Dissertations / Theses on the topic 'Aerobic and Resistance Exercise'

Aerobic exercise (AE) may interfere with muscle adaptations induced by resistance exercise (RE). Three experimental campaigns were conducted to explore the influence of AE on molecular, functional and muscular adaptations to acute and chronic RE. Twenty-nine men performed unilateral knee extensor RE preceded by AE (AE+RE). The contralateral leg did RE only. First, the influence of acute AE on muscle molecular responses to RE performed 6 h later was studied. Subsequently, this exercise regimen was implemented over 5 weeks training. The relationships between acute and chronic outcomes were examined and molecular responses to acute exercise were assessed in untrained and trained muscle. Finally, acute and chronic responses to AE+RE, interspersed by only 15 min recovery, were investigated.Phosphorylation of mTOR and p70S6K was greater after AE+RE than after RE. In parallel, myostatin was suppressed for a longer time after AE+RE. These results suggest that AE+RE enhance skeletal muscle anabolic environment more than RE alone (Paper I). After 5 weeks training, improvements in muscle strength and power were similar across legs. However, AE+RE prompted a greater increase in muscle size than RE, suggesting that AE potentiates the hypertrophic stimulus to RE training without altering muscle function progress (Paper II). Consistent with changes in whole-muscle size, AE+RE showed greater anabolic molecular responses than RE. As chronic training blunted this effect, it appears that AE offers a synergistic hypertrophic stimulus to RE only during short-term training (Paper III). Although putative regulators of hypertrophy such as p70S6K, myostatin and PGC-1a4 were examined, no molecular marker correlated with changes in muscle size, strength or power induced by training. Hence, this study challenges the concept that single molecular markers are viable predictors of training-induced muscle adaptations (Paper III–IV). When recovery time between exercise bouts was reduced to 15 min, AE+RE still produced a more substantial increase in muscle size than RE. However, progression of concentric strength was blunted. Thus, while restored muscle function between exercise bouts is a prerequisite for achieving maximal gains in strength and power, incomplete recovery appears not to compromise muscle hypertrophy (Paper V).Collectively, the results suggest that outcomes of AE+RE are impacted by chronic training and time allowed for recovery between exercise modes. Yet, the current study offers no support to the view that AE interferes with muscle hypertrophy induced by RE.

In previous research, resistance exercise reduced HbA1c primarily in studies of older type 2 diabetic (T2DM) subjects (age>55), while aerobic exercise reduced HbA1c primarily in studies of relatively younger subjects. We compared changes in HbA1c, fitness and body composition in response to 6 months of exercise training in older (55-70 yrs: n= 53) vs. younger (40-54 yrs: n=44) T2DM participants in a randomized trial. Previously inactive T2DM subjects were randomized to aerobic exercise (A; progressing to 45min at 75% HR max, n=24), resistance exercise (R; 2-3 sets of 8-12 RM, n=23), combination aerobic and resistance training (AR; n=25) or a waiting control-list group (C; n=25). Each exercise group trained 3x/wk for 6 months. Strength testing was done using an 8 repetition maximum (RM) protocol for seated row, leg press and bench press. V02peak was assessed using graded treadmill protocols to volitional fatigue. A single cut CT scan was used to quantitate abdominal visceral and subcutaneous fat and mid-thigh muscle cross-section. All tests were performed at baseline and 6-months. The responses of older and younger subjects did not differ significantly on any measure. A1c decreased from 8.0% to 7.1% in younger A, and from 7.4% to 6.7% in older A. In AR decreases were similar: 7.9% to 6.8% in younger AR, 7.8% to 6.8% in older AR. A1c changed little in R: 7.8% to 7.7% in younger R, 7.7 to 7.3% in older R. No significant change in HbA1c occurred in either older or younger subjects in C. Mean increases in VO2peak for A were 6.9% in old and 7.4% in young and for AR were 7.6% in old and 4.9% in young. Strength increased in AR by 47.5%, 51.0% and 37.9% in young and 41.1%, 46.0% and 30.4% in young for bench press, leg press and seated row respectively. The R young group improved by 68.6%, 86.2% and 47.6% and the old by 44.3%, 72.3% and 31.9% for bench press, leg press and seated row respectively. The aerobic only group also improved in strength. Neither VO2peak nor strength changed significantly in C. Therefore, older (55-70 years old) and younger (40-54 year old) T2DM subjects responded similarly to aerobic, resistance or combined exercise in terms of glycemic control, strength, and aerobic fitness.

Despite pharmacological advances, exercise remains a cost effective preventative for cardiovascular disease (CVD) by acutely and chronically lowering systolic blood pressure (SBP). Although numerous studies have investigated aerobic and resistance training’s role in eliciting an acute SBP response termed post-exercise hypotension (PEH), few researchers have investigated how performing both cardiovascular and weight training in a single session (concurrent training) or how different prescriptions for order of exercise modality will elicit this PEH response; no known studies have attempted altering the order of exercise types within each session. This study seeks to determine if the order of exercise type will affect a PEH response following concurrent exercise. Participants (n=13), considered low risk for cardiovascular disease participated in a control session, graded exercise test (GXT) and two concurrent sessions, with concurrent sessions counterbalanced for order of exercise mode. Recovery SBP was analyzed in the laboratory for sixty minutes and for twenty-four hours thereafter using an ambulatory blood pressure monitor. All exercise conditions elicited a depression in SBP; however, only the cardiovascular-weight training (CVWT) concurrent session elicited PEH (p = 0.05). However, there were no differences in SBP attenuation between conditions. There was no main effect for PEH between conditions during twenty-four hour assessment. With no statistically significant differences in the magnitude of PEH twenty-four hours after exercise, it may be determined that the order of exercise does not vi affect the preventative attributes of aerobic and resistance exercise in regards to acute SBP response. Furthermore, only exercise involving resistance training (CVWT) provoked PEH during the first 60 minutes; therefore it may be argued that individuals should pair cardiovascular exercise with weight training in order to elicit the greatest cardiovascular benefits. Future studies should consider evaluating the effect of time of day and PEH following concurrent exercise to determine if pairing exercise modalities will at different times will affect the blood pressure response.

This study had 2 components investigating the effects of exercise in Sri Lankan adults with type 2 diabetes mellitus (T2DM). The quantitative component consisted of a 12 week randomized controlled trial comparing aerobic training, resistance training and usual care on glycaemic control (HBA1C), % body fat and range of clinically important endpoints. The qualitative component consisted of in-depth interviews to determine barriers/facilitators for adherence to different modes of exercise. The study proved, despite cultural challenges and barriers, the possibility of conducting a large-scale exercise intervention in Sri Lankans for the first time and merit of exercise in Sri Lankans with T2DM.

This research provides valuable insight into exercise barriers and prescription for individuals with cancer-related lymphoedema, particularly following breast cancer. Findings from this work demonstrate that by identifying and addressing exercise barriers, exercise confidence improves and, as such, enables longer-term exercise participation. Further, the findings demonstrating similar lymphoedema-related and physical and psychosocial benefits are achieved through participation in either resistance- or aerobic-based exercise highlights that exercise programs can be individualised, taking into consideration participants' interests, without jeopardising a woman's recovery and longer-term function, health, quality of life and survival.

Diabetes is a common chronic disease that affects almost all countries in the world and has continued to increase at an alarming rate in the last decades. It kills a person every seven seconds. Recent thinking treats both types of diabetes as inflammatory diseases. The aim of the thesis was to obtain a better understanding of the relationship between exercise and the management of diabetes by conducting surveys and experimental work. It investigates the effects of exercise on the physiology and metabolic control in Type 1 (T1D) and Type 2 diabetes (T2D), using non-diabetic (ND) people as a control. The management and treatment of T1D and T2D volunteers were first assessed in surveys and the novelty was second to expose both to exercise. In the latter, volunteers were compared biochemically including for inflammatory responses to their illness and to practical exercise. Four studies were undertaken in this thesis involving a mixed approach: questionnaire based studies (first and second surveys) and experimental based studies (first and second exercise studies). The first survey study was about insulin users with opinions gathered from both T1D and T2D (T2I) respondents (n=707). In this survey diabetic people were asked about the condition and coping strategies for the difficulties using insulin in daily life. The first survey does touch on exercise but only as part of the larger picture. The second survey study (n=240) evolved from the first one and was again about opinions but in this case oral anti-hyperglycaemics were included in the management of T2D respondents (T2T). This survey focused more strongly on the role of exercise. The surveys were conducted by post, email and online while detailed statistical analysis followed. Two exercise studies with the same volunteers (n=25; ND=7, T1D=7, T2T=7, T2I=4) were then carried out based on some findings of the surveys. These studies explored the effects of a combination of aerobic (AE) and resistance exercise (RE) components for a six week period on diabetes. The methodology of the first exercise study concentrated on the physiological variables, involving the use of exercise and measurement equipment to monitor for expired gases and anthropometric changes. Substrate oxidation, blood profiles for lipid, blood glucose (BG) and glycated haemoglobin (HbA1c) were also assessed. The second exercise study builds on this with specific inflammatory marker profiles such as tumour necrosis alpha (TNF-α), interleukin-6 (IL-6), leptin and resistin on ND, T1D and T2D volunteers over the same time period as in the first exercise study. The first survey study showed that many respondents (13-47%) lacked adequate professional information about the various separate aspects of their insulin-treated illness. For example, 38% of T1D and 28% of T2I reported that they did not have enough information regarding raised cholesterol levels. The results for diabetes complications revealed that T2I had greater complications compared to T1D (for example angina 18.5% for T2I compared to 4.6% for T1D), although the groups could not be matched for age, reasons for responding to the survey, duration of illness or severity of illness when starting insulin. The second survey revealed that insulin users often had an HbA1c that did not meet best practice expectations of 6.5% - 7.5% (48 -58 mmol/mol). It also showed that those who did exercise regularly were more likely to have acceptable HbA1c values (5-7% or 31-53mmol/mol), than those who did not. This is especially the case for the type 2 groups (eg for T2T 46% exercising compared to 31% non-exercising) who were less likely (19% respondents compared to 25%) to have HbA1c over 8% or 64 mmol/mol. It was of interest to know the risks, barriers and likely recommendations for the two groups. For example, fewer T2I people test BG frequently (12.5% compared to T1D 62%, testing four or more times daily), even when they are insulin basal bolus users, which could foster hypoglycaemic events during exercise. The findings of the first and second surveys showed that managing diabetes in the 21st century remains difficult for many people, despite the availability of diagnostic, monitoring and medication improvements. This leads to anxiety and illness over the short and long term. In the first exercise study, it was clear that for this combined exercise regimen, the chronic effects were notable. The most significant finding was that the effect of 6 weeks was the drop in HbA1c in all groups ND from 5.4-5.2% or 36-33mmol/mol (p ˂ 0.01), T1D 7.0 to 6.7% or 53-50mmol/mol (p ˂ 0.01), T2T 7.6 to 7.2% or 60-55mmol/mol (p ˂ 0.05), T2I 7.3 to 6.8 or 56-51mmol/mol (p ˂ 0.05). This is equivalent to raising insulin or other medication and while clearly very beneficial, especially as occurring as a result of moderate exercise over only 6 weeks. Lipid factors showed improvements, not all significantly but these were likely to be influenced by support medication such as statins. However, the heart rate (HR) and blood pressure (BP) reduced at rest for all groups over the six weeks. The respiratory exchange ratio (RER), a measure of substrates oxidation showed that the carbohydrate metabolism was steady. The muscular strength and the subjective assessment improved after the exercise period. The second exercise study showed the interleukin 6 levels fell with the chronic effects of combined exercise ND (3.97-2.7pg/ml), T1D (2.15-1.02 pg/ml), T2T (3.67-2.72pg/ml) and T2I (3.66-1.17pg/ml) as did TNFα and other cytokine levels which may thus be cardioprotective. This suggests that exercise could be part of the anti-inflammatory treatment of T1D and T2D. To conclude, the findings of the two survey studies showed that the management of diabetes is difficult for many diabetics. Furthermore, the exercise studies demonstrated that a regular combined (RE and AE) exercise trial at moderate intensity for six week could be physiologically beneficial for diabetics. The underlying mechanism for this could be improvements in glycaemic control, lipid profile, cardiovascular fitness level and strength, as well as the inflammatory features of both T1D and T2D.

