Širdies ir kraujagyslių sistemos stebėsena taikant ištvermės, jėgos užduotis arba multimodalines fizinių pratimų programas sveikatos gerinimo tikslais.

Abstract

Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide, responsible for 19.8 million deaths in 2022 – approximately 32% of all global deaths - with a considerable proportion occurring prematurely in individuals under 70 years of age (WHO, 2024). It is projected that between 2025 and 2050, the prevalence of CVD will increase by as much as 90%, while overall mortality is expected to rise by 73.4% (Chong et al., 2024), further emphasizing the growing importance of prevention strategies in the coming decades. Efforts to control CVD must be intensified to meet Sustainable Development Goal 3.4, which aims to reduce premature mortality from non-communicable diseases, including CVD, by one-third by 2030. This objective corresponds with the World Heart Federation’s World Heart Vision 2030 (Di Cesare et al., 2023). Health promotion and preservation are pertinent scientific and practical issues, given the greater resources allocated to prevention compared with rehabilitation or treatment (Al-Worafi, 2023). Among the available interventions, regular physical activity (PA) stands out as the most accessible, cost-effective, and evidence-based approach for reducing cardiovascular system (CVS ) risk and improving population health. Large-scale epidemiological studies consistently demonstrate that individuals engaging in recommended levels of PA have a significantly lower risk of developing CVD and a reduced risk of premature death (Pavlović et al., 2022; Quinn et al., 2022; Sari et al., 2024; Warburton & Bredin, 2021). According to the World Health Organization (WHO), adults should engage in 150–300 minutes of moderateintensity aerobic activity per week, ideally supplemented by strength and multicomponent exercises (WHO, 2022). While the benefits of PA are indisputable, participation rates remain suboptimal, and the specific exercise modalities that maximize CVS health outcomes are not yet fully established. As a form of PA, exercise is generally classified into endurance (aerobic) and resistance (strength) training (Bosscher et al., 2023; Hollerbach et al., 2021; Manojlović et al., 2021). Endurance exercise increases heart and respiratory rates for extended periods, enhancing CVS efficiency by strengthening the heart and lungs, improving myocardial function, boosting circulation, and reducing the risk of heart disease (Barcelos et al., 2022; Farrell & Turgeon, 2023). Resistance training, on the other hand, contributes to musculoskeletal resilience, bone density, metabolic health, and long-term functional capacity through improvements in muscle mass and strength (Abou Sawan et al., 2023; Hutchinson et al., 2023; Tyler & Thanos, 2023). In recent years, multimodal exercise programs (EP) have gained increasing attention as a promising approach to health promotion. These programs integrate aerobic, strength, balance, and flexibility components into a single session, thereby targeting multiple physiological systems simultaneously (Palermi et al., 2023; Sharp et al., 2022). Multimodal EPs, typically incorporating three or more components, have been shown to benefit both motor and non-motor functions, enhance functional skills, support mental and physical well-being, and serve as a preventive measure for numerous chronic diseases across all ages and ability levels (Fraga et al., 2021; WHO, 2022). Researchers emphasize the need to scientifically evaluate the effectiveness of PA to optimize their design and ensure maximal health benefits. Although numerous forms of physical activity have been shown to provide general health benefits, there is limited understanding of their specific and differential effects on the CVS, particularly in relation to both acute responses and long-term adaptations (Egan & Sharples, 2023). Identifying how various exercise modalities influence the CVS is essential for optimizing training loads and selecting the most appropriate type of activity for each individual. Furthermore, the interaction between CVS and neuromuscular adaptations remains insufficiently explored, despite its relevance for tailoring exercise prescriptions to maximize preventive and therapeutic outcomes. The mechanisms through which body systems interact are central to understanding the organism as a complex, dynamic, and adaptive entity. Continuous changes in functional status, the need to assess fatigue and recovery processes, and the evaluation of adaptation effectiveness are daily practical challenges for both health-oriented individuals and professional athletes (Bestwick-Stevenson et al., 2022; Hou et al., 2020). In health sciences, the assessment of the CVS functional