Aquatic high-intensity interval training improves cardiometabolic profile and physical fitness in active middle-age and older adults: quasi-randomized clinical trial study

Authors

  • Rayne Borges Torres Sette aDepartamento de Fisioterapia, Centro Universitário Unifip, Patos, Paraíba, Brasil; bLaboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brasil;
  • Tassiane Cristina Morais cEscola Superior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), Vitória 29045-402, ES, Brasil;
  • Andrea Cristina de Sousa Rocha do Rêgo Costa aDepartamento de Fisioterapia, Centro Universitário Unifip, Patos, Paraíba, Brasil;
  • Luiz Vinicius de Alcântara Sousa bLaboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brasil;
  • Juliana Zangirolami-Raimundo bLaboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brasil; dDisciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil;
  • Blanca Elena Guerrero Daboin bLaboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brasil;
  • Henrique Ferreira Leite bLaboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brasil;
  • Matheus Paiva Emidio Cavalcanti bLaboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brasil; ePrograma de Pós-Graduação em Ciências Médicas/Processos Imunes e Infecciosos. Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil.
  • Rodrigo Daminello Raimundo bLaboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brasil; dDisciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil;

DOI:

https://doi.org/10.36311/jhgd.v34.16305

Keywords:

exercise, walking, lipoproteins, oxygen consumption, aquatic high-intensity interval training

Abstract

Introduction: aquatic exercises have been increasingly suggested to the population. Despite evidence on the benefits of high-intensity interval training in aquatic environments, scientific production still needs to be improved. Research involving middle-aged and older individuals usually seeks physiological responses from the assumption that they are sedentary.

Objective: to assess the physical fitness, lipid profile, and glycemic control of active middle-aged and older adults undergoing aquatic high-intensity interval training associated or not with intense water walking.

Methods: it is a quasi-randomized clinical trial composed of 45 active middle-aged and older adults subdivided into two groups with aquatic high-intensity interval training in the absence (AHIIT) or presence (AHIITW) of intense water walking. Participants were dosed with biochemical parameters, bioimpedance analysis, and physical and cardiopulmonary tests at the intervention’s beginning and end.

Results: both groups showed increased HDL, reduced LDL, and hemoglobin glycated, with increased endurance and strength of upper and lower limbs. The AHIIT group showed a lean mass gain and fat mass decline compared to the AHIITW. The intense walking promoted an increase in oxygen ventilatory equivalent, maximum oxygen consumption, and the task metabolic equivalent at values like the AHIIT.

Conclusion: our findings indicate that high-intensity aquatic training holds the potential to enhance the lipid profile of individuals. However, the incorporation of pool walking into the training regimen did not lead to any notable differences in this regard. Conversely, the inclusion of pool aquatic exercises did result in improved functional capacity among participants.

Brazilian Registry of Clinical Trials (ReBEC): #RBR-99b6jr6

Downloads

Download data is not yet available.

References

Kramer A. An Overview of the Beneficial Effects of Exercise on Health and Performance. Adv Exp Med Biol [Internet]. 2020;1228:3–22. Available from: http://dx.doi.org/10.1007/978-981-15-1792-1_1.

World Health Organization. Noncommunicable diseases [Internet]. [cited 2024 Jul 17]. Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.

Ross R, Blair SN, Arena R, Church TS, Després J-P, Franklin BA, et al. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation [Internet]. 2016 Dec 13;134(24):e653–99. Available from: http://dx.doi.org/10.1161/CIR.0000000000000461.

Orkaby AR, Forman DE. Physical activity and CVD in older adults: an expert’s perspective. Expert Rev Cardiovasc Ther [Internet]. 2018 Jan;16(1):1–10. Available from: http://dx.doi.org/10.1080/14779072.2018.1419062.

Wood G, Murrell A, van der Touw T, Smart N. HIIT is not superior to MICT in altering blood lipids: a systematic review and meta-analysis. BMJ Open Sport Exerc Med [Internet]. 2019 Dec 17;5(1):e000647. Available from: http://dx.doi.org/10.1136/bmjsem-2019-000647.