There is abundant evidence supporting the health benefits physical activity in cancer survival. Exercise per se is associated with positive physical and psychosocial benefits for survivors of solid tumours. There are limited available research data on blood borne cancers. Lymphoma is one such haematological cancer where survivors often experience decrements in psychosocial, physical functioning and quality of life (QoL) domains. A minority (~25%) of lymphoma survivors meet the recommended public guidelines for exercise. Further to this, the work of Bellizzi and colleagues (2009) indicates that QoL decrements often persist for years following treatment. Conventional wisdom dictates that exercise is likely to be an effective means of alleviating some adverse outcomes from blood borne cancers but this hypothesis is largely untested to date. Further to this, the theory of planned behaviour (TPB) has been shown to provide effectual model for predicting exercise behaviour amongst cancer survivors but known to differ by tumour type. Therefore, the aims of the present thesis were to determine the effects of 12-weeks of a combined aerobic and resistance training programme (CARP) on QoL and health related outcomes in Hodgkin’s lymphoma (HL) and Non-Hodgkin’s lymphoma (NHL) survivors. The thesis focused specifically on four main aims; Aim 1 the primary aim was to identify whether a 12-week CARP is effective at improving QoL in HL and NHL survivors. Secondary Aims were to; Aim 2 to determine whether a 12-week CARP is effective at improving standard measures of muscle function and cardio-respiratory fitness in HL and NHL survivors. Aim 3 to examine whether a 12-week CARP affects inflammatory environment and/or immune function in HL and NHL survivors. Aim 4 to identify whether theory of planned behaviour (TPB) may be an effectual model to predict exercise intention in HL and NHL survivors. In realising these aims, a parallel group randomised control exercise trial (RCT) was conducted with two components. Forty-one (n=41) HL and NHL survivors completed the trial at St George’s hospital, London. Participants, who had completed chemotherapy or radiation treatment (<6 months), were stratified according to tumour type and randomly assigned to either control (CON; n=21) or intervention (INT; n=20). The intervention consisted of a combination of 12-weeks supervised aerobic and resistance training (CARP) whilst the control group received usual care. The first component consisted of three measurement phases; baseline (To; n=41), post-intervention (T1; n=41) for all measurements, and 12 months follow-up (T2; n=15) for qualitative measures. A representative sample (n=6) from the intervention group took part in a focus group to explore participant perception of the impact of the CARP. QoL was assessed using the previously validated European Organization for Research and Treatment of Cancer Quality of Life (EORTC-QLQ-30) questionnaire. Secondary outcome measures consisted of health-related quality of life (HRQoL) determined by Functional Assessment of Cancer Therapy in Lymphoma (FACT-Lym); Mood disturbance and fatigue were determined using Profile of Mood States (POMS) questionnaire; anxiety and depression were determined using Hospital Anxiety and Depression scale (HADS). Participant cardiorespiratory fitness was assessed using the Balke-ware treadmill test, muscle function assessed by grip strength and muscle endurance tests. Blood was sampled using the standard venepuncture method followed by radioimmunoassay to determine interleukin 6 (IL-6) and c-reactive protein (CRP) concentrations. In order to identify determinants of exercise intention and behaviour in HL and NHL survivors, a second component to the trial utilised a validated TPB questionnaire, assessed at baseline (To; n=41), and post-intervention (T1; n=41). Data were analysed using SPSS version 18.0 using appropriate statistical functions. Statistical significance was set at p<0.05. Data are presented as means i standard deviations (S.D.). Results demonstrate that study adherence between To and T1 was 87.2% (41/47) with a large accession rates at 12 months follow up (15/41). Linear mixed models analysis was used to examine subjectively reported outcomes. Clinically relevant improvements in QoL were achieved in both groups at T1. HRQoL, a domain of QoL, increased with exercise; the improvements were both clinically relevant and statistically significant. Subscales of QoL and HRQoL that significantly improved with exercise are social function (p=0.020), emotional well-being (p=0.029), and functional well-being (p=0.025), as well as functional lymphoma specific concerns (p=0.034). Mood disturbance was unchanged in either group, physical function improved only in the control group (p=0.049). Both groups showed improved (p<0.05) physical well-being, vigour, reduced fatigue, and increase in subjectively reported amount of physical activity (IPAQ) as time passed from the end of treatment. At follow-up, HRQoL, lymphoma concerns, fatigue, and the trial outcome index significantly improved in both groups (p<0.05) from baseline; anxiety significantly increased in the intervention and anxiety, physical well-being, and functional well-being improved in the control group. Both groups reduced physical activity at follow-up. Predicted aerobic capacity showed a trend towards an increase, whereas resting heart rate (p=0.041) abdominal muscle endurance (p=0.018) significantly improved in the [NT group with a concomitant trend for a decrease in the CON group. However, this did not reach a level of significance. Although both groups experienced worsening of pulmonary function post intervention, this only reached a level of significance in the ]NT group. No significant changes in either IL-6 or CRP were observed during the study. ANOVA and MANOVA were used to analyse physical outcomes. Regression analysis was used to determine the predictive value of the TPB variables upon intention to exercise, and TPB variables and intention upon actual behaviour. Simultaneous Multiple Regressions were used first to determine the equation for each model. Stepwise Multiple Regressions were used to examine the impact of each variable on the dependent variable to find the best model of prediction. At baseline (both INT and CON groups collapsed to one) the model predicts intention (68.6%), but prediction of variation in actual behaviour is low (36.2%); self- efficacy (13:0.495) and social support (13:0.469) predict intention to exercise among lymphoma survivors and self-efficacy (B=0.609) alone predicts actual behaviour at To. At T1, the model predicts 77.0% of the variation in intention amongst the CON group but only 14.7% of actual behaviour; attitude (B=0.864) predicted intention to behave. Amongst the exercising group, the model predicts 61.5% of the variation in intention, but only 19.2% of actual behaviour; social support (B=0.800) predicts intention to exercise. None of the determinants significantly predicted actual behaviour at T1. The current thesis presents the first data in examination of the impact of a CARP amongst post- treatment lymphoma survivors. The exercise training intervention significantly improved HRQOL and psychosocial well-being. This is noteworthy as lymphoma survivors are often burdened with reduced HRQOL and psychosocial morbidity. Although predicted aerobic fitness levels were statistically unchanged in INT following the intervention, the trend towards an improvement indicates that either an increase in exercise programme length or intensity of exercise sessions may achieve statistical improvement in future studies. The findings from this thesis indicate CARP to be effective in improving psychosocial outcomes in lymphoma survivors. At 12-month follow-up, reduced physical activity was associated with increased anxiety; functional and physical well-being did not improve despite increases seen in CON.

Previous research has shown that chronic exercise positively impacts body image in women. Research defining the modality that yields the best results following an acute session of exercise has yet to be determined. This research attempted to show the psychological benefits that exercise could have on female body image after only one bout of exercise. PURPOSE: The purpose of the current study was to examine the effects of three different modalities of acute exercise on state body image in women. This study aimed to determine which modality, if any, is more effective in increasing state body image. METHODS: Twenty-five female participants (20.2 ± 2.2 years; 23.6 ± 4.0 BMI, 25.5 ± 6.0 body fat percent) attended laboratory sessions on six different occasions; the initial informed consent, risk stratification, and descriptive data session, the familiarization session, the three exercise sessions, and the control session. During the familiarization session, each participant was acquainted with each exercise modality. The aerobic (AE) session consisted of a five-minute warm-up, 30 minutes of treadmill exercise, and a five-minute cool-down. The interval circuit (IC) session involved a five-minute warm-up, two circuits containing five bodyweight exercises each, and five minutes of cool-down stretching. The resistance (RE) session included a five-minute warm-up, three sets of eight repetitions of the bench press, bent-over row, overhead press, squat, deadlift, and lunge exercises, and five-minutes of cool-down stretching. The control session included 40 minutes of quiet reading. Ratings of perceived exertion and heart rate were monitored and recorded during each trial. State body image, positive mood, and negative mood were measured immediately before and after each experimental session. RESULTS: Following the AE and RE sessions, state body image significantly improved from pre- to post-session (AE: 5.2 ± 1.2 to 5.7 ± 1.0; RE: 5.4 ± 1.4 to 5.9 ± 1.2; p < 0.05). Only the RE post-session state body image (5.4 ± 1.4) was significantly different from the CO post-session state body image (5.4 ± 1.1; p < 0.05). The AE and RE sessions significantly increased positive mood and decreased negative mood from pre- to post-session (p < 0.05). CONCLUSION: Participation in the aerobic and resistance sessions significantly improved body image from pre- to post-exercise. Resistance exercise was the only research modality that yielded significantly higher post-exercise state body image as compared to the control session. Thus, a single resistance exercise session may help individuals to improve their state body image.

