Optimización del entrenamiento concurrente de fuerza y resistencia en remeros y palistas de alto nivel

Tesis inédita presentada en la Universidad Europea de Madrid. Facultad de Ciencias de la Actividad Física y el DeporteEl objetivo general del presente trabajo de investigación fue examinar 1) las características fisiológicas y predictores del rendimiento en remeros de banco fijo, 2) los efectos de la manipulación del volumen de entrenamiento de fuerza sobre las adaptaciones producidas por el entrenamiento concurrente de fuerza y resistencia, y 3) los efectos que las estrategias de cesión total o reducción parcial del entrenamiento producen en el rendimiento de estos deportistas de alto nivel. Para ello se realizaron tres estudios. El objetivo del estudio I fue determinar los factores de rendimiento en remo tradicional y que pueden diferenciar a los remeros de élite (ER) de los de nivel amateur (AR). Cuarenta y seis remeros entrenados entre 21-30 años con 8-15 años de experiencia en este deporte fueron reclutados de manera voluntaria para examinar sus características antropométricas, la potencia media durante el test de 20 minutos (W20 min), potencia media que provocó la concentración sanguínea de 4 mmol¿l-1 (W4 mmol¿l-1 ) de lactato, potencia máxima en el test 10 paladas ( W10 strokes), así como la fuerza máxima y la potencia muscular durante el ejercicio de Remo Tumbado. El grupo ER mostró un peso mayor (5%, P<0.05), 1RM mayor (13%, P<0.001), experiencia mayor (43%, P<0.001), mejor tiempo en el test de 2000 metros (4%, P<0.05) que el grupo AR. El grupo ER mostró también unos mayores valores de potencia en W10 strokes (9%, P<0.01), W4 mmol¿l-1 (17.8%, P<0.01), W20 min (15.4%, P<0.01) en comparación con el grupo AR. Se observaron relaciones significativas entre W4 mmol¿l-1 y W20 min (r=0.65 y 0.80; P<0.01 en ER y AR, respectivamente). Los resultados sugieren que W10 strokes , W4 mmol L-1 ,W20 min y 1RM, son los mejores predictores del rendimiento del remo tradicional en los remeros de élite y amateur. El estudio II se realizó con el objetivo de examinar la eficacia de 8 semanas de entrenamiento hasta el fallo vs. sin llegar hasta el fallo (p.e. utilizando un volumen bajo y moderado de entrenamiento) para mejorar la fuerza y la potencia, así como los parámetros cardiovasculares durante un entrenamiento periodizado concurrente. Cuarenta y tres remeros fueron aleatoriamente repartidos en 4 grupos que realizaban el mismo entrenamiento de resistencia, pero ejecutaban diferentes volúmenes de entrenamiento de fuerza: 4 ejercicios hasta el fallo (4RF; n=14), 4 ejercicios sin llegar hasta el fallo (4NRF; n=15), 2 ejercicios sin llegar hasta el fallo (2NRF; n=6) y un grupo control (C; n=8). Antes y después de 8 semanas de entrenamiento periodizado se valoró la fuerza máxima (1RM) y la potencia durante el ejercicio de remo tumbado, la potencia media durante el test de 20 minutos (W20 min), potencia media que provocó