Wang Y, Xu D. Effects of aerobic exercise on lipids and lipoproteins. Lipids Health Dis [Internet]. 2017 Jul 5;16(1):132. Available from: http://dx.doi.org/10.1186/s12944-017-0515-5.

Hwang C-L, Yoo J-K, Kim H-K, Hwang M-H, Handberg EM, Petersen JW, et al. Novel all-extremity high-intensity interval training improves aerobic fitness, cardiac function and insulin resistance in healthy older adults. Exp Gerontol [Internet]. 2016 Sep;82:112–9. Available from: http://dx.doi.org/10.1016/j.exger.2016.06.009.

Campbell WW, Kraus WE, Powell KE, Haskell WL, Janz KF, Jakicic JM, et al. High-Intensity Interval Training for Cardiometabolic Disease Prevention. Med Sci Sports Exerc [Internet]. 2019 Jun;51(6):1220–6. Available from: http://dx.doi.org/10.1249/MSS.0000000000001934.

Oliveira BRR, Santos TM, Kilpatrick M, Pires FO, Deslandes AC. Affective and enjoyment responses in high intensity interval training and continuous training: A systematic review and meta-analysis. PLoS One [Internet]. 2018 Jun 6;13(6):e0197124. Available from: http://dx.doi.org/10.1371/journal.pone.0197124.

Nagle EF, Sanders ME, Franklin BA. Aquatic High Intensity Interval Training for Cardiometabolic Health: Benefits and Training Design. Am J Lifestyle Med [Internet]. 2017 Jan-Feb;11(1):64–76. Available from: http://dx.doi.org/10.1177/1559827615583640.

Waller B, Munukka M, Rantalainen T, Lammentausta E, Nieminen MT, Kiviranta I, et al. Effects of high intensity resistance aquatic training on body composition and walking speed in women with mild knee osteoarthritis: a 4-month RCT with 12-month follow-up. Osteoarthritis Cartilage [Internet]. 2017 Aug;25(8):1238–46. Available from: http://dx.doi.org/10.1016/j.joca.2017.02.800.

Carayannopoulos AG, Han A, Burdenko IN. The benefits of combining water and land-based therapy. J Exerc Rehabil [Internet]. 2020 Feb;16(1):20–6. Available from: http://dx.doi.org/10.12965/jer.1938742.371.

Reichert T, Delevatti RS, Prado AKG, Bagatini NC, Simmer NM, Meinerz AP, et al. Low- and High-Volume Water-Based Resistance Training Induces Similar Strength and Functional Capacity Improvements in Older Women: A Randomized Study. J Phys Act Health [Internet]. 2018 Aug 1;15(8):592–9. Available from: http://dx.doi.org/10.1123/jpah.2017-0286.

Depiazzi JE, Forbes RA, Gibson N, Smith NL, Wilson AC, Boyd RN, et al. 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. Clin Rehabil [Internet]. 2019 Feb;33(2):157–70. Available from: http://dx.doi.org/10.1177/0269215518792039.

Kwok MMY, Ng SSM, Man SS, So BCL. The effect of aquatic High Intensity Interval Training on cardiometabolic and physical health markers in women: A systematic review and meta-analysis. J Exerc Sci Fit [Internet]. 2022 Apr;20(2):113–27. Available from: http://dx.doi.org/10.1016/j.jesf.2022.02.001.

Pianna B, Moreno BC, de Souza CA, Bôscoa TF, Alcalde GE, Barrile SR, et al. Impact of deep water running in interval training (DWR-IT) on body composition, functional capacity, and quality of life in overweight adults: study protocol for a randomized controlled trial. Trials [Internet]. 2019 Sep 11;20(1):562. Available from: http://dx.doi.org/10.1186/s13063-019-3618-7.

