Impact of Aquatic-Based Physical Exercise Programs on Risk Markers of Cardiometabolic Diseases in Older People: A Study Protocol for Randomized-Controlled Trials
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Participants
2.3. Protocols
2.4. Instruments
2.4.1. Individual Characterization
2.4.2. Environmental Characteristics
2.4.3. Anthropometry
2.4.4. Physical Function
- Chair stand, assesses lower body strength and consists of the maximum number of full stands that can be concluded in 30 s. Necessary equipment: chair and stopwatch.
- Arm curl, assesses upper body strength and consists of the maximum number of bicep curls that can be completed in 30 s while holding a hand weight. Necessary equipment: 2.27 kg hand weight for women and 3.63 kg for men, chair and stopwatch.
- 2-min step, assesses aerobic endurance and consists of maximum number of full steps completed in 2 min, a full step is recorded when each knee reaches the point midway between the patella (kneecap) and iliac crest (top hip bone). Necessary equipment: stopwatch, sticky-tape and ruler.
- Chair sit and reach, assesses lower body flexibility and is conducted from a sitting position where one of the participant’s legs is extended while the other is flexed and where hands are reaching towards the toes. This test is assessed in cm and is positive (+) if the extended fingers pass the tip of the toes or negative (−) if the extended fingers do not pass the tip of the toes. Necessary equipment: chair and ruler.
- Back scratch, assesses upper body flexibility and is conducted with one hand reaching over the shoulder in the direction of the floor and the other hand up the middle of the back in the direction of the head. This test is assessed in cm and is positive (+) if both hands overlap and is negative (−) if overlapping does not occur. Necessary equipment: ruler.
- Timed up and go, assesses agility and dynamic balance and is conducted from a starting sitting position where the participant stands up and walks, as fast as possible, to and from a distance 2.44 m (marked by a cone). Necessary equipment: chair, cone and stopwatch.
- Hand grip, assesses hand grip strength and consists of asking the participant to grip a dynamometer with maximum achievable force, the output value of the device is then registered. Necessary equipment: Lafayette hydraulic manual dynamometer (model J00105).
2.4.5. Cognitive Function
2.4.6. Mental Health
- RSES, assesses global self-esteem and is composed of 10 items that are answered using a 4-point Likert scale, the answers vary from “I totally agree” to “I totally disagree”. In items 1, 2, 4, 6 and 7 the score is reversed. Global self-esteem is represented by the summation of all individual scores, providing a final score ranging from 10 to 40 points, where higher scores indicate higher self-esteem.
- CPSPP, is an instrument designed to provide a self-assessment summary of the physical characteristics of elderly groups in clinical and rehabilitation settings. A scale is defined by six subscales of three items that evaluate the following subdomains: functionality, physical health, sports competence, physical attractiveness, physical strength and physical self-worth. Answers to the items are displayed in an alternative structured format that is designed to eliminate social desirability bias. The score can vary between 3 to 12, with higher scores representing better performance.
- WHO-5, is an instrument that assesses psychological well-being. It is a self-administrated short questionnaire composed of 5 items with positive words, these words are related to a positive mood (good mood, relaxation), vitality (being active and waking up fresh and rested) and general interests. Each item is classified on a 5-point Likert scale, ranging from 0 (not present) to 5 (constantly present). The scores are summed, with the final score ranging from 0 to 25 points. The final score is then converted to a scale of 0 to 100 (by multiplying by 4), where higher scores represent a higher level of well-being and better quality of life. A final score equal to or below 50 points represents poor well-being but does not necessarily mean depression. A final score equal to or below 28 possibly indicates clinical depression.
- SWLS, assesses global cognitive parameters of life satisfaction. It is composed of 5 items with a 7-point Likert scale. The answers indicate the level of agreement the participant feels with each item. The final score ranges from 1 to 35 points, where higher final scores indicate higher satisfaction with life.
- EQ-5D, is an instrument that assesses general health status. It consists of two parts: the EQ-5D health descriptive system and the EQ visual analogue scale. The descriptive system consists of five dimensions (mobility, personal care, usual activities, pain/discomfort and anxiety/depression). The participant is asked to indicate their health status by selecting the most appropriate options in the five dimensions. The visual analogue is self-assessed and is conducted in a scale from the lowest rate (0) “the worst health you can imagine” to the highest rate (100) “the best health you can imagine”.
- GDS, assesses life satisfaction, interruptions in activities, annoyances, isolation, energy, joy and memory problems. It consists of fifteen easy to understand questions and has a binary answer system (0 or 1 point) for answers of “no” and “yes”, respectively. A participant who obtains a final score between 0 and 5 points is considered healthy; scores between 6 and 10 points indicate signs of mild to moderate depression; scores between 11 and 15 points indicate signs of severe depression.