la concentración sanguínea de 4 mmol¿l-1 (W4 mmol¿l-1) de lactato y la potencia máxima en el test 10 paladas (W10 strokes). El grupo 4NRF experimentó mayores ganancias en la 1RM y la potencia (4.6% y 6.4% respectivamente) en remo tumbado comparado con 4RF (2.1% y -1.2%) y 2NRF (0.6% y -0.6%). Los grupos 4NRF y 2NRF experimentaron mayores ganancias en W10 strokes (3.6% y 5%), y en W20 min (7.6% y 9%) comparado con lo obtenido tras 4RF (-0.1% y 4.6%), mientras no se encontraron diferencias en la magnitud del cambio en W4 mmol¿l-1 (4NRF: 6.2%, 4RF: 5.3%, 2NRF:6.8%, C: 4.5%). En conclusión, durante 8 semanas de entrenamiento lineal periodizado concurrente para remeros altamente entrenados, se observo que utilizar un programa de entrenamiento sin llegar hasta el fallo permite conseguir incrementos superiores fuerza y potencia muscular, así como un mayor aumento del rendimiento en remo comparado con entrenamientos de grandes volúmenes hasta el fallo. En el estudio III se analizó los cambios en las variables neuromusculares, de resistencia cardiovascular y de composición corporal durante 4 semanas de puesta a punto y las subsiguientes 5 semanas de reducción (RE) o cesión total de entrenamiento (CE). Catorce kayakistas de elite mundial fueron asignados aleatoriamente a los grupos de RE (n = 7) o CE (n = 7). Se realizaron valoraciones de una repetición máxima (1RM), velocidad media de la fase concéntrica con el 45% del 1RM (V45%) en los ejercicios de press banca y dorsal remo, así como mediciones de la composición corporal. Estas valoraciones se realizaron al comienzo (T0) y al final (T1) de un programa de entrenamiento de 43 semanas de duración, tras la fase de puesta a punto del Campeonato del Mundo (T2) y finalmente al concluir las fases de RE o CE (T3). Se realizó un test incremental maximal en kayak ergómetro para la determinación del consumo máximo de oxígeno en T0, T1 y T3. Tras la fase de puesta a punto, no se observaron cambios significativos en el 1RM o en la V45%. El grupo de CE mostró mayores descensos en la 1RM (-8.9% y -7.8%, P<0.05, para el press de banca y el remo tumbado respectivamente) que los observados para el grupo de RE (-3.9% y -3.4%). Los descensos en la V45% en el press de banca y el remo tumbado fueron mayores para el grupo de CE (-12.6% y -10.0%) que para el grupo RE (-9.0% y -6.7%). Se observaron incrementos en el sumatorio de ocho pliegues cutáneos tras la RE y CE, mientras que los descensos en la potencia aeróbica fueron menores tras la RE (-5.6%) que tras la CE (-11.3%). En resumen se observó como periodos cortos de cesión de entrenamiento producen mayores descensos en la fuerza máxima y especialmente en la V45% que la RE en atletas de alta cualificación. Estos resultados sugieren la necesidad de realizar un programa de mantenimiento para evitar descensos a nivel neuromuscular en aquellos casos en los que sea necesaria una fase de recuperación del entrenamiento. [Resumen Teseo

