aquatic exercise [AQU], and yoga-Pilates) that measured efficacy on LBP symptoms, and at least one other outcome such as perceived disability, QOL, physical function, and body composition. RX, AQU, and Pilates exercise programs demonstrated the greatest effects on pain reduction, perceived disability, QOL, and other health components. The highest adherence rate occurred with RX and AQU exercise programs, indicating that these types of programs may provide a greater overall impact on relevant outcomes for overweight-obese LBP patients.

LEVEL OF EVIDENCE

V.

Forced respiration during the deeper water immersion causes the greater inspiratory muscle fatigue in healthy young men

[Purpose] The purpose of the present study was to evaluate the effect of water immersion at different water depths on respiratory function and the effect of inspiratory load breathing (ILB) during water immersion at different water depths on respiratory muscle strength evaluated by maximum inspiratory and expiratory pressures (PImax and PEmax, respectively). [Subjects] Eight healthy men participated randomly in three trials. [Methods] All sessions were conducted with the participants in a sitting position immersed in a water bath. We evaluated respiratory function, PImax and PEmax during submersion at three different levels of water depth (umbilicus; 4th-rib; or clavicle, CL) and after subsequent 15-min ILB. [Results] Decreases in vital capacity and expiratory reserve volume from baseline by water immersion were significantly greater in the CL trial than those in the other trials. In the CL trial, PImax was immediately reduced after ILB compared to that at baseline, and the reduction was significantly greater than those in the other trials. PEmax was not affected by ILB in any of the trials. [Conclusion] Forced respiration during deeper water immersion caused greater inspiratory muscle fatigue in healthy young men.