- PSS, is an instrument to measure perceptions of stress. It is composed of 14 items, where 7 items are considered as positive aspects while the rest are considered as negative aspects. The questions are about feelings and thoughts during the last month. A point reversal is conducted on items 4, 5, 6, 7, 9, 10 and 13. The final score may vary between 14 and 70 points and a higher score indicates higher stress levels.
2.4.7. Assessment of Carotid Arteries Intima-Media Thickness
2.4.8. Heart Rate Variability (HRV) Measurement
2.4.9. Biochemical Markers
2.5. Ethical Aspects
2.6. Statistical Analysis
3. Expected Results/Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Filho, M.; Zanella, A.; Aidar, F.; Silva, A.; Salgueiro, R.; Matos, D. Atividade física e envelhecimento humano: A busca pelo envelhecimento saudável. Rev. Bras. Ciências Envelhec. Hum. 2010, 7, 97–106. [Google Scholar] [CrossRef] [Green Version]
- Roque, F.; Hernanz, R.; Salaices, M.; Briones, A. Exercise training and cardiometabolic diseases: Focus on the vascular system. Curr. Hypertens. Rep. 2013, 15, 204–214. [Google Scholar] [CrossRef] [PubMed]
- Collard, R.; Boter, H.; Schoevers, R.; Voshaar, R. Prevalence of frailty in community-dwelling older persons: A systematic review. J. Am. Geriatr. Soc. 2012, 60, 1487–1492. [Google Scholar] [CrossRef]
- Furtado, G.; Caldo, A.; Rieping, T.; Filaire, E.; Hogervorst, E.; Teixeira, A.; Ferreira, J. Physical frailty and cognitive status over-60 age populations: A systematic review with meta-analysis. Arch. Gerontol. Geriatr. 2018, 78, 240–248. [Google Scholar] [CrossRef]
- Jang, I.; Kim, H.; Lee, E.; Jung, H.; Park, H.; Cheon, S.; Lee, Y.; Park, Y. Impact of a Wearable Device-Based Walking Programs in Rural Older Adults on Physical Activity and Health Outcomes: Cohort Study. JMIR mHealth uHealth 2018, 6, e11335. [Google Scholar] [CrossRef] [PubMed]
- WHO. Global Action Plan on Physical Activity 2018–2030: More Active People for a Healthier World; Wold Health Organization: Geneva, Suiça, 2018; ISBN 9789241514187. [Google Scholar]
- Arazi, H.; Asadi, R.; Taati, B. Exercise training in thermo-mineral spring water has beneficial effects on hemodynamic and health-related factors in young-older hypertensive women: A randomized control trial. J. Women Aging 2018, 1–13. [Google Scholar] [CrossRef]
- Sykes, K.; Roberts, A. The Chester step test-a simple yet effective tool for the prediction of aerobic capacity. Physiotherapy 2004, 90, 183–188. [Google Scholar] [CrossRef]
- Pereira, T.; Pereira, T.; Santos, H.; Correia, C.; Cardoso, J. Arterial pulse pressure waveform monitoring by novel optical probe. Int. J. Cardiol. 2015, 179, 95–96. [Google Scholar] [CrossRef] [Green Version]
- Teixeira, A.; Ferreira, J.; Hogervorst, E.; Braga, M.; Bandelow, S.; Rama, L.; Figueiredo, A.; Campos, M.; Furtado, G.; Chupel, M.; et al. Study Protocol on Hormonal Mediation of Exercise on Cognition, Stress and Immunity (PRO-HMECSI): Effects of Different Exercise Programmes in Institutionalized Elders. Front. Public Health 2016, 4, 1–13. [Google Scholar] [CrossRef] [Green Version]
- Chupel, M.; Direito, F.; Furtado, G.; Minuzzi, L.; Pedrosa, F.; Colado, J.; Ferreira, J.; Filaire, E.; Teixeira, A. Strength training decreases inflammation and increases cognition and physical fitness in older women with cognitive impairment. Front. Physiol. 2017, 8, 1–13. [Google Scholar] [CrossRef] [Green Version]
- Furtado, G.; Chupel, M.; Carvalho, H.; Souza, N.; Ferreira, J.; Teixeira, A. Effects of a chair-yoga exercises on stress hormone levels, daily life activities, falls and physical fitness in institutionalized older adults. Complement. Ther. Clin. Pract. 2016, 24, 123–129. [Google Scholar] [CrossRef] [PubMed]
- Novaes, G.; Novaes, J.; Garrido, N.; Reis, V. Chronic Effects of Strength Training Vs. Hydro Aerobics on Functional and Cardiorespiratory Ability in Postmenopausal Women. J. Hum. Kinet. 2014, 43, 57–66. [Google Scholar] [CrossRef] [Green Version]