Aerobic exercise interventions involving individuals with type 1 diabetes have had little positive effect on blood glucose control as reflected by hemoglobin A1c. The few existing interventions involving resistance exercise, either alone or combined with aerobic exercise, while small in sample size, have had better outcomes. The purpose of this research program was to examine the changes in blood glucose levels during activity and for 24 hours post-exercise (as measured by continuous glucose monitoring) when resistance exercise is performed, either on its own or combined with aerobic exercise, as compared to aerobic exercise alone or no exercise. Twelve physically active individuals with type 1 diabetes performed 5 separate exercise sessions in random order separated by at least five days: 1) no exercise/control; 2) aerobic exercise (45 minutes of treadmill running at 60% VO2peak); 3) resistance exercise (45 minutes of weight lifting – 3 sets of 8 repetitions of 7 different exercises); 4) aerobic then resistance exercise (2 and 3 combined with the aerobic exercise first); 5) resistance then aerobic exercise (2 and 3 combined with the resistance exercise first). We found that resistance exercise was associated with a lower risk of hypoglycemia during exercise, less carbohydrate intake during exercise, less post-exercise hyperglycemia and more frequent (but less severe) nocturnal hypoglycemia than aerobic exercise. When aerobic and resistance exercise were combined, performing resistance exercise prior to aerobic exercise (rather than the reverse) resulted in attenuated declines in blood glucose during aerobic exercise, accompanied by a lower need for carbohydrate supplementation during exercise and a trend towards milder post-exercise nocturnal hypoglycemia.

Considerable research has been performed on the effects of exercise and glucose tolerance, however, most of this work has examined aerobic exercise designs. This study examines the immediate post-exercise glucose turnover in eight male subjects exposed to a single bout of running and PRE. Both exercise protocols were designed to be of similar duration and at an intensity representing a typical exercise session. This study was conducted in an effort to offer individuals with NIDDM an alternative to the established aerobic forms of exercise for improved glucose control. Each subject completed two preliminary procedures, which consisted of a maximal graded exercise test and a session where a 1 RM was established on six different Cybex variable resistance machines. Subjects then completed a baseline oral glucose tolerance test (OGTT) in which eight blood samples were analyzed for glucose, insulin, hemoglobin, and hematocrit. Two exercise protocols, separated by 3 to 10 days, consisting of a 40 minute treadmill run at 75% VO2max and a 40 minute, 3 set x 10 repetition based on 75% of the1 RM, were performed and followed 45 minutes later by another OGTT. The results demonstrated that there were no apparent differences in blood glucose or insulin levels post-exercise between the exercise modes. However, the form of exercise did seem to have a varied effect on insulin production. The results of the OGTT demonstrated an explicit difference in the insulin response between the lifting and running trials, with the lifting trial being significantly higher than the resting or running trials. The increased insulin levels observed in the lifting trial may be indicative of increased secretion from the pancreas or that the secreted insulin is simply not being used. The insulin resistance observed in the lifting trial may be due to the muscles inability to respond to insulin or some other metabolic factor(s) released during exercise. Additional studies should be performed on different populations to examine the effects of PRE and running in a effort to better understand the mechanisms responsible for glucose uptake.<br>School of Physical Education

The conductor of a large instrumental ensemble is constantly confronted with the task of detecting and correcting rhythm and pitch performance errors in daily rehearsals. The purpose of this investigation was to design a computer-assisted instruction program for error detection skills development and then evaluate this program's effectiveness in training beginning conductors to identify rhythm and pitch errors within 2-, 3-, 4-, and 5-voice synthesized music excerpts from the existing band literature. The transfer of error detection skills from synthesized to acoustic sounds also was explored indirectly by virtue of utilizing taped excerpts from wind band performances to assess error detection skills.Subjects (N=24) in this study were drawn from the pool of undergraduate instrumental music education majors at Ball State University and were randomly assigned to control treatment groups prior to the administration of the Acoustic Error Detection Skills Inventory. Following this pretest, the treatment group used the Computer Error Detection Skills Program for approximately eight hours during an eight week treatment period. At the end of the treatment period, and control and treatment groups were administered the Acoustic Error Detection Skills Inventory posttest.The data were analyzed using a series of one-way, repeated measures analyses of variance (ANOVA) to assess pretest to posttest changes in subjects' scores on the Acoustic Error Detection Skills Inventory. Composite scores (reflecting general skill in error detection) improved significantly for the treatment group (p = .007), while the pretest to posttest gain for the control group was not statistically significant (p = .232). These results suggest that the Computer Error Detection Skills Program was effective in enhancing subjects' rhythm and pitch error detection skills and the viability of using synthesized sound sources for training was confirmed.The following recommendations were made: (1) Jazz directors need to do more listening to jazz music, (2) band directors who direct jazz programs should join IAJE, (3) jazz ensembles shouldtheir own improvisational skills, and rehearse in the fall, (4) jazz ensemble directors should develop (5) jazz ensemble directors should have their students sing their parts during rehearsals for increased learning efficiency and retention.<br>Human Performance Laboratory

Physical inactivity and obesity in adolescence are associated with an increased risk of cardiovascular disease (CVD). Although exercise is recommended for the management of obesity, we know little about which types of exercise training are the most effective in reducing excess body fat and improving CVD risk in obese adolescents. This dissertation examined the effects of aerobic training, resistance training and their combination on the cardiometabolic health (body composition, CVD risk markers, resting metabolic rate (RMR), and fitness) of obese adolescents who participated in the Healthy Eating Aerobic and Resistance Training in Youth (HEARTY) trial. After a 4-week supervised moderate-intensity exercise run-in period, 304 overweight and obese adolescents were randomized to 4 groups for 22 weeks: Aerobic training, Resistance training, Combined aerobic and resistance exercise training, or a non-exercising Control. All four groups received dietary counseling designed to promote healthy eating with a maximum daily energy deficit of 250 kcal. Participants were assessed at baseline and after 3 and 6 months. Body composition was assessed using magnetic resonance imaging. Blood tests for traditional and non-traditional CVD risk markers were measured after a 12-hour fast. RMR and cardiorespiratory fitness were assessed using indirect calorimetry at rest and during a maximal treadmill test respectively. Musculoskeletal fitness (muscular strength, endurance, flexibility) was assessed using eight repetition maximum tests (8-RM) on the leg press, chest press and upright row machines and using the Canadian Society for Exercise Physiology- Canadian Physical Activity Fitness and Lifestyle Appraisal (CSEP-CPAFLA) tests for grip strength, push-ups, sit-ups, sit and reach and vertical jump. Decreases in percent body fat and abdominal fat were greatest in the combined training group. Although body weight, RMR and traditional CVD risk markers did not improve following the exercise intervention, the combined training group showed improvements in cardiorespiratory and musculoskeletal fitness and some non-traditional CVD risk markers. Cumulatively, combined aerobic and resistance exercise training showed the greatest improvements in cardiometabolic health in overweight and obese adolescents. This thesis concludes with a knowledge translation article detailing the practical lessons learned from exercise interventions with obese youth with hopes of increasing adherence to future exercise programs and improving the overall health of children and adolescents with obesity.

A procura crescente por atividades aquáticas tem estimulado o aumento de estudos nessa área objetivando uma melhor prescrição para diferentes populações. A hidroginástica, em específico, tem sido amplamente indicada para a população idosa, devido aos seus inúmeros benefícios já documentados, principalmente na força muscular e nas respostas cardiorrespiratórias. Entretanto, ainda não se sabe qual o modelo ideal para essas melhoras, visto que as metodologias utilizadas são muito distintas entre os estudos. Desta forma, o objetivo do presente estudo foi avaliar os efeitos de dois modelos de treinamento de hidroginástica nas respostas cardiorrespiratórias e na força de mulheres idosas. Para tanto, participaram do estudo 69 mulheres idosas e sedentárias (60-75 anos) que foram divididas nos dois grupos de treinamento e no grupo controle: grupo de hidroginástica aeróbio (GA, n=23), grupo de hidroginástica de força (GF, n= 23) e grupo controle de relaxamento em imersão (GC, n=23). As intervenções tiveram uma duração de 10 semanas e foram realizadas sessões de 45 minutos duas vezes por semana. Antes e após esse período foram realizadas duas sessões de avaliações, sendo uma destinada aos testes de força muscular dinâmica máxima e outra para as avaliações cardiorrespiratórias em repouso e em máximo esforço. Para análise estatística utilizamos a Generalized Estimating Equations (GEE), com teste post hoc de Bonferroni (α=0,05). Os resultados demonstraram uma diminuição significativa da pressão arterial sistólica (GA: - 4%; GF: -6%; GC: -5%) e diastólica (GA: -1%; GF: -7%; GC: -6%) de repouso para todos os grupos avaliados, sem diferenças entre eles. A frequência cardíaca de repouso, no segundo limiar ventilatório e de pico não modificaram com as intervenções realizadas. Em contrapartida, o GA apresentou aumentos significativos no consumo de oxigênio no segundo limiar ventilatório (17%) e de pico (14%) e esse comportamento não foi observado nos demais grupos avaliados. Em relação à força muscular, todos os grupos apresentaram um aumento significativo da força dinâmica máxima de extensão de joelho sem diferenças entre eles (GA: 11%; GF: 8%; GC: 5%), a força dinâmica máxima de flexão de joelho aumentou no GA (14%) e no GF (18%) e, por fim, a força de flexão horizontal de ombro não apresentou diferenças significativas após as intervenções realizadas. Assim, concluímos que as três intervenções realizadas demonstraram melhoras significativas na pressão arterial de repouso. O treinamento de força na hidroginástica proporciona aumentos significativos na força muscular de membros inferiores. Por fim, o treinamento aeróbio na hidroginástica parece ser um modelo de treino efetivo tanto para aumentos na força muscular de membros inferiores quanto para melhoras nas respostas cardiorrespiratórias de mulheres idosas sedentárias.<br>The growing demand for aquatic exercises has stimulated the increase of studies in this area aiming at a better prescription for different populations. The water-based exercise in particular has been widely recommended for the elderly due to its numerous benefits already documented, especially in muscle strength and cardiorespiratory responses. Thus, the aim of this study was to evaluate the effects of two water-based training models on the cardiorespiratory and strength responses in older women. Sixty-nine elderly and sedentary women (60-75 years) were divided into two water-based training groups and control group: aerobic group (AG, n = 22), resistance group (RG, n = 23) and control group of relaxation in immersion (CG, n = 24). The interventions had a 10-week duration and 45 minute sessions were held twice a week. Before and after this period there were two sessions assessments, one destined to maximal dynamic strength test and one for cardiorespiratory evaluations at rest and at maximal effort. The Generalized Estimating Equations (GEE), with post hoc Bonferroni was used to statistical analysis of data (α = 0.05). The results showed a significant decrease in systolic blood pressure (AG: -4%; RG: -6%; CG: -5%) and diastolic (AG: -1%; RG: -7%; CG: -6%) at rest for all the groups, with no differences between them. The resting, ventilatory threshold and peak heart rate did not change with the interventions. In contrast, the GA showed significant increases in oxygen consumption in the second ventilatory threshold (17%) and peak (14%) and this behavior was not observed in the other groups assessed. Regarding muscular strength, all groups showed a significant increase in maximal dynamic knee extension without differences between them (GA: 11%; GF: 8%; GC: 5%), the maximum dynamic strength of knee flexion increased in GA (14%) and GF (18%) and, finally, the strength of shoulder horizontal flexion showed no significant differences after interventions. Thus, we conclude that the three interventions showed significant improvements in blood pressure at rest. The strength training in the water aerobics provides significant increases in muscle strength of the lower limbs. Finally, the aerobic waterbased training seems to be an effective training model for both increases in muscle strength of the lower limbs and to improvements in cardiorespiratory responses among sedentary older women.

