Water-based continuous and interval training in older women: Cardiorespiratory and neuromuscular outcomes (WATER study)

https://doi.org/10.1016/j.exger.2020.110914Get rights and content

Highlights

  • Water-based training may counteract some deleterious effects of the aging process.

  • CTG and ITG programs improved cardiorespiratory and neuromuscular outcomes similarly.

  • These benefits were provided by training programs prescribed by RPE.

Abstract

The purpose of this study was to investigate the effects of two water-based aerobic programs on cardiorespiratory and neuromuscular outcomes in older women. Forty-one women (60 to 75 years old) volunteered to participate in the study. Participants were randomized into a water-based continuous (CTG; n = 21; 63.9 ± 2.5 years) or an interval (ITG; n = 20; 64.8 ± 3.6 years) aerobic training group. Both training programs were performed for 12 weeks (45-min sessions twice a week), with exercise intensity based on rating of perceived exertion (Borg's RPE 6–20 Scale). Pre and post training assessments of cardiorespiratory and neuromuscular outcomes were performed. Data analyses were conducted using Generalized Estimating Equations and Bonferroni post-hoc test (α = 0.05). After the intervention, the CTG and the ITG displayed similar improvements in time to exhaustion (8% vs. 11%), peak oxygen uptake (9% vs. 7%), maximal dynamic knee extension strength (5% vs. 6%), dynamic muscular endurance of knee extensors (10% vs. 11%), maximal vastus lateralis electromyographic signal amplitude (13% vs. 35%), as well as an increase in muscle thickness (5% vs. 6%) and decrease in muscle echo intensity (−2% vs. −3%) of the quadriceps femoris. In conclusion, older women benefited from water-based exercise training prescribed based on participants' RPE, with both the interval and the continuous training programs resulting in similar increases in the cardiorespiratory and neuromuscular parameters.

Introduction

Aging is characterized by several physiological processes, including cardiorespiratory and muscular deconditioning, which are generally related to muscle wasting and negatively affect the health of older individuals (Aagaard et al., 2010; Izquierdo et al., 2001). Although biological aging is inexorable, regular practice of physical exercise can counteract some of the deleterious effects, leading to a healthy aging phenotype (American College of Sports Medicine et al., 2009).

Exercise performed in the aquatic environment promotes several health-related benefits, due to the drag force created by the water (Torres-Ronda and Schelling i del Alcázar, 2014). The effectiveness of water-based training programs to improve cardiorespiratory capacity (Bocalini et al., 2008; Kanitz et al., 2015; Meredith-Jones et al., 2009; Takeshima et al., 2002) and neuromuscular function (Bento et al., 2012; Kanitz et al., 2015; Meredith-Jones et al., 2009; Takeshima et al., 2002; Tsourlou et al., 2006) of older adults has been reported in a number of investigations. Nevertheless, the majority of studies investigated both cardiorespiratory and neuromuscular adaptations as a result of water-based, combined training programs (i.e., aerobic and resistance exercises; Bento et al., 2012; Kanitz et al., 2015; Katsura et al., 2010; Meredith-Jones et al., 2009; Takeshima et al., 2002; Tsourlou et al., 2006).

Recent findings suggest that the drag force generated during water-based aerobic exercises may create enough resistive load to bring about improvements not only in cardiorespiratory parameters but also in neuromuscular outcomes (Costa et al., 2018; Kanitz et al., 2015). Studies comparing neuromuscular adaptations to aerobic training to combined (Kanitz et al., 2015) or resistance (Costa et al., 2018) water-based training programs revealed similar strength gains between training routines, with superior cardiorespiratory adaptations after water-based aerobic training. To the best of the authors' knowledge, studies on the effects of water-based aerobic training on physical fitness are scarce (Broman et al., 2006; Kanitz et al., 2015; Pasetti et al., 2012; Reichert et al., 2016), especially in a shallow water pool (Bergamin et al., 2013; Bocalini et al., 2008, Bocalini et al., 2010; Costa et al., 2018; Rica et al., 2013). Although the neuromuscular adaptations to water-based aerobic training programs in older individuals have been described (Costa et al., 2018; Kanitz et al., 2015), the benefits of different training routines (e.g., interval or continuous training) upon cardiorespiratory and neuromuscular outcomes are largely unknown.

Movement velocity exerts great influence on water drag force (Alexander, 1977), so increasing exercise velocity during water-based aerobic exercises also increases exercise resistance. As such, greater force output and muscle activation are necessary to overcome water resistance during high velocity movements (Alberton et al., 2011; Pinto et al., 2011). Accordingly, interval training performed with high intensity efforts, interspaced by active recovery, could create a greater stimulus for neuromuscular adaptations than continuous exercise performed at a moderate intensity, but this hypothesis remains speculative. Therefore, the purpose of the present study was to investigate the effects of 12 weeks of water-based continuous and interval aerobic training programs on cardiorespiratory and neuromuscular parameters in older women. It was hypothesized that (a) both training programs would result in positive cardiorespiratory and neuromuscular adaptations; (b) but superior improvements would be observed after the interval training program because of the greater water drag force and resistance created during this exercise routine.