- Reis, V.M. Effects of Exercise on Biomarkers in Health and Disease: Some New Insights with Special Focus on Extreme Exercise and Healthy Ageing. Int. J. Environ. Res. Public Health 2020, 17, 1986. [Google Scholar] [CrossRef] [Green Version]
- Timmons, J.; Minnock, D.; Hone, M.; Cogan, K.; Murphy, J.; Egan, B. Comparison of Time-Matched Aerobic, Resistance, or Concurrent Exercise Training in Older Adults. Scand. J. Med. Sci. Sport 2018, 28. [Google Scholar] [CrossRef]
- Morat, M.; Faude, O.; Hanssen, H.; Ludyga, S.; Zacher, J.; Eibl, A.; Albracht, K.; Donath, L. Agility training to integratively promote neuromuscular, cognitive, cardiovascular and psychosocial function in healthy older adults: A study protocol of a one-year randomized-controlled trial. Int. J. Environ. Res. Public Health 2020, 17, 1853. [Google Scholar] [CrossRef] [Green Version]
- Melro, F.; Mesquita, P.; Carvalho, H.; Filaire, E.; Teixeira, A.; Ferreira, J. Metabolic health indicators and perceived quality of life in active versus inactive older adults: The Funchal community based intervention study. Asian J. Gerontol. Geriatr. 2016, 11, 1–8. [Google Scholar]
- Furtado, G.; Carvalho, H.; Loureiro, M.; Patrício, M.; Uba-Chupel, M.; Colado, J.; Hogervorst, E.; Ferreira, J.; Teixeira, A. Chair-based exercise programs in institutionalized older women: Salivary steroid hormones, disabilities and frailty changes. Exp. Gerontol. 2020, 130, 110790. [Google Scholar] [CrossRef]
- ACSM. Diretrizes do ACSM Para Os Testes de Esforço e Sua Prescrição, 10ath ed.; Guanabara Koogan LTDA: Philadelphia, PA, USA, 2016. [Google Scholar]
- Karvonen, M.; Kentala, E.; Mustala, O. The effects of training on heart rate; a longitudinal study. Ann. Med. Exp. Biol. Fenn. 1957, 35, 307–315. [Google Scholar]
- Franklin, B.; Whaley, M.; Howley, E.; Balady, G. ACSM’s Guidelines for Exercise Testing and Prescription. 2000. Available online: http://books.google.com/books?id=_g5sAAAAMAAJ (accessed on 22 February 2020).
- Rikli, R.; Jones, J. Development and validation of a functional fitness test for a community-residing adults. J. Aging Phys. Act. 1999, 7, 129–161. [Google Scholar] [CrossRef]
- Baptista, F.; Sardinha, L. Avaliação da Aptidão Física e do Equilíbrio de Pessoas Idosas: Baterias de Fullerton; Faculdade de Motricidade Humana: Cruz Quebrada, Portugal, 2005. [Google Scholar]
- Morgado, J.; Rocha, C.; Maruta, C.; Guerreiro, M.; Martins, I. Novos valores Normativos do mini-mental state examination. Sinapse 2009, 9, 10–16. [Google Scholar]
- Mungas, D. In-office mental status testing: A practical guide. Geriatrics 1991, 46, 54–58,63,66. [Google Scholar] [PubMed]
- Neto, F. Correlates of social blushing. Pers. Individ. Dif. 1996, 20, 365–373. [Google Scholar] [CrossRef]
- Ferreira, J.; Cruz, M.; Salgueiro, T.; Fox, K. Propriedades psicométricas do perfil físico de autopercepção: Versão clínica curta em populações geriátricas. EUJAPA 2017, 10, 3–13. [Google Scholar]
- Canavarro, M.; Serra, A.; Simões, M.; Rijo, D.; Pereira, M.; Gameiro, S.; Quartilho, M.; Quintais, L.; Carona, C.; Paredes, T. Development and psychometric properties of the world health organization quality of life assessment instrument (WHOQOL-100) in Portugal. Int. J. Behav. Med. 2009, 16, 116–124. [Google Scholar] [CrossRef]
- Neto, F.; Oliveira, J. Satisfação Com a Vida Conforme a Religião e a Cultura. Psicol. Educ. Cult. 2004, 6, 349–361. [Google Scholar]
- Ferreira, P.; Ferreira, L.; Pereira, L. Contributos para a validação da versão Portuguesa do EQ-5D. Acta Med. Port. 2013, 26, 664–675. [Google Scholar]
- Apóstolo, J.; Loureiro, L.; Reis, I.; Silva, I.; Cardoso, D.; Sfetcu, R. Contribuição para a adaptação da Geriatric Depression Scale-15 para a língua portuguesa. Rev. Enferm. Ref. 2014, 65–73. [Google Scholar] [CrossRef]