The aim of this research was to develop a novel multi-function exercise system for use in a broad range of applications. Market research indicates that the demand for aerobic and anaerobic exercise devices will continue to grow with the introduction of government physical activity guidelines and increased social pressure regarding health related issues. A detailed investigation of the basic exercise science fundamentals and training methodologies was conducted in order to develop a system which would provide efficient and effective training related stimuli for improving fitness. The generation, storage and utilisation of actual and virtual load and velocity profiles for use in the development of original training modes was identified as an important area of the research. The proposed solution utilises an electromechanical programmable motion control system which provides all of the necessary exercise modalities defined in the system specification. This system combines existing industrial servo drive technology with proprietary software and database facilities to provide a step change in functionality, ease of use and safety for all users. Development of these hardware and software elements was supported by the creation of a series of system models at the initial stages of the research using the computer integrated manufacturing open systems architecture (CIMOSA) modelling approach. These diagrams were an invaluable resource during the concept generation and refinement processes and have clearly demonstrated the cross-discipline applications of such formalised modelling techniques. Validation and reliability data collected during prototype testing indicated that the exercise motion generation capabilities and performance measurement facilities were comparable to existing isokinetic dynamometer equipment. Additional subject testing produced results with peak output values and parameter trends which correlated closely to those determined during clinical and academic research. These experimental results suggest that the modular exercise system could be a valuable tool for the collection of research data to be used in support of current and future training theories.

Thesis (M.S.)--Georgia Southern University, 2006.<br>"A thesis submitted to the Graduate Faculty of Georgia Southern University in partial fulfillment of the requirements for the degree Master of Science" ETD. Includes bibliographical references (p. 30-32) and appendices.

O objetivo da presente tese foi investigar os efeitos da ordem das modalidades de treino de força e aeróbico nas adaptações neuromusculares e cardiorrespiratórias ao treinamento concorrente em idosos. Vinte seis homens idosos saudáveis (64,7 ± 4,1 anos) foram distribuídos em 2 grupos de treino concorrente: treino de força executado antes do treino aeróbico (GFA, n=13), e treino aeróbico executado antes do treino de força (GAF, n = 13). Os indivíduos treinaram 12 semanas, 3 vezes por semana executando os dois tipos de treinamento na mesma sessão. A espessura muscular (EM) de membros superiores (músculos do quadríceps) e inferiores (flexores do cotovelo) foram mensuradas com a técnica de ultrasonografia. Foram avaliados a força de membros superiores (flexores do cotovelo) e inferiores (extensores do joelho) com o teste de uma repetição máxima (1RM), o pico de torque isométrico (PTiso) dos extensores e flexores do joelho, e a taxa de produção de força (TPF) dos extensores do joelho em um dinamômetro isocinético. Além disso, a tensão específica foi avaliada através do quociente entre os valores de 1RM/2 e o somatório dos valores de EM do quadríceps. A atividade neuromuscular máxima e a economia neuromuscular (valores root mean square obtidos a 50% do PTiso normalizados pela atividade neuromuscular máxima) dos músculos vasto lateral (VL) e reto femoral (RF) foram avaliadas com eletromiografia (EMG) de superfície. O consumo de oxigênio de pico (VO2pico), a potência máxima (Wmáx), os limiares ventilatórios absolutos (LV1 e LV2) e relativos (LV1% e LV2%) e as potências nos limiares (WLV1 e WLV2) foram avaliadas em um teste incremental em ciclo ergômetro. Ambos os grupos aumentaram os valores de 1RM e a tensão específica de membros inferiores (P<0,001), mas os aumentos foram maiores no grupo GFA do que em GAF [(35,1 ± 12,8 vs. 21,9 ± 10,6%, respectivamente, P<0,01) e (27,5 ± 12,7 vs. 15,2 ± 10,3%, respectivamente P<0,02)]. Ambos os grupos aumentaram os valores de 1RM de membros superiores (P<0,001), o PTiso dos flexores e extensores do joelho (P<0,001), TPF dos extensores do joelho (P<0,05), a EM dos extensores do joelho e flexores do cotovelo (P<0,001), a atividade neuromuscular máxima do VL e RF (P<0,01 a 0,05) e a economia neuromuscular do VL (P<0,001), sem diferenças entre os grupos. A economia neuromuscular do RF melhorou somente em GFA (P<0,01) e esse aumento foi maior (P<0,05) que em GAF. Houve aumento no VO2pico (P<0,001), na Wmáx, (P<0,001) e na WLV2 (P<0,001) em GAF e GFA, sem diferenças entre os grupos. Somente o grupo GFA aumentou a WLV1 (P<0,05). Não houve modificações nos valores de LV1, LV2, LV1% e LV2% nos grupos. A execução do treinamento concorrente com o treino de força realizado antes do treino aeróbico resulta em maiores ganhos na força máxima e economia neuromuscular dos membros inferiores, bem como resulta em maiores ganhos na potência do primeiro limiar ventilatório.<br>The aim of this study was investigate the effects of different intra-session exercise orders in the neuromuscular and cardiorespiratory adaptations induced by concurrent training in elderly. Twenty-six healthy elderly men (64.7 ± 4.1 years), were placed into two concurrent training groups: strength prior to (GFA, n=13) or after (GAF, n=13) endurance training. Subjects trained strength and endurance training during 12 weeks, three times per week performing both exercise types in the same training session. Upper and lower body muscle thickness (MT) were determined by ultrasonography. Upper (elbow flexors) and lower body (knee extensors) one maximum repetition test (1RM), lower-body isometric peak torque (PTiso) and rate of force development (RFD) of knee extensors were evaluated as strength parameters. In addition, the specific tension was evaluated by the quotient between knee extensors 1RM/2 and the quadríceps femoris MT. Lower-body maximal electromyographic activity and the neuromuscular economy (root mean square values at 50% of pre training PTiso normalized by maxima neuromuscular activity) of vastus lateralis (VL) and rectus femoris (RF) muscles were determined by surface electromyography. The peak oxygen uptake (VO2peak), maximum aerobic workload (Wmáx), absolute (VT1 and VT2) and relative (VT1% and VT2%) ventilatory thresholds, as well as workloads at VT1 and VT2 (WVT1 and WVT2) were evaluated during a maximal incremental test on a cycle ergometer. Both GFA and GAF increased the lower-body 1RM and specific tension, but the increases observed in the GFA were greater than GAF [(35.1 ± 12.8 vs. 21.9 ± 10.6%, respectively, P<0.01) and (27.5 ± 12.7 vs. 15.2 ± 10.3%, respectively, P<0.02)]. In addition, GFA and GAF increased upper-body 1RM, PTiso of knee extensors and flexors (P<0.001), RFD of knee extensors (P<0.05), MT of elbow flexors and knee extensors (P<0.001), maximal neuromuscular activity of VL and RF (P<0.01 to 0.05), and, neuromuscular economy of VL (P<0.001), with no differences between groups. The neuromuscular economy of RF was improved only in GFA (P<0.01) and this increase was greater that GAF (P<0.05). There were increases in the VO2peak (P<0.001), Wmáx (P<0.001) and WVT2 (P<0.001), with no difference between GFA and GAF. Only GFA increased the WVT1 (P<0.05). There were no modifications after training in the VT1, VT2, VT1%, and VT2%. Performing strength prior to endurance exercise during concurrent training resulted in greater maximal strength gains and neuromuscular economy of lower-body, as well as greater changes in the in the power at first ventilatory threshold.

Introduction: Surgical patients undergoing ear, nose and, throat (ENT) surgery experience on average a greater length of stay (LOS; 25 days) compared to lung cancer surgery patients (8.3 days). Prehabilitation enhances physical functioning prior to surgery to allow patients to better cope with stressors of surgery. Previous research has investigated the benefits of aerobic-focused prehabilitation programs at improving post-surgery recovery in general surgery populations; however, research investigating resistance-based prehabilitation programs has not been investigated. This study investigated the effects of a resistance-based prehabilitation program on LOS, readmission rate, and physical functioning in an ENT surgery population. Study design and Methods: Twenty-seven participants (18 males, 9 females; age: 72.3 ± 9.0 years) were recruited prior to inpatient admission and were randomly assigned to either a usual care group or a prehabilitation group. Prior to surgery occurring, five participants were excluded as no longer required surgery, and a further 3 participants withdrew due to other reasons resulting in the data for nineteen participants being used in the results section. The prehabilitation program consisted of six resistance-based exercises (6-12 reps) of moderate-intensity (Category Ratio RPE Scale 5- 7), RPE between 5-7 on the Category Ratio RPE Scale, targeting major muscle groups, and 20 minutes of aerobic exercise at 60-85%HR max. The program was completed three days per week with a minimum one-day recovery between each session. The average number of exercise prehabilitation sessions between participant recruitment and surgery was 10 (± 4) sessions. The two primary outcome measures used were LOS (days) and 28-day readmission rate, which were recorded 6-weeks post-surgery. LOS was measured with the day surgery occurred being day zero and the first-day post-surgery recorded as day one. Secondary outcome measures were taken pre and post-surgery these included: whole-body bioimpedance, isometric grip strength, aerobic fitness, self-reported physical functioning, quality of life, lower-limb disability, and upper-limb disability. Secondary outcome measures included both questionnaires (self-reported physical functioning, quality of life, lower-limb disability, and upper-limb disability) as well as physical measures (whole-body bioimpedance, isometric grip strength, and aerobic fitness), which were recorded both pre and post-surgery. Results: No significant differences were evident in LOS between groups (p=0.344); however, there was a medium effect (Hedges' g=0.51) favouring a reduced LOS in the prehabilitation group. A large effect size (Hedges' g=0.72) favouring a reduced 28-day readmission rate in the prehabilitation group was found; however, no significant differences were evident. A significant positive main effect for time was observed in the physical functioning (p=0.033) and physical role-limitation (p=0.033) component of the SF-36. A significant improvement in the physical functioning (p=0.033) and physical role-limitation (p=0.033) component of the SF-36 was identified in both groups, which was collected 6-weeks post-surgery. Conclusion: Relative to the usual care group, LOS was not significantly shortened in patients allocated to the prehabilitation group, despite a medium effect favouring the prehabilitation group. However, the study did indicate resistance-based prehabilitation improved patients’ self-reported physical and mental role limitations and physical functioning post-surgery. Though not supported by objective measures, exercise prehabilitation appears to subjectively improve the patient’s physical function. Therefore, this study shows preliminary support for short-term exercise prehabilitation to be included in the standard care of ENT patients.