state is among the most important measures for evaluating physiological responses to exercise (Rozumbetov & Esimbetov, 2021). Early detection of at-risk individuals, ongoing monitoring of those with diagnosed CVD, and a deeper understanding of CVS mechanisms are critical for advancing diagnostic precision and improving treatment strategies (Merdjanovska & Rashkovska, 2022). Consequently, the identification of specific cardiac deviations through the analysis of ECG signals has become imperative for diagnosing cardiac disorders. A new method for the evaluation of dynamic interactions between ECG parameters using algebraic co-integration has been proposed and utilised in many investigations by Lithuanian scientists (Kairiūkštienė, 2020; Saunoriene et al., 2019; Šiaučiūnaitė et al., 2021; Slapsinskaite et al., 2013; Velicka et al., 2019; Ziaukas et al., 2017). Researchers have conducted extensive studies in the field of complexity assessment and demonstrating that the interrelations between ECG parameters remain an active area of research. Additionally, the stiffness of arteries is closely linked to risk factors for CVD and contributes significantly to CVS morbidity and mortality (Salvi et al., 2022). Pulse wave (PW) velocity is considered one of the most important clinical parameters in assessing the risk of CVD, vascular adaptation, and therapeutic efficacy (Claessens et al., 2023; Clara et al., 2021). The problem - a sedentary lifestyle is a major health risk, highlighting the need to identify the most effective and suitable physical activity and effective evaluation methods. Monitoring CVS parameter dynamics and interactions may provide a sensitive means of assessing functional changes under varying exercise loads. Therefore, the hypothesis of this study is that monitoring the dynamics and interactions of CVS parameters provides a more sensitive assessment of the CVS functional state compared to traditional single-parameter analysis. The aim of this study was to determine the peculiarities of cardiovascular changes during endurance, strength tasks, or multimodal exercise programs are applied for health-promoting purposes. Research objectives: 1. To determine whether the combination of pulsometry and applied kinesiology-based manual muscle testing enables researchers to follow the effects of acute and long-term cardiovascular adaptations. 2. To compare the acute cardiovascular effects of different types of exercise (endurance, strength, and multimodal). 3. To evaluate the features of cardiovascular adaptation following a 6-week endurance, strength, or multimodal exercise program. Novelty of the investigations 1. Dosed exercise tests integrate HR values registered during rest, workload, and recovery, or, when continuously recording ECG, the dynamics of separate parameters. Information technologies allow the application of new and advanced methods for analyzing registered indices, providing an opportunity to more accurately assess individual responses to exercising. Traditional single-parameter ECG measurements are limited, while the analysis of concatenation between ECG parameters offers a more nuanced and accurate description of the residual effects of exercise and monitoring the process of adaptation. The algebraic data cointegration method enables the assessment of dynamic relationships between ECG indices and is a suitable approach for feedback formation. 2. The characteristics of muscle function have a significant influence on the peculiarities of oxygen delivery to the muscles and on the cardiovascular responses to both training and testing workloads. Highlighting the need for further research and consideration of this phenomenon to improve exercise effectiveness. CONCLUSIONS 1. The multimodal approach applied in health-enhancing exercise programs demonstrated broader beneficial effects on both the cardiovascular and muscular systems; however, the combination of pulsometry with applied kinesiology–based manual muscle testing proved methodologically inappropriate for reliable monitoring of these physiological adaptations. 2. Notably, ECG measurements taken 24 hours after endurance exercise demonstrate more significant residual effects on the cardiovascular system compared to strength or multimodal training sessions. Assessment of the dynamic concatenation (interaction) between ECG parameters proves to be a sensitive method for capturing these residual training effects. 3. Endurance, strength, and multimodal physical activity tasks applied for health promotion induce positive adaptations in both the muscular and cardiovascular systems. In individuals performing multimodal exercises, greater improvements in muscle strength were observed, whereas changes in cardiovascular indicators were not pronounced