Assis MR, Silva LE, Alves AMB, Pessanha AP, Valim V, Feldman D, et al. A randomized controlled trial of deep water running: clinical effectiveness of aquatic exercise to treat fibromyalgia. Arthritis Rheum [Internet]. 2006 Feb 15;55(1):57–65. Available from: http://dx.doi.org/10.1002/art.21693.

Park S-Y, Kwak Y-S, Pekas EJ. Impacts of aquatic walking on arterial stiffness, exercise tolerance, and physical function in patients with peripheral artery disease: a randomized clinical trial. J Appl Physiol [Internet]. 2019 Oct 1;127(4):940–9. Available from: http://dx.doi.org/10.1152/japplphysiol.00209.2019.

Wadell K, Sundelin G, Henriksson-Larsén K, Lundgren R. High intensity physical group training in water--an effective training modality for patients with COPD. Respir Med [Internet]. 2004 May;98(5):428–38. Available from: http://dx.doi.org/10.1016/j.rmed.2003.11.010.

Gomes Neto M, Pontes SS, Almeida L de O, da Silva CM, da Conceição Sena C, Saquetto MB. Effects of water-based exercise on functioning and quality of life in people with Parkinson’s disease: a systematic review and meta-analysis. Clin Rehabil [Internet]. 2020 Dec;34(12):1425–35. Available from: http://dx.doi.org/10.1177/0269215520943660.

Faíl LB, Marinho DA, Marques EA, Costa MJ, Santos CC, Marques MC, et al. Benefits of aquatic exercise in adults with and without chronic disease-A systematic review with meta-analysis. Scand J Med Sci Sports [Internet]. 2022 Mar;32(3):465–86. Available from: http://dx.doi.org/10.1111/sms.14112.

Ochoa Martínez PY, Hall Lopez JA, Paredones Hernández A, Martin Dantas EH. Effect of periodized water exercise training program on functional autonomy in elderly women. Nutr Hosp [Internet]. 2014 Dec 1;31(1):351–6. Available from: http://dx.doi.org/10.3305/nh.2015.31.1.7857.

López JAH, Martínez PYO, Meza EIA, Moncada-Jiménez JA, Bertruy OG, Dantas EHM, et al. Programa de entrenamiento de hidrogimnasia sobre las capacidades físicas de adultas mayores/Hydrogymnastics Training Program on Physical Fitness in Elderly Women. Revista Internacional de Medicina y Ciencias de la Actividad Física y del Deporte [Internet]. (66). Available from: https://revistas.uam.es/rimcafd/article/view/7995/0.

Penaforte FRO, Calhau R, Mota GR, Chiarello PG. Impact of short-term water exercise programs on weight, body composition, metabolic profile and quality of life of obese women. Journal of Human Sport and Exercise [Internet]. 2015 Jan 1 [cited 2024 Jul 17];10(4). Available from: https://www.researchgate.net/publication/307900158_Impact_of_short-term_water_exercise_programs_on_weight_body_composition_metabolic_profile_and_quality_of_life_of_obese_women.

Zhu H, Jin J, Zhao G. The effects of water-based exercise on body composition: A systematic review and meta-analysis. Complement Ther Clin Pract [Internet]. 2023 Aug;52:101766. Available from: http://dx.doi.org/10.1016/j.ctcp.2023.101766.

McDaniel BB, Naquin MR, Sirikul B, Kraemer RR. Five Weeks of Aquatic-Calisthenic High Intensity Interval Training Improves Cardiorespiratory Fitness and Body Composition in Sedentary Young Adults. J Sports Sci Med [Internet]. 2020 Mar;19(1):187–94. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32132842.

Benedetti TRB, Antunes P de C, Rodriguez-Añez CR, Mazo GZ, Petroski ÉL. Reprodutibilidade e validade do Questionário Internacional de Atividade Física (IPAQ) em homens idosos. Rev Brasil Med Esporte [Internet]. 2007 Feb [cited 2024 Jul 17];13(1):11–6. Available from: https://www.scielo.br/j/rbme/a/qMfYbx6NVfKKFyKZLSnBJgH/.