Bakgrund: Regelbunden fysisk aktivitet leder till positiva hälsoeffekter och är därmed viktig som primär- och sekundärprevention för flera olika sjukdomar och för tidig död. Primärprevention ges dock begränsat utrymme inom sjukvården och därmed kan ett samarbete med andra hälsofrämjande aktörer i samhället vara motiverat. Syfte: Att undersöka om deltagare skattar högre upplevd livskvalitet och fysisk aktivitetsnivå efter Friskis&amp;Svettis (F&amp;S) tio veckor långa ”Börja träna”-kurs samt undersöka om det fanns en korrelation mellan livskvalitet och fysisk aktivitetsnivå. Metod: 95 deltagare (81 kvinnor, 14 män) med en medelålder på 50 år fyllde i två enkäter, en före och en efter interventionen. En inomgruppsjämförelse samt en korrelationsanalys gällande livskvalitet och fysisk aktivitetsnivå gjordes. Resultat: Medianen för livskvalitet var 7 före interventionen och 8 efter vilket var en signifikant ökning (p=0,022). Även för fysisk aktivitet var ökningen signifikant med en median på 3 före interventionen och 4 efter (p&lt;0,001). I studien sågs ett mycket svagt samband mellan livskvalitet och fysisk aktivitetsnivå före interventionen (r=-0,172, p=0,122). Konklusion: Efter deltagande i F&amp;S ”Börja träna”-kurs skattade deltagarna högre livskvalitet och fysisk aktivitetsnivå. På grund av ett stort bortfall och flera metodologiska felkällor bör resultatet användas med försiktighet och vidare studier är därmed nödvändiga.

Magister Artium (Sport, Recreation and Exercise Science) - MA(SRES)<br>Obesity is recognised as a risk factor for non-communicable diseases which has reached epidemic proportions globally. South Africa is one of the developing countries with significant statistical representation reported for these conditions. Obesity is associated with other conditions such as type 2 diabetes, hypertension and dyslipidaemia which are all part of what is called metabolic syndrome. As a strategy to reduce the levels of obesity, physical activity has been introduced to compliment clients who are on medication for diabetes.

The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Title from PDF of title page (University of Missouri--Columbia, viewed on November 19, 2009). Thesis advisor: Dr. Thyfault. Includes bibliographical references.

Aim Aerobic exercise may interfere with subsequent responses to strength training. The aim of this research was to examine the acute effects of cycling or running on subsequent leg strength performance. It was hypothesized that eccentric contractions induced by running would impair strength performance more than the cycling mode of exercise, which consist mainly of concentric muscle actions. Method In order to investigate if continuous running or cycling affected following strength performance, 6 healthy individuals (5 males, 1 female) were subjected to a randomized cross-over design. Subject characteristics were age (year) 25,5 ± 2,1, height (cm) 180,5 ± 6,4, and body weight (kg) 83 ± 3,4. The experimental sessions included three protocols: strength protocol (S) which included 3 repetitions measuring peak power followed by 3 sets to muscular failure at 80% of 1RM in the squat exercise; and continuous running (RS) and cycling (CS) conditions (40 minutes at 80% of maximal heart rate), followed by the S protocol. Peak power performance and total work volume was measured. Results Average peak power attained between the three protocols were CS = 1639± 444Watts (W), RS = 1633± 422 and S = 1565 ± 349. No significant differences were observed between the three conditions (P = 0,817). No differences across the three protocols was observed for highest peak power attained by each subject (P = 0,619). Total work volume performed (main effect P = 0,027) revealed a significant difference between CS = 2559 kg and S = 3715 kg (P=0,037), and CS and RS = 3345 kg (P=0,037) due to the lower loads lifted in CS.  Conclusions There were no differences observed between the three training protocols regarding peak power performance. When cycling exercise was performed prior to the strength session, the total volume lifted was lower than when performing the strength test alone. Thus, it is concluded that cycling exercise, but not running, interferes with subsequent strength training performance.<br>Syfte och frågeställningar Uthållighetsträning kan leda till försämrad styrkeprestation. Syftet med denna forskning var att undersöka de akuta effekterna från cykling eller löpning på efterföljande benstyrka. Hypotesen var att löpning, som omfattar excentriska muskelaktioner, skulle leda till en större försämring av efterföljande styrkeprestation jämfört med cyking, som främst omfattar koncentriska muskelaktioner. Metod För att undersöka om kontinuerlig cykling och löpning påverkade efterföljande benprestation, undersöktes 6 deltagare (5 män, 1 kvinna) i en randomiserad cross-over design. Försökspersonernas karakteristika var ålder (år) 25,5 ± 2,1, längd (cm) 180,5 ± 6,4, vikt (kg) 83 ± 3,4. Försökspersonerna utförde tre experimentella protokoll: styrka (S), vilket bestod av 3 repetitioner av maximal kraftutveckling efterföljt av 3 set till muskulär utmattning på 80% av 1RM i benböj; och löpning (RS) samt cykling (CS) protokoll (40-minuter på 80% av maximal hjärtfrekvens), efterföljt av S protokollet. Data för maximal kraftutveckling och total arbetsvolym samlades in.  Resultat Den genomsnittliga maximala effekten som uppnåddes mellan de tre protokollen var: CS = 1639 ± 444 Watt (W), RS = 1633 ± 422W och S = 1565 ± 349W. Inga signifikanta skillnader observerades mellan de tre förhållandena (P=0,817). Högst uppnådda effekten för varje deltagare mellan de tre förhållandena visade ingen skillnad (P=0,619). Totala arbetsvolymen (tidseffekt: P=0,027) visade signifikanta skillnader mellan CS = 2559 kg och S = 3715 kg (P=0,037), och CS och RS = 3345 kg (P=0,037) på grund av lägre vikt lyft vid CS. Slutsats Ingen skillnad observerades mellan de tre förhållandena angående maximal styrkeprestation. Den totala vikt volymen som kunde lyftas var dock lägre när cykling utfördes innan styrketestet. Slutsatsen är därför att cykling, men inte löpning, hindrar maximal träningsprestation vid ett efterföljande styrkepass.

O objetivo do presente estudo foi comparar os efeitos de um treinamento combinado, de força e aeróbio na hidroginástica, nas adaptações neuromusculares, cardiorrespiratórias e funcionais de mulheres idosas. Para tanto, 36 mulheres idosas foram divididas em três grupos: treinamento combinado na hidroginástica (TC; n=11; 64,18±3,6 anos), treinamento de força na hidroginástica (TF; n=14; 67,86±4,2 anos), e treinamento aeróbio na hidroginástica (TA; n=11; 66,45±4,23 anos), e realizaram esses treinamentos ao longo de 12 semanas, duas vezes por semana. Previamente ao início do treino e ao final do mesmo, os sujeitos foram submetidos a avaliações relacionadas às respostas neuromusculares, cardiorrespiratórias e funcionais, e, além disso, uma subamostra das participantes (n=9) fizeram parte de um período controle de quatro semanas antes do início do treinamento, realizando as principais avaliações antes e após esse período. Para análise estatística utilizou-se o teste T pareado e coeficiente de correlação intra-classe (ICC) para a comparação dos dados no período controle e a Generalized Estimating Equations (GEE), com teste post-hoc de Bonferroni, para a comparação entre os momentos (pré e pós-treinamento) e entre os grupos (TC, TF, TA). Adotou-se um nível de significância de α=0,05 e os dados foram rodados no SPSS 20.0. Em relação às variáveis neuromusculares, foram encontradas melhoras significativas na força muscular dinâmica máxima e na resistência muscular localizada de extensores e flexores de joelhos, na força isométrica máxima e na economia neuromuscular de extensores de joelho (p<0,05), sem incrementos na atividade eletromiográfica isométrica máxima dos músculos vasto lateral e reto femoral (p>0,05). Quanto às variáveis cardiorrespiratórias, a frequência cardíaca de repouso e o tempo de exaustão melhoraram significativamente após o treinamento (p<0,05), enquanto o consumo de oxigênio referente ao primeiro e ao segundo limiar ventilatório e de pico não apresentaram alterações (p>0,05). Nas avaliações da capacidade funcional, uma melhora significativa foi verificada nos testes de sentar e alcançar e de sentar e levantar (p<0,05), já no teste de agilidade (8-foot Up and Go), foi observada uma manutenção dos valores (p>0,05). Salienta-se que as respostas verificadas em todas as variáveis foram semelhantes entre os grupos de treinamento, sem diferenças significativas entre eles (p>0,05), com exceção da economia muscular do músculo vasto lateral, que apresentou melhores valores no grupo TF em relação ao TA (p<0,05). Assim sendo, conclui-se que os três métodos de treinamento na hidroginástica foram efetivos em gerar incrementos em diversos parâmetros da aptidão física de mulheres idosas, na mesma magnitude.<br>The aim of the present study was to compare the effects of a combined training, resistance training and an aerobic training performed on the water environment, on the neuromuscular, cardiorespiratory and functional adaptations of elderly women. Thirty-five women were divided into three training groups of water-based exercise: combined training (CT; n=11; 64,18±3,6 years), resistance training (RT; n=14; 67,86±4,2 years) and aerobic training (AT; n=11; 66,45±4,23 years), and performed those trainings for 12 weeks, twice a week. Before and after the training period, the subjects were evaluated on neuromuscular, cardiorespiratory and functional responses, furthermore nine subjects made part of a control period of four weeks before the beginning of the training, performing the main evaluations before and after this period. Statistical analysis used the paired T test and Intraclass Correlation Coeficient (ICC) for comparisons in the control period, and Generalized Estimating Equations (GEE), with post-hoc Bonferroni test, to compare the moments (pre and post-training) and between groups (CT, RT and AT). A significance level of α = 0.05 was adopted (SPSS 20.0). Regarding the neuromuscular variables, a significant improvement was found in maximal dynamic strength and muscle endurance of knee extensors and flexors, as well as in maximal isometric contraction and neuromuscular economy of knee extensors (p<0,05), without significant changes in maximal isometric electromyography activity of vastus lateralis and rectus femoris (p>0,05). In relation to the cardiorespiratory variables, rest heart rate and time to exhaustion showed significant improvements after training (p<0,05), while the peak oxygen uptake and the oxygen uptake relative to the ventilatory thresholds did not increase significantly (p>0,05). Furthermore, in the funcional capacity evaluations, significant increases were found on the flexibility and resistance test (p<0,05) without significant increases on the agility test (p>0,05). It is important to highlight that, the responses founded in all variables were similar between the three training groups, without significant differences between them (p>0,05), except for muscular economy on vastus lateralis muscle, which showed better values in TF group compared to TA (p <0.05). Thus, we can conclude that those three training methods on water-based exercise were effective to promote benefits in several parameters of physical fitness of elderly women, at the same magnitude.