Exercise in people over 85

Sin financiación39.890 JCR (2020) Q1, 5/169 Medicine, General & Internal1.831 SJR (2020) Q1, 177/2448 Medicine (miscellaneous)No data IDR 2019UE

Exercise intevention in the Physically frail older adult to prevent disability

Los beneficios del ejercicio físico en el envejecimiento y, específicamente, en la fragilidad han sido objeto de reciente investigación científica. En el anciano, la práctica de actividad física regular se asocia a una disminución del riesgo de mortalidad, enfermedades crónicas, institucionalización, deterioro cognitivo y funcional. La práctica de ejercicio físico es la intervención más eficaz para retrasar la discapacidad y los eventos adversos que asocia habitualmente el síndrome de la fragilidad. De manera más concreta, el tipo de ejercicio físico más beneficioso en el anciano frágil es el denominado «entrenamiento multicomponente». Este tipo de programas combina entrenamiento de fuerza, resistencia, equilibrio y marcha, y es con el que más mejorías se ha demostrado en la capacidad funcional, que es un elemento fundamental para el mantenimiento de la independencia en las actividades básicas de la vida diaria (ABVD) de los ancianos. Los objetivos deberían centrarse, por tanto, en mejorar dicha capacidad funcional a través de mejorías en el equilibrio y la marcha, así como mediante la disminución del riesgo y del número de caídas. Para la obtención de estos objetivos, el diseño de un programa de ejercicio físico en el anciano frágil debe acompañarse necesariamente de recomendaciones sobre variables tales como la intensidad, la potencia, el volumen y la frecuencia de entrenamiento ideales en esta población.Aging is associated with declines in the neuromuscular and cardiovascular systems, resulting in an impaired capacity to perform daily activities. Frailty is an age-associated biological syndrome characterized by decreases in the biological functional reserve and resistance to stressors due to changes in several physiological systems, which puts older individuals at special risk of disability. To counteract the neuromuscular and cardiovascular declines associated with aging, as well as to prevent and treat the frailty syndrome, the strength and endurance training seems to be an effective strategy to improve muscle hypertrophy, strength and power output, as well as endurance performance. The combination of strength and endurance training (i.e., concurrent training) performed at moderate volume and moderate to high intensity in elderly populations is the most effective way to improve both neuromuscular and cardiorespiratory functions. Moreover, exercise interventions that include muscle power training should be prescribed to frail elderly in order to improve the overall physical status of this population and prevent disability. A multi-component exercise intervention program that consists of strength, endurance, and balance training appears to be the best strategy for improving gait, balance, and strength, as well as reducing the rate of falls in elderly individuals and consequently maintaining their functional capacity during aging. Most of the studies demonstrating improvements in gait, balance, and fall risk have used multicomponent exercise training as intervention in their subjects.Sin financiaciónNo data 201

Concurrent exercise training on hyperglycemia and comorbidities associated: Non-responders using clinical cutoff points

This study examined the effects of a 20-week concurrent training (CT, ie, resistance plus endurance training) intervention on cardiovascular risk factors, such as body composition, blood pressure, and lipid profile among adult women with hyperglycemia. A secondary aim was to report prevalence of non-responders for the different study outcomes. Physically inactive overweight/obese and hyperglycemic adult women (42 ± 6 years; BMI = 30.9 ± 4.8 kg/m 2 ) were randomly assigned to a 20-week CT intervention group or a control (non-exercise) group (CG) (n = 14/group). Cardiovascular risk factors for body composition (body mass, waist circumference [WC], fat mass, and lean mass), blood pressure, and lipid profile (total, LDL cholesterol and HDL cholesterol, triglycerides, and fasting glucose) were assessed before and after the 20-week intervention. Our results show that a CT intervention results in a reduction of comorbidities in terms of abdominal obesity and cardiovascular risk in adult women with hyperglycemia by decreasing WC and improving lipid profile in “mean” terms. At the individual level, after CT, some subjects changed their status from a “high” to a “low” cardiovascular risk in terms of WC, while others changed from hypertension to either high blood pressure or normotension, or from high blood pressure to normotension, and others changed from hypercholesterolemia/dyslipidemia to normocholesterolemia. Overall, there were ~30%, 50%, and 20% of individuals in the CT exercise group who showed no change/adverse response for body composition, blood pressure, and lipid profile, respectively, after the 20-week CT intervention.Sin financiación3.255 JCR (2019) Q1, 14/85 Sport Sciences1.373 SJR (2019) Q1, 28/284 Orthopedics and Sports Medicine, 10/207 Physical Therapy, Sports Therapy and Rehabilitation, 19/125 Sports ScienceNo data IDR 2019UE

Physical Exercise Improves Function in Acutely Hospitalized Older Patients: Secondary Analysis of a Randomized Clinical Trial