- Trujillo, H.; Cabrera, J. Psychometric properties of the Spanish version of the Perceived Stress Scale (PSS). Psicol. Conductual 2007, 15, 457–477. [Google Scholar]
- Stein, J.; Korcarz, C.; Hurst, R.; Lonn, E.; Kendall, C.; Mohler, E.; Najjar, S.; Rembold, C.; Post, W. Use of Carotid Ultrasound to Identify Subclinical Vascular Disease and Evaluate Cardiovascular Disease Risk: A Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force Endorsed by the Society for Vascular. J. Am. Soc. Echocardiogr. 2008, 21, 93–111. [Google Scholar] [CrossRef]
- Abad, C.; Kobal, R.; Kitamura, K.; Gil, S.; Pereira, L.; Loturco, I.; Nakamura, F. Heart rate variability in elite sprinters: Effects of gender and body position. Clin. Physiol. Funct. Imaging 2017, 37, 442–447. [Google Scholar] [CrossRef]
- Franz, F.; Erdfelder, E.; Buchner, A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. J. Mater. Environ. Sci. 2007, 7, 3759–3766. [Google Scholar] [CrossRef]
- Furtado, G.; Chupel, M.; Minuzzi, L.; Patrício, M.; Loureiro, M.; Bandelow, S.; Hogervorst, E.; Ferreira, J.; Teixeira, A. Exploring the potential of salivary and blood immune biomarkers to elucidate physical frailty in institutionalized older women. Exp. Gerontol. 2020, 129. [Google Scholar] [CrossRef]
Program | Description | Intensity (Week 1–13) | Intensity (Week 14–28) | Exercises |
---|---|---|---|---|
Continuous Aerobic | 30 min exercise aerobic (moderate intensity) | 60–65% maximum HR | 65–70% maximum HR | Basic hydro-gymnastics exercise, with some variations: running, bounce, kicking, pendulum jumping, skiing, twister and horse. |
Interval Aerobic | 10 min exercise aerobic (moderate intensity) | 60–65% maximum HR | 65–70% maximum HR | Basic hydro-gymnastics exercise, with some variations: running, bounce, kicking, pendulum jumping, skiing, twister and horse. |
5 min exercise aerobic (high intensity) | 70–75% maximum HR | 75–80% maximum HR | ||
10 min exercise aerobic (moderate intensity) | 60–65% maximum HR | 65–70% maximum HR | ||
5 min exercise aerobic (high intensity) | 70–75% maximum HR | 75–80% maximum HR | ||
Combined | 15 min exercise aerobic (moderate intensity) | 60–65% maximum HR | 65–70% maximum HR | Basic hydro-gymnastics exercise, with some variations: running, bounce, kicking, pendulum jumping, skiing, twister and horse. |
15 min muscular strengthening exercises | 2 steps 12 repetitions | 3 steps 16 repetitions | Exercises with auxiliary equipment (dumbbells, pool noodles, etc.): elbow extension/flexion; shoulder extension/flexion; shoulder abduction/adduction; hip abduction/adduction; hip flexion/extension; knee flexion/extension; dorsal and plantar flexion of the ankle. |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Ferreira, J.P.; Teixeira, A.; Serrano, J.; Farinha, C.; Santos, H.; Silva, F.M.; Cascante-Rusenhack, M.; Luís, P. Impact of Aquatic-Based Physical Exercise Programs on Risk Markers of Cardiometabolic Diseases in Older People: A Study Protocol for Randomized-Controlled Trials. Int. J. Environ. Res. Public Health 2020, 17, 8678. https://doi.org/10.3390/ijerph17228678
Ferreira JP, Teixeira A, Serrano J, Farinha C, Santos H, Silva FM, Cascante-Rusenhack M, Luís P. Impact of Aquatic-Based Physical Exercise Programs on Risk Markers of Cardiometabolic Diseases in Older People: A Study Protocol for Randomized-Controlled Trials. International Journal of Environmental Research and Public Health. 2020; 17(22):8678. https://doi.org/10.3390/ijerph17228678
Chicago/Turabian StyleFerreira, José Pedro, Ana Teixeira, João Serrano, Carlos Farinha, Hélder Santos, Fernanda M. Silva, Márcio Cascante-Rusenhack, and Paulo Luís. 2020. "Impact of Aquatic-Based Physical Exercise Programs on Risk Markers of Cardiometabolic Diseases in Older People: A Study Protocol for Randomized-Controlled Trials" International Journal of Environmental Research and Public Health 17, no. 22: 8678. https://doi.org/10.3390/ijerph17228678