Type 1 diabetes (T1D) is characterised by an absolute insulin deficiency resulting from the chronic and progressive destruction of pancreatic β-cells by the immune system cells. Continuous subcutaneous insulin infusion (CSII) is becoming a popular technique for insulin delivery among T1D patients. Exercise is known to exert anti-inflammatory effects and metabolic control. Therefore it was of interest to study this in T1D using CSII. The objectives of this thesis were to further understanding of the effect of exercise on blood glucose, hemoglobin A1c, lipids, insulin and inflammatory markers in healthy and T1D volunteers. Three studies have been investigated where the diabetic volunteers used multi daily injections (MDI) or CSII. Firstly a survey was conducted aimed to investigate the effect of exercise on T1D patients using CSII therapy. The second study examined the acute and chronic effects of resistance and cardio exercise at moderate intensity on inflammatory markers such as IL-6, IL-1β, TNF-α and IFN-γ in healthy and T1D using MDI or CSII. Finally, a study was undertaken to find out the effects of chronic moderate intensity exercise on lipids profile and glycaemic control in healthy and T1D using MDI or CSII. The statistical analysis of the survey showed that CSII therapy for T1D had a significant reduction on A1c, insulin requirement and improvement of lipids profile compared to MDI. Moreover, majority of CSII users (63%) rarely suffered from hypoglycemia during exercise. The second study demonstrated that acute and chronic exercises have a positive impact on the inflammatory markers among CSII users e.g. in CSII users statistically significant increase in IL-6 and TNF-α levels were observed (P=0.014 and P=0.001 respectively). The last study showed that lipids profile, total daily insulin units were improved and A1c levels were significantly reduced in CSII as well as MDI groups after 6 weeks of exercise. T1D affects major organs e.g. heart, kidneys, blood vessels etc. However, good glycaemic control can reduce the risk of diabetes complications. This study suggested that CSII therapy along with exercise can maintain the BG level close to normal, as all 5 participants of the study showed an improvement in their BG levels after exercise.

Highly-active antiretroviral therapy (HAART) has improved the prognosis of HIV-infected individuals. Unfortunately it has also been associated with impaired functional capacity and development of metabolic perturbations which increases health risk. This study tested the hypothesis that a combined cardiorespiratory and resistance exercise training (CARET) intervention may result in significant health benefits in HIV-infected individuals receiving HAART. Thirty-seven HIV-infected men and women, predominantly of lower socioeconomic status (SES), were recruited and randomly assigned to: 1) a group of moderate-intensity CARET for three months or 2) a control group receiving no exercise intervention for three months. At baseline and following the intervention, physical characteristics (body weight, body mass index, waist circumference, and blood pressure), physical fitness variables (estimated VO2max and one repetition maximum for upper and lower body), metabolic variables (fasting glucose and serum lipids), immune functioning (CD4+ T Cell count, CD4/CD8 ratio, and HIV RNA viral load), and quality of life (SF-36 Health Survey) were measured. Exercise participants evidenced increases in estimated VO2max (21%, p < 0.01), upper body strength (15%, p < 0.05), and lower body strength (22%, p < 0.05), while showing reductions in waist circumference (-2%, p < 0.05), and fasting glucose (-16%, p < 0.05). While the control group showed a significant decrease in CD4+ T cell count (-16%, p < 0.05) from baseline, the exercise group maintained a more stable count following training (-3%, p = 0.39). Finally, the exercise participants showed self-reported improvements in physical (11%, p < 0.03) and mental (10%, p < 0.02) quality of life. In conclusion, our study demonstrated that a three-month supervised and moderate intensity CARET program performed three times a week, can result in significant improvements in physical characteristics, physical fitness, metabolic variables, and physical and mental quality of life. Furthermore, the same intervention resulted in more favorable immunological responses following training in HIV-infected individuals of lower SES. Key words: Highly active antiretroviral therapy, HIV, combined aerobic and resistance exercise training, cardiorespiratory fitness, muscular strength, and immune functioning.

INTRODUÇÃO: A atividade física faz parte do tratamento do portador de diabetes mellitus tipo 1 (DM1), devendo ser encorajada pelas mesmas razões que é em não portadores. Os portadores de DM1, como evidenciam os estudos, apresentam póstreino: redução dos fatores de risco para o desenvolvimento de doenças cardiovasculares, melhora do condicionamento físico, da sensibilidade à ação da insulina e do bem-estar. Mas é fundamental realizar a monitorização glicêmica, adequar alimentação e dose de insulina para a prática de exercícios, a fim de evitar hipo ou hiperglicemias antes, durante ou após as sessões, e consequentemente, obter melhora ou manutenção do controle glicêmico. Além disso, o nível de atividade física relaciona-se inversamente ao aparecimento de complicações do diabetes e risco de mortalidade em portadores de DM1. Porém, poucos estudos demonstram o comportamento da glicemia destes pacientes em diferentes tipos de exercícios. O conhecimento da variação glicêmica durante o exercício é fundamental para a conduta terapêutica do médico, para a prescrição e orientação segura de exercícios pelos professores de educação física. OBJETIVOS: Analisar a variação da glicose de DM1, submetidos às sessões de exercício aeróbio, exercícios resistidos e teste ergoespirométrico, utilizando o Sistema de Monitorização Contínua da Glicose (CGMS) e o glicosímetro portátil para monitorização da glicemia capilar. E como objetivo secundário, analisar a acurácia do CGMS e as respostas agudas e crônicas às sessões de exercícios aeróbio, resistidos e teste ergoespirométrico por portadores de DM 1. CASUÍSTICA E MÉTODOS: Dez portadores de DM1, de ambos os sexos, com idade entre 16 e 45 anos, sem complicações da doença. Os pacientes foram submetidos ao teste ergoespirométrico máximo (TE) e a 40 sessões de exercícios aeróbios (A) ou resistidos (R). As sessões foram realizadas no período pós-prandial do almoço e nestes dias, os pacientes foram orientados pela equipe médica a reduzir: 1U (se dose <20U) ou 2U (se dose >20U) da insulina basal (NPH) da manhã e 50 a 75% da insulina pré-prandial ultra-rápida (UR) do almoço; não houve redução para o TE. Os pacientes mediam a glicemia capilar antes, durante (se, necessário) e após as sessões. RESULTADOS: Os exercícios aeróbios promoveram uma queda maior na GC (67 mg/dL), quando comparada a queda causada pelos exercícios resistidos (37mg/dL) (p=0,047). A correlação entre os dados obtidos pelo CGMS e pelo glicosímetro durante o exercício é significativa (p<0,001), positiva e direta (r=+0,925). A freqüência cardíaca e a pressão arterial sistólica apresentaram aumento durante A (p<0,001), não apresentando diferença para R. A pressão arterial diastólica não mostrou diferença em nenhum dos dois grupos. A freqüência média de consumo [(A=19,8) e (R=16,7)] e a quantidade de gel [(A=28,2) e (R=21,3)] utilizada durante o período de treinamento foram similares em ambos os grupos. A freqüência de hipoglicemias foi igual em ambos os grupos [(A=1,5) e (R=1,5)] durante o treinamento, não apresentando diferenças em relação às reduções de dose de insulina UR ou período de treinamento. As respostas crônicas foram obtidas ao final do período de treinamento (40 sessões): o controle glicêmico (HbA1c), o perfil lipídico (colesterol total, triglicérides, HDL, LDL, VLDL) e os parâmetros antropométricos não foram influenciados pelo treinamento. Os níveis médios de microalbuminúria em repouso não modificaram, mas os níveis médios de microalbuminúria induzida pelo exercício praticamente dobraram. CONCLUSÕES: O grupo A apresentou maior declínio da glicose quando comparado ao grupo R. O CGMS pode ser considerado um método acurado para a sua utilização durante o exercício. O comportamento da freqüência cardíaca e pressão arterial foram similares aos não portadores de diabetes. O protocolo de redução de insulina se mostrou efetivo durante o período de treinamento. Houve mudanças na composição corporal detectadas pelo DEXA<br>Background and Aims: For type 1 diabetes patients is essential self monitoring of blood glucose and adjustment of carbohydrate intake and insulin dose for exercise practice. The aim of this study was to assess glucose variability during: spiroergometric test (ST) and aerobic (A) and resistance exercises(R). Materials and Methods: 10 DM1 patients performed ST, and 40 A and R bouts and they reduced their insulin dose in A and R exercise days. Results: Glycemia variation groups were: A=67mg/dL and R=37mg/dL. Heart rate and systolic blood pressure increased during A. Diastolic blood pressure was not modified. Glycemic control, lipids and body measurements were not influenced by training. Conclusions: Aerobic and resistance exercise produced glycemia reduction but glycemia fall was higher during aerobic exercise bouts when compared with resistance exercise bouts