Section snippets

Experimental design and approach to the problem

The study, Effects of Two Water-based Aerobic Training Programs in Elderly Women (WATER), is characterized as a randomized clinical trial, registered in ClinicalTrials.gov (NCT03289091). To compare the effects of water-based continuous and interval aerobic training programs on cardiorespiratory and neuromuscular outcomes in older women, both training programs were performed for 12 weeks, with a frequency of two 45-min sessions per week. Forty-one individuals were evaluated at baseline and one

Results

Study flow chart is presented in Fig. 1. One hundred ninety-six women were contacted. From these 126 did not meet the eligibility criteria and 29 refused to take part in the study. Therefore, 41 older women were selected and randomized for the CTG or the ITG. Seven participants dropped out during the intervention period due to health-related issues not related to the study (3 from CTG and 4 from ITG) and 2 of participants from the CTG did not complete post intervention measurements. As such, a

Discussion

The present study shows that periodized water-based continuous or interval aerobic programs can improve both cardiorespiratory and neuromuscular parameters in older women, irrespective of the training pattern employed. In contrast to our initial hypothesis, the interval training did not bring about superior neuromuscular gains compared to the continuous water-based exercise routine in older women, even though water drag, and thus resistance to movement, was supposedly higher in the ITG.

Conclusion

In summary, both water-based training programs employed in the present study resulted in similar improvements in the cardiorespiratory capacity and lower limb muscular strength, which were supported by positive adaptations in terms of maximal neuromuscular activity, muscle mass and muscle quality in older women. A water-based aerobic program performed in a continuous or interval model resulted in positive adaptations after 12 weeks of training in both cardiorespiratory and neuromuscular

CRediT authorship contribution statement

Luana Siqueira Andrade: Conceptualization, Methodology, Formal analysis, Investigation, Writing - original draft, Visualization. Stephanie Santana Pinto: Conceptualization, Methodology, Writing - review & editing, Supervision. Mariana Ribeiro Silva: Methodology, Investigation, Data curation. Gustavo Zaccaria Schaun: Methodology, Investigation, Data curation. Elisa Gouvêa Portella: Investigation, Data curation. Gabriela Neves Nunes: Investigation, Data curation. Gabriela Barreto David:

Acknowledgements

The authors thank the participants for their contribution to this study. This work was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES, Finance Code 001) and Conselho Nacional de Desenvolvimento Científico e Tecnológico – Brazil (CNPq, 307496/2017-1).

References (46)

  • C.L. Alberton et al.

    Rating of perceived exertion in maximal incremental tests during head-out water-based aerobic exercises

    J. Sports Sci.

    (2016)
  • R. Alexander

    Mechanics and Energetics of Animal Locomotion

    (1977)
  • American College of Sports Medicine et al.

    American College of Sports Medicine position stand. Exercise and physical activity for older adults

    Med. Sci. Sports Exerc.

    (2009)
  • I.M.P. Arts et al.

    Normal values for quantitative muscle ultrasonography in adults

    Muscle Nerve

    (2010)
  • P.C.B. Bento et al.

    The effects of a water-based exercise program on strength and functionality of older adults

    J. Aging Phys. Act.

    (2012)
  • M. Bergamin et al.

    Water- versus land-based exercise in elderly subjects: effects on physical performance and body composition

    Clin. Interv. Aging

    (2013)
  • D.S. Bocalini et al.

    Water- versus land-based exercise effects on physical fitness in older women

    Geriatr Gerontol Int

    (2008)
  • G. Borg

    Psychophysical scaling with applications in physical work and the perception of exertion

    Scand. J. Work Environ. Health

    (1990)
  • G. Broman et al.

    High intensity deep water training can improve aerobic power in elderly women

    Eur. J. Appl. Physiol.

    (2006)
  • B.C. Clark et al.

    Sarcopenia =/= dynapenia

    J. Gerontol. A Biol. Sci. Med. Sci.

    (2008)
  • G.B. David et al.

    HR, VO2, and RPE relationships in an aquatic incremental maximum test performed by young women

    J. Strength Cond. Res.

    (2017)
  • J.L. Fleg et al.

    Role of muscle loss in the age-associated reduction in VO2 max

    J. Appl. Physiol.

    (1988)
  • E.T. Howley et al.

    Criteria for maximal oxygen uptake: review and commentary

    Med. Sci. Sports Exerc.

    (1995)
  • Cited by (16)

    • The effect of aquatic High Intensity Interval Training on cardiometabolic and physical health markers in women: A systematic review and meta-analysis

      2022, Journal of Exercise Science and Fitness
      Citation Excerpt :

      Two studies were of low quality, as a result of a lack of information about the follow-up procedures and blinding of assessors during the intervention.24,25 Our analysis of five studies23,24,27,34,38 revealed a significant (P < 0.001) moderate effect size point estimate of 0.610 in favour of AHIIT compared with the control for peak oxygen uptake (VO2 peak) (95% CI 0.277 to 0.943), with no significant heterogeneity found (I2 = 26.69%, P = 0.244) (Fig. 2a). Four studies23,24,31,37 indicated a significant (P = 0.009) moderate effect size point estimate of −0.495 (95% CI -0.866 to −0.124) in favour of reducing resting heart rate (HR), without significant heterogeneity across studies (I2 = 0%, P = 0.599) (Fig. 2b).

    • Short and long-term effects of water-based aerobic and concurrent training on cardiorespiratory capacity and strength of older women

      2020, Experimental Gerontology
      Citation Excerpt :

      Studies conducted in the aquatic environment have shown that concurrent training promotes improvements in strength and cardiorespiratory capacity on older people (Kanitz et al., 2015; Pinto et al., 2015; Takeshima et al., 2002). It has also been shown that aquatic aerobic training promotes, in addition to cardiorespiratory gains (Andrade et al., 2020; Costa et al., 2018; Kanitz et al., 2015), significant increases in muscle strength (Andrade et al., 2020; Costa et al., 2018; Kanitz et al., 2015) of the same magnitude as those demonstrated with resistance (Costa et al., 2018) and concurrent training (Kanitz et al., 2015). This is an interesting issue, because if aquatic aerobic training simultaneously improves both cardiorespiratory capacity and muscle strength, it does not seem necessary to perform complementary resistance training.

    View all citing articles on Scopus
    View full text