Mazo GZ, Benedetti TRB. Adaptação do questionário internacional de atividade física para idosos. Rev bras cineantropom desempenho hum [Internet]. 2010 Dec [cited 2024 Jul 17];12(6):480–4. Available from: https://www.scielo.br/j/rbcdh/a/RrtQnvbnQvFQDxKs9VZcGMK/abstract/?lang=pt.

Khalil SF, Mohktar MS, Ibrahim F. The theory and fundamentals of bioimpedance analysis in clinical status monitoring and diagnosis of diseases. Sensors [Internet]. 2014 Jun 19;14(6):10895–928. Available from: http://dx.doi.org/10.3390/s140610895.

Both DR, Matheus S, Behenck M. Acuracidade de diferentes tipos de impedância bioelétrica na estimativa da gordura corporal de homens. Nutr Hosp [Internet]. 2015;35:8–15. Available from: https://enfispo.es/servlet/articulo?codigo=5137734.

Rikli RE, Jones CJ. Development and validation of a functional fitness test for community-residing older adults. J Aging Phys Act [Internet]. 1999 Apr;7(2):129–61. Available from: https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=10638652&asa=N&AN=6156314&h=bo07idLb9u%2BsG3hvgGUf%2Fq284%2Fq7K0gIl7oK0620zGC%2FxItRjnPrIgxXPi%2BzS%2Bil%2BYCGkbwApwwMa1j%2Fd4Ljtw%3D%3D&crl=c.

Neder, J.Á.; Nery, L.E. Teste de exercício cardiopulmonar. J Pneumol. 2002, 28(Supl 3), 166-206.

Moreira LDF, Fronza F, dos Santos RN, Zach P, Kunii I, Hayashi L, et al. The benefits of a high-intensity aquatic exercise program (HydrOS) for bone metabolism and bone mass of postmenopausal women. J Bone Miner Metab [Internet]. 2013 Sep 19;32:411–9. Available from: https://bv.fapesp.br/en/publicacao/98778/the-benefits-of-a-high-intensity-aquatic-exercise-program-h/.

Moreira, L.D.; Fronza, F.C.; Dos Santos, R.N.; Zach, P.L.; Kunii, I.S.; Hayashi, L.F.; Teixeira, L.R.; Kruel, L.F.; Castro, M.L. The benefits of a high-intensity aquatic exercise program (HydrOS) for bone metabolism and bone mass of postmenopausal women. J Bone Miner Metab. 2014, 32(4), 411-9. doi:10.1007/s00774-013-0509-y.

Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc [Internet]. 1982;14(5):377–81. Available from: https://www.ncbi.nlm.nih.gov/pubmed/7154893.

Lobanov AA, Irina A Grishechkina, Andronov SV, Gleb N Barashkov, Andrey I Popov, Anatoliy D Fesyun, et al. Can aquatic exercises contribute to the improvement of the gait stereotype function in patients with Long COVID outcomes? Eur J Transl Myol [Internet]. 2022 Jul 14;32(3). Available from: http://dx.doi.org/10.4081/ejtm.2022.10698.

Sklempe Kokic I, Vuksanic M, Kokic T, Peric I, Duvnjak I. Effects of Electromyographic Biofeedback on Functional Recovery of Patients Two Months after Total Knee Arthroplasty: A Randomized Controlled Trial. J Clin Med Res [Internet]. 2022 Jun 2;11(11). Available from: http://dx.doi.org/10.3390/jcm11113182.

Peyré-Tartaruga LA, Martinez FG, Zanardi APJ, Casal MZ, Donida RG, Delabary MS, et al. Samba, deep water, and poles: a framework for exercise prescription in Parkinson’s disease. Sport Sci Health [Internet]. 2022 Feb 17;18(4):1119–27. Available from: http://dx.doi.org/10.1007/s11332-022-00894-4.