A hipotensão pós-exercício têm sido observada tanto após o exercício aeróbio quanto o resistido, porém o efeito desta associação não é conhecido. Este estudo verificou, o efeito agudo isolado e associado do exercício aeróbio e resistido na pressão arterial (PA) pós-exercício e nos seus mecanismos. 23 jovens submeteram-se a 4 sessões: controle(C); exercício aeróbio - 30 minutos em cicloergômetro em 75% do VO2 pico (A); c) exercício resistido; 6 exercícios, 3 séries de 20 repetições, 50% de uma repetição máxima (R) e; d) associação do exercício aeróbio e resistido (AR). Após as sessões de exercício, a PA sistólica, média e diastólica, diminuíram (AR=A) e o débito cardíaco (DC) reduziu de forma similar nas três sessões, enquanto que a resistência vascular periférica aumentou após as três sessões, mas o aumento foi maior na sessão AR. Nas três sessões de exercício o volume sistólico (VS) diminuiu e a freqüência cardíaca (FC) aumentou pelo aumento da modulação simpática e redução da parassimpática para o coração. Estas respostas foram maiores na sessão AR. Concluindo: o exercício A, R e AR promoveram hipotensão pós-exercício, devido à queda do DC, pela redução do VS. O exercício A foi o principal determinante desta resposta. A FC permaneceu elevada pós-exercício devido ao aumento da modulação simpática e redução da vagal para o coração, sendo estas respostas exacerbadas na sessão AR<br>Post-exercise hypotension has been observed after aerobic and resistance exercises, however the effect of the association of these exercises are unknown. This study verified the effect of aerobic and resistance exercise performed alone and in combination on post exercise blood pressure (BP), and its mechanisms. 23 young subjects were submitted to 4 sessions: control (C); aerobic exercise 30 minutes on cycle ergometer at 75% of the peak VO2 (A); c) resistance exercise; 6 exercises, 3 sets of 20 repetitions, 50% of one repetition maximum (R) and; d) association of aerobic and resistance exercises (AR). After exercise sessions, systolic, mean and diastolic BP decreased (AR=A), and cardiac output (CO) reduced similarly in the sessions. Systemic vascular resistance increased after the three exercise sessions, but this increase was greater in the AR session after all exercise sessions. Stroke volume (SV) decreased, while heart rate (HR) increased due to an increase in sympathetic and a decrease in vagal modulation to the heart. These responses were greater in the AR session. In conclusion: A, R and AR exercises promoted postexercise hypotension, due to a fall in the CO, with reduction in SV. Aerobic exercise xxi was the main determinant of this response. HR remained elevated after exercise bouts because the increase in sympathetic and reduction in the vagal modulation of the heart, and these responses were exacerbated in the AR session

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Agradecemos a compreensão on 2016-05-30T18:33:22Z (GMT)<br>Submitted by TIEGO APARECIDO DINIZ null (tiegodiniz@gmail.com) on 2016-06-16T15:22:21Z No. of bitstreams: 1 20 - DEFESA.pdf: 4027170 bytes, checksum: 5d80e6b779588d24d06e4f27aa4bee6e (MD5)<br>Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-06-16T16:12:44Z (GMT) No. of bitstreams: 1 diniz_ta_me_rcla.pdf: 4027170 bytes, checksum: 5d80e6b779588d24d06e4f27aa4bee6e (MD5)<br>Made available in DSpace on 2016-06-16T16:12:44Z (GMT). No. of bitstreams: 1 diniz_ta_me_rcla.pdf: 4027170 bytes, checksum: 5d80e6b779588d24d06e4f27aa4bee6e (MD5) Previous issue date: 2016-03-15<br>Introdução: O período pós-menopausa é caracterizado por 12 meses ininterruptos de ausência de ciclo menstrual. Mulheres nesse período apresentam aumento da gordura corporal total, especialmente abdominal. Sabe que a gordura dessa região está relacionada com o desenvolvimento de diversas doenças, sendo assim, estratégias que visem tratar ou prevenir esse desfecho se fazem importante. Nesse contexto se destaca o treinamento combinado (associação de treinamento de força e aeróbio na mesma sessão de treino), por favorecer o aumento da massa corporal magra e a diminuição da gordura corporal. Estudos vêm mostrando que após um período de investigação clinica a reposta individual ao treinamento para variáveis metabólicas apresenta grande variação em relação à média. Entretanto, até a presente data nenhum estudo objetivou investigar as características das participantes que responderam positivamente e negativamente na composição corporal e no perfil metabólico após 16 semanas de treinamento combinado. Objetivo: Analisar as variáveis da composição corporal e metabólicas que podem interferir na resposta a 16 semanas de treinamento combinado em mulheres pós-menopausa. Materiais e métodos: Participaram do estudo mulheres com idade entre 50 a 77 anos, todas na pósmenopausa (FSH > 30mUI/ml). As avaliações foram realizadas em dois momentos: pré-intervenção e após 16 semanas de treinamento combinado. Foram realizadas medidas antropométricas, de composição corporal por meio da densitometria radiológica de dupla energia e análises bioquímicas (colesterol total e frações, triacilglicerol e glicemia de jejum. O treinamento foi composto de três sessões semanais com duração de, aproximadamente, 80 minutos. A prescrição do treinamento aeróbio foi realizada de acordo com a velocidade crítica (VC), e prescrita com volume de 30 minutos diários com intensidade fixada em 100% da VC. O treinamento de força foi prescrito de acordo com a zona de repetição máxima ou do teste de uma repetição máxima (RM) dependendo do exercício. O número de series foram fixadas em três, entretanto, os números de repetições foram decrescente (15 para 8 repetições) e a intensidade crescente (65 para 80% do RM). As cargas de treinamento do aeróbio e de força foram ajustadas a cada quatro semanas. O grupo treinamento foi dividido em tercis de responsividade para as alterações percentuais de lipoproteína de alta densidade (HDL), bem como distribuição de gordura inicial. Todas as análises estatísticas foram realizadas utilizando o programa SPSS, versão 13.0 (SPSS Inc, Chicago, IL) e a significância estabelecida em 5%. Resultados: As participantes responsivas positivas para HDL apresentaram valores inferiores de triacilglicerol e lipoproteína de muito baixa densidade (VLDL) após 16 semanas de treinamento combinado. As participantes com gordura corporal predominantemente abdominal apresentaram menor responsividade ao treinamento combinado. Conclusão: Variáveis da composição corporal e metabólicas interferem na responsividade à 16 semanas de treinamento combinado em mulheres pós-menopausa.<br>Introduction: Postmenopausal is characterized by 12 months of amenorrhea. Women in this period show increase in total and segmental body fat, especially, abdominal adiposity. It is know that such adiposity is related with the development of chronic disease, therefore, strategies to treat or prevent this outcome becomes important. In this view, the combined training stands out, since it can stimulate increase lean body mass and decrease body fat. Studies has been shown that there is heterogeneity in the response of aerobic training regarding metabolic variables. However, to date no study aimed to investigate the characteristics of menopausal women who responded positively and negatively on body composition and metabolic profile after 16 weeks of combined training. Objective: To analyze the variables of body composition and metabolic that may interfere with the response to 16 weeks of combined training in postmenopausal women. Materials and methods: Sample consisted of women aged 50 to 77 years, all postmenopausal. The evaluations were performed twice: baseline and post-16 weeks of combined training. Body composition were assessed by Dual Energy X-ray Absorptiometry (DEXA), total and segmental, and analysis of the biochemical profile: total cholesterol, Low Density Lipoprotein (LDL-c) and High Density Lipoprotein (HDL-c), triacylglycerol and fasting glucose. The combined training was performed three times per week on nonconsecutive days, during 80 minutes (50 minutes of resistance training followed by 30 minutes of aerobic training) per section. The training group was divided into tertile of responsiveness to HDL-c percentage changes, as well as baseline fat distribution. All statistical analyzes were performed using SPSS version 13.0 (SPSS Inc, Chicago, IL) and statistical significance set at 5 %. Results: The positive responders to HDL showed lower triacylglycerol and VLDL after 16 weeks of combined training. Participants with predominantly abdominal body fat had lower responsiveness to combined training. Conclusion: Body composition and metabolic variables interfere with responsiveness to 16 weeks of combined training in postmenopausal women.