Objectives To evaluate the effects of an exercise intervention on physical function, maximal muscle strength, and muscle power in very old hospitalized patients. Design In a randomized controlled trial, 130 hospitalized patients were allocated to an exercise intervention (n = 65) or a control group (n = 65). The intervention consisted of a multicomponent exercise training program performed during 5-7 consecutive days (2 sessions/d). The usual care group received habitual hospital care, which included physical rehabilitation when needed. Setting and participants Acute care for elderly unit. Older adults age >75 years. Measures Physical function, assessed with the Short Physical Performance Battery test and the Gait Velocity Test (GVT), were the primary endpoints. The GVT was also administered under dual-task conditions (ie, verbal and arithmetic GVT). The functional tasks were recorded using an inertial sensor unit to determine the movement pattern. The secondary endpoints were maximal muscle strength and muscle power output. Results The exercise intervention program provided significant benefits over usual care. At discharge (primary time point), the exercise group showed a mean increase of 1.7 points in the Short Physical Performance Battery scale (95% confidence interval [CI] 0.98, 2.42) and 0.14 m·s-1 in the GVT (95% CI 0.086, 0.194) over the usual care group. The intervention also improved the verbal (0.151; 95% CI 0.119, 0.184 vs −0.001; 95% CI –0.025, 0.033 in the control group) and arithmetic GVT (0.115; 95% CI 0.077, 0.153 vs −0.004; 95% CI –0.044, 0.035). Significant benefits were also observed in the intervention group in movement pattern, as well as in muscle strength and muscle power. Conclusions and implications An individualized multicomponent exercise training program improves physical function, maximal muscle strength, and muscle power in acutely hospitalized older patients. These findings support the importance of physical exercise for avoiding the loss of physical functional capacity that frequently occurs during hospitalization in older adults.Sin financiación4.367 JCR (2019) Q1, 8/51 Geriatrics & Gerontology2.054 SJR (2019) Q1, 5/109 Geriatrics and Gerontology, 8/257 Health Policy, 138/2754 Medicine (miscellaneous), 3/150 Nursing (miscellaneous)No data IDR 2019UE

Safety of in-hospital early rehabilitation in chronic obstructive pulmonary disease exacerbations: a systematic review and meta-analysis

Sin financiación4.919 JCR (2020) Q1, 2/68 Rehabilitation0.962 SJR (2020) Q1, 69/288 Orthopedics and Sports MedicineNo data IDR 2020UE

Improvements cardiometabolic risk factors in Latin American Amerindians (the Mapuche) with concurrent training

Our aim was to investigate the effects of 12 weeks of CT (ie, high‐intensity interval and resistance training) in Mapuche adults from Chile and in their peers of European descent. In total, 96 hyperglycemic adult women (mean age 46 years [95% confidence interval; 38, 53]) were divided in four groups: Mapuche CT (Map‐CT, n = 14) or control group (Map‐CG, n = 44), and European CT (Eur‐CT, n = 14) or control group (Eur‐CG, n = 23). The following endpoints were analyzed at baseline and after 12 weeks: anthropometric (body mass, body mass index, waist circumference), body composition (fat mass, muscle mass, lean mass), cardiovascular (systolic [SBP]/diastolic [DBP] blood pressure), metabolic (blood fasting glucose and total cholesterol), and muscle strength (handgrip of dominant/non‐dominant arm). There were significant positive changes in body mass, body fat, and muscle mass (P < 0.0001) in both Map‐CT and Eur‐CT groups, whereas waist circumference was decreased significantly only in the Eur‐CT group (P < 0.0001). Both Map‐CT and Eur‐CT groups showed decreased levels of fasting glucose (P < 0.05) and total cholesterol after the intervention (P < 0.0001). Also, both Map‐CT (P < 0.05) and Eur‐CT (P = 0.01) groups showed a lowered SBP. Finally, significant increases were observed after training in handgrip strength (dominant arm) in Map‐CT and Eur‐CT groups (both P < 0.0001). CT led to similar improvements in cardiometabolic risk factors for metabolic syndrome development in Mapuche and European participants, with additional improvements in other anthropometric, body composition, cardiovascular, metabolic, and muscle strength parameters related to the prevention of metabolic syndrome. These results suggest future more complex studies.Concurso Buenas Practicas en Promoción de La Salud, Región de Los RíosISCIII and Fondos FEDER (PI17/01814 and PI15/00558)Comite de Becas de internacionalización de la Universidad del Rosario (Contract No 10004611 de 2017)3.255 JCR (2019) Q1, 14/85 Sport Sciences1.373 SJR (2019) Q1, 28/284 Orthopedics and Sports Medicine, 10/207 Physical Therapy, Sports Therapy and Rehabilitation, 19/125 Sports ScienceNo data IDR 2019UE

mHealth and Aging

Sin financiación4.899 JCR (2018) Q1, 6/53 Geriatrics & Gerontology2.123 SJR (2018) Q1, 6/114 Geriatrics and Gerontology, 9/259 Health Policy, 139/2844 Medicine (miscellaneous), 2/152 Nursing (miscellaneous)No data IDR 2018UE