Kim J-H, Ha M-S, Ha S-M, Kim D-Y. Aquatic Exercise Positively Affects Physiological Frailty among Postmenopausal Women: A Randomized Controlled Clinical Trial. Healthcare (Basel) [Internet]. 2021 Apr 2;9(4). Available from: http://dx.doi.org/10.3390/healthcare9040409.

Igarashi Y, Nogami Y. Response of Lipids and Lipoproteins to Regular Aquatic Endurance Exercise: A Meta-Analysis of Randomized Controlled Trials. J Atheroscler Thromb [Internet]. 2019 Jan 1;26(1):14–30. Available from: http://dx.doi.org/10.5551/jat.42937.

Kelley DE, Price JC, Cobelli C. Assessing skeletal muscle glucose metabolism with positron emission tomography. IUBMB Life [Internet]. 2001 Dec;52(6):279–84. Available from: http://dx.doi.org/10.1080/152165401317291129.

Cugusi L, Cadeddu C, Nocco S, Orrù F, Bandino S, Deidda M, et al. Effects of an aquatic-based exercise program to improve cardiometabolic profile, quality of life, and physical activity levels in men with type 2 diabetes mellitus. PM R [Internet]. 2015 Feb;7(2):141–8; quiz 148. Available from: http://dx.doi.org/10.1016/j.pmrj.2014.09.004.

Farinha C, Santos H, Serrano J, Oliveiros B, Silva FM, Cascante-Rusenhack M, et al. The Impact of Aquatic Exercise Programs on the Intima-Media thickness of the Carotid Arteries, Hemodynamic Parameters, Lipid Profile and Chemokines of Community-Dwelling Older Persons: A Randomized Controlled Trial. Int J Environ Res Public Health [Internet]. 2022 Mar 13;19(6). Available from: http://dx.doi.org/10.3390/ijerph19063377.

Gonçalves GCV, Santos ATS, Calixto Júnior R, Dias MPF, Iunes DH, Chaves E de CL, et al. Aquatic Exercise on Brain Activity in Type 2 Diabetic: Randomized Clinical Trial. Int J Environ Res Public Health [Internet]. 2022 Nov 10;19(22). Available from: http://dx.doi.org/10.3390/ijerph192214759.

MacInnis MJ, Zacharewicz E, Martin BJ, Haikalis ME, Skelly LE, Tarnopolsky MA, et al. Superior mitochondrial adaptations in human skeletal muscle after interval compared to continuous single-leg cycling matched for total work. J Physiol [Internet]. 2017 May 1;595(9):2955–68. Available from: http://dx.doi.org/10.1113/JP272570.

Lambert BS, Shimkus KL, Fluckey JD, Riechman SE, Greene NP, Cardin JM, et al. Anabolic responses to acute and chronic resistance exercise are enhanced when combined with aquatic treadmill exercise. Am J Physiol Endocrinol Metab [Internet]. 2015 Feb 1;308(3):E192–200. Available from: http://dx.doi.org/10.1152/ajpendo.00689.2013.

Ouerghi N, Fradj MKB, Bezrati I, Khammassi M, Feki M, Kaabachi N, et al. Effects of high-intensity interval training on body composition, aerobic and anaerobic performance and plasma lipids in overweight/obese and normal-weight young men. Biol Sport [Internet]. 2017 Dec;34(4):385–92. Available from: http://dx.doi.org/10.5114/biolsport.2017.69827.

Pandey A, Cornwell WK 3rd, Willis B, Neeland IJ, Gao A, Leonard D, et al. Body Mass Index and Cardiorespiratory Fitness in Mid-Life and Risk of Heart Failure Hospitalization in Older Age: Findings From the Cooper Center Longitudinal Study. JACC Heart Fail [Internet]. 2017 May;5(5):367–74. Available from: http://dx.doi.org/10.1016/j.jchf.2016.12.021.

Published

2024-07-31

Issue

Section

ORIGINAL ARTICLES