Safety and Effectiveness of Long-Term Exercise Interventions in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Background Physical exercise is beneficial to reduce the risk of several conditions associated with advanced age, but to our knowledge, no previous study has examined the association of long-term exercise interventions (≥ 1 year) with the occurrence of dropouts due to health issues and mortality, or the effectiveness of physical exercise versus usual primary care interventions on health-related outcomes in older adults (≥ 65 years old). Objective To analyze the safety and effectiveness of long-term exercise interventions in older adults. Methods We conducted a systematic review with meta-analysis examining the association of long-term exercise interventions (≥ 1 year) with dropouts from the corresponding study due to health issues and mortality (primary endpoint), and the effects of these interventions on health-related outcomes (falls and fall-associated injuries, fractures, physical function, quality of life, and cognition) (secondary endpoints). Results Ninety-three RCTs and six secondary studies met the inclusion criteria and were included in the analyses (n = 28,523 participants, mean age 74.2 years). No differences were found between the exercise and control groups for the risk of dropouts due to health issues (RR = 1.05, 95% CI 0.95–1.17) or mortality (RR = 0.93, 95% CI 0.83–1.04), although a lower mortality risk was observed in the former group when separately analyzing clinical populations (RR = 0.67, 95% CI 0.48–0.95). Exercise significantly reduced the number of falls and fall-associated injuries, and improved physical function and cognition. These results seemed independent of participants’ baseline characteristics (age, physical function, and cognitive status) and exercise frequency. Conclusions Long-term exercise training does not overall influence the risk of dropouts due to health issues or mortality in older adults, and results in a reduced mortality risk in clinical populations. Moreover, exercise reduces the number of falls and fall-associated injuries, and improves physical function and cognition in this population.Sin financiación11.136 JCR (2020) Q1, 2/88 Sport Sciences4.092 SJR (2020) Q1, 45/2448 Medicine (miscellaneous)No data IDR 2019UE

Tailored exercise is safe and beneficial for acutely hospitalised older adults with chronic obstructive pulmonary disease

Exercise rehabilitation programs have proven to increase exercise capacity and quality of life (QoL) in hospitalised patients with COPD. However, controversy exists as to the actual safety and effectiveness of this type of intervention We assessed the effects of an individualised exercise program on the functional capacity of acutely hospitalised older adults with COPD (as assessed with Barthel index and physical performance (Short Physical Performance Battery [SSPB]). Depression and QoL indicators, as well as serum C-reactive protein [CRP] and red blood cell distribution width [RDW] were also determined. Exercise-related side effects and incidence of readmission and mortality at 3 and 12-month–follow-up were also reported. We used the intention-to-treat approach. Of the 370 patients initially included in the RCT (11), 86 with COPD were identified (40 and 46 for the control and intervention group, respectively. The median length of stay was 8d (interquartile range, 4) for both groups. The exercise intervention improved all functional and physical performance-related outcomes (Barthel index, SPPB, 1RM leg strength) as well as depression and QoL scores, but no significant changes were found for CRP or RDW. No side effects associated were noted with the exercise sessions. No between-group differences were found for the incidence of readmission at 3 or 12-month follow-up; or for the incidence of mortality at 3 or 12-month follow-up. Our findings add to the existing limited literature supporting the benefits and safety of early rehabilitation programs in acutely hospitalised, older patients with COPD. Of note, the fact that our results were found in very older people (87 years on average) strengthens the potential safety of this type of interventions.Sin financiación16.671 JCR (2020) Q1, 3/64 Respiratory System4.021 SJR (2020) Q1, 46/2447 Medicine (miscellaneous)No data IDR 2020UE