O crescimento acelerado da população idosa juntamente com o aumento da procura por atividades físicas tem motivado cada vez mais estudos que envolvam treinamento e o idoso. A corrida em piscina funda parece ser uma alternativa interessante para essa população, uma vez que não possui impacto nos membros inferiores possibilitando que o indivíduo se exercite em grandes cargas aeróbias com menor risco de lesão. Desta forma, o objetivo do presente estudo foi avaliar os efeitos de dois programas de treinamento em piscina funda nas respostas cardiorrespiratórias, neuromusculares e no equilíbrio de idosos. Participaram do estudo 34 sujeitos, divididos em um grupo que realizou um treinamento aeróbio de corrida em piscina funda (AERO; n=16; 66±4 anos) e um grupo que realizou um treinamento de força em meio aquático seguido do treinamento aeróbio de corrida em piscina funda (FOR-AERO; 64±4 anos). Ambos os grupos realizaram um período de familiarização com o meio aquático e com a técnica de corrida em piscina funda anteriormente ao período de treinamento, com duração de quatro semanas e com frequência semanal de duas sessões. Já o período de treinamento teve uma duração de 12 semanas realizando três sessões por semana. Antes e após ambos os períodos, os indivíduos foram avaliados em parâmetros relacionados à capacidade cardiorrespiratória, às respostas neuromusculares e ao equilíbrio. Para análise dos dados pré e pós-período de familiarização foi realizado um teste T pareado, para as comparações pré e pós-treinamento foi utilizado uma ANOVA para medidas repetidas com fator grupo ( =0,05). Em relação às variáveis cardiorrespiratórias e neuromusculares não foram observadas mudanças significativas após o período de familiarização. Entretanto, o equilíbrio em todas as situações avaliadas (apoio unipodal e bipodal com e sem venda nos olhos) apresentou uma melhora significativa após as quatro semanas de familiarização (p<0,05). Após o período de treinamento, ambos os grupos apresentaram uma redução da frequência cardíaca de repouso, um aumento do consumo de oxigênio de pico e um aumento do consumo de oxigênio no segundo (VO2LV2) e no primeiro limiar ventilatório (p<0,05). Somente o VO2LV2 apresentou diferença entre os grupos no pós-treinamento, demonstrando valores maiores para o grupo AERO (p<0,05). Em relação às variáveis neuromusculares, ambos os grupos aumentaram a força muscular dinâmica máxima e a força muscular isométrica de extensão de joelho após o treinamento (p<0,05), sem diferenças entre os grupos (p>0,05). A resistência muscular dinâmica apresentou um aumento significativo (p<0,05) tanto para flexão como para a extensão de joelho, sem diferença entre os grupos (p>0,05). A atividade eletromiográfica máxima apresentou um aumento significativo para os músculos vasto lateral, reto femoral e semitendinoso (p<0,05), sem diferenças entre os grupos (p>0,05). Em relação às repostas de equilíbrio, observamos uma manutenção dos valores em ambos os grupos após o período de treinamento (p>0,05). Assim, concluímos que os dois modelos de treinamento avaliados foram eficientes para melhoras significativas nas respostas cardiorrespiratórias e neuromusculares de homens idosos, e não foram específicos para melhoras nas respostas de equilíbrio. Entretanto, o período de familiarização proporcionou melhoras significativas no equilíbrio em todas as situações avaliadas.<br>The accelerated growth of the elderly population together with increased demand for physical activities has motivated more studies involving training and the elderly. The deep water running seems to be an interesting alternative for this population, since it does not have any impact on the lower limbs allowing the individual to exercise in high aerobic loads with less risk of injury. Thus, the aim of this study was to evaluate the effects of two deep water training programs on the cardiorespiratory, neuromuscular and balance responses in elderly. Thirty-four elderly men were placed into two groups: deep water aerobic training (AERO; n=16; 66±4 years); and deep water strength followed aerobic training (FOR-AERO; 64±4 years). Both groups performed four weeks of familiarization with the aquatic environment and with the deep water running technique prior to the training period, twice a week. On the other hand, the training period lasted 12 weeks, with three sessions a week. Before and after both periods, the subjects were evaluated on cardiorespiratory, neuromuscular and balance responses. Statistical comparisons in the familiarization period were performed by using paired T tests; and a repeat measure ANOVA with group factor was used to analyze the training-related effects ( =0,05). After the familiarization period, there were no significant differences in cardiorespiratory and neuromuscular variables. However, in all situations evaluated (one and two-legged standing with eyes opened and closed) the balance showed a significant decrease after four weeks of familiarization (p<0,05). After the training period, the heart rate at rest decreased significantly, the peak oxygen uptake and the oxygen uptake corresponding to the first and second ventilator threshold (VO2LV2) showed significant increases in both groups (p<0,05). Only the VO2LV2 showed differences among the groups after the training period, showing higher values for the AERO group (p<0,05). In addition, after training there was a significant increase in the knee extensors maximal dynamic strength and maximal isometric voluntary contraction in both groups (p<0,05), with no difference between groups (p>0,05). The dynamic muscular endurance showed a significant increase for both knee flexion and extension, with no difference between groups (p<0,05). There was a significant increase of the maximal isometric electromyography activity of vastus lateralis, rectus femoris and semitendinosus (p<0,05), with no difference between groups (p>0,05). Finally, after the training period the balance responses were unchanged (p>0,05). In summary, the two training models evaluated were effective for significant improvements in cardiorespiratory and neuromuscular responses in elderly men, and not specific to improvements in balance responses. However, the familiarization period improved significantly the balance in all situations evaluated.

Submitted by Izabel Franco (izabel-franco@ufscar.br) on 2016-09-27T19:15:08Z No. of bitstreams: 1 TeseFCRC.pdf: 2532238 bytes, checksum: 322c81814ed25c363ba5e4aae4040c14 (MD5)<br>Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-10T14:14:43Z (GMT) No. of bitstreams: 1 TeseFCRC.pdf: 2532238 bytes, checksum: 322c81814ed25c363ba5e4aae4040c14 (MD5)<br>Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-10T14:14:54Z (GMT) No. of bitstreams: 1 TeseFCRC.pdf: 2532238 bytes, checksum: 322c81814ed25c363ba5e4aae4040c14 (MD5)<br>Made available in DSpace on 2016-10-10T14:15:05Z (GMT). No. of bitstreams: 1 TeseFCRC.pdf: 2532238 bytes, checksum: 322c81814ed25c363ba5e4aae4040c14 (MD5) Previous issue date: 2015-06-29<br>Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)<br>The thesis consisted of three studies described below. The study I, entitled "Hemodynamic and metabolic response during aerobic and resistance dynamic exercise in different intensities: A cross-sectional study on implications of intensity on safety and symptoms in patients with coronary disease". Where the objective of this study was to evaluate the clinical and physiological responses during resistance exercise in loads of 30 and 60% of 1-RM on the leg press 45° and compare the responses with maximum aerobic exercise. The evaluation included aerobic test on cycle ergometer and resistance test in leg press 45°. Ventilation, hemodynamic and clinical measurements were performed. The results showed that 60% of resistance exercise and the dynamic test increased variables response studied in compared the load of 30% in resistance exercise. We conclude that high repetition of resistance exercise results in physiological changes at an intensity comparable to maximal aerobic exercise. Further, the study II, entitled "Resistance training improves heart rate variability and muscular performance: A randomized controlled trial in patients with coronary artery disease study" The objective was to investigate the effects of a high repetition program/low load resistance training (RT) (HR/LL-RT) in heart rate variability (HRV) in muscular strength and endurance in patients with CAD. Test were carried out in 1-RM test in leg press 45°, HRV was captured in the supine position before and after eight weeks of RT. The HR/LL-RT program consisted of an exercise using leg press 45°; (three sets, twenty repetitions, twice a week for eight weeks). The results showed that after eight weeks RT there was a significant increase in the values of the RMSSD, ApEn SD1 indices and only the TG (p<0.05). There was a significant decrease in Mean HR after RT for TG (p<0.05). Additionally, there was significant improvement in muscular strength and endurance only for the TG (p<0.05). We conclude that eight weeks of HR/LL-RT is a sufficient stimulus to change heart function, muscle strength and endurance in patients with CAD. Finally, the study III, entitled: ''What the impact of resistance training on hemodynamic, autonomic and metabolic variables in coronary artery disease patients? The randomized controlled trial of eight weeks''. Where the objective was to evaluate the hemodynamic, metabolic, and the HRV effects during maximum intensity tolerated in constant loads protocols during dynamic and resistance exercise before and after eight weeks of resistance training program of low intensity and high reps (RTLHr) in patients with CAD. The results showed increase in maximum and submaximal load (p<0.01) and attenuation of the hemodynamic performance in the higher load (p<0.01) and reduced lactate concentration compared for TG. During the cycle ergometer exercise, there was attenuation of hemodynamic performance and increased minute ventilation (p<0.01). Finally, the TRBAr produced greater parasympathetic contribution (RMSSD and SD1), after RT. We conclude that eight weeks of RTLHr may attenuate the hemodynamic stress, metabolic and autonomic during resistance exercise with cardiovascular and autonomic beneficial effects also in the dynamic exercise.<br>A tese constou de três estudos descritos a seguir. O estudo I, intitulado: “Respostas hemodinâmicas e metabólicas durante o exercício dinâmico aeróbio e resistido em diferentes intensidades: Um estudo transversal com implicações da intensidade na segurança e sintomas nos pacientes com doença coronariana”, cujo o objetivo foi avaliar as respostas clínicas e fisiológicas durante o exercício resistido nas cargas de 30 e 60% de 1-RM no leg press 45° e comparar as respostas durante o exercício aeróbio máximo. A avaliação incluiu teste aeróbio no cicloergômetro e teste resistido no leg press 45°. Foram realizadas medidas ventilatórias, hemodinâmicas e clínicas. Os resultados apresentaram que na carga de 60% do exercício resistido e no teste dinâmico aumentaram a resposta nas variáveis estudadas quando comparados a carga de 30% no exercício resistido. Concluímos que altas repetições de exercício resistido resulta em modificações fisiológicas a uma intensidade comparável ao exercício aeróbio máximo. Na sequência, o estudo II, intitulado: “Treinamento resistido melhora a variabilidade da frequência cardíaca e o desempenho muscular: um estudo randomizado e controlado em pacientes com doença arterial coronariana.” O objetivo foi investigar os efeitos de um programa de alta repetição/baixa carga de treinamento resistido (TR) (AR/BC-TR) na variabilidade da frequência cardíaca (VFC), na força e resistência muscular em pacientes com doença arterial coronariana (DAC). Foram realizados teste de 1-RM, teste descontínuo no leg press 45°; a VFC foi captada na posição supina antes e após oito semanas de TR. O programa AR/BC-TR consistiu de um exercício utilizando leg press 45°; (três séries de vinte repetições, duas vezes por semana durante oito semanas). Os resultados mostraram que, após oito semanas de TR, houve aumento significativo dos valores dos índices RMSSD, SD1 e ApEn apenas para o GT (p<0,05). Houve uma diminuição significativa na média de FC após TR para GT (p<0,05). Adicionalmente, houve melhora significativa na força e resistência muscular apenas para o GT (p<0,05). Concluímos que oito semanas de AR/BC-TR foram um estímulo suficiente para alterar a função cardíaca, bem como a força e resistência muscular em pacientes com DAC. Finalmente, o estudo III, intitulado: ''Qual o impacto do treinamento resistido nas variáveis, hemodinâmicas, autonômicas e metabólicas em pacientes com doença arterial coronariana? Um estudo randomizado e controlado de 8 semanas'', cujo objetivo foi verificar os efeitos hemodinâmicos, metabólicos e da VFC durante a intensidade máxima tolerada em protocolos de cargas constantes de resistência e dinâmico antes e após oito semanas de programa de treinamento resistido de baixa intensidade e altas repetições (TRBAr) em pacientes com DAC. Os resultados mostraram aumento da carga máxima e submáxima (p<0,01) e atenuação da performance hemodinâmica na maior carga atingida (p<0,01) e redução da concentração de lactato para o GT. Durante o exercício em cicloergômetro, houve atenuação da performance hemodinâmica e aumento da ventilação minuto (p<0,01). Finalmente, o TRBAr produziu maior contribuição parassimpática (RMSSD e SD1), após o TR. Concluímos que oito semanas de TRBAr pode atenuar o estresse hemodinâmico, metabólico e autonômico durante o exercício resistido, com efeitos benéficos cardiovasculares e autonômicos também no exercício dinâmico.

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia<br>Objetivo: Averiguar os efeitos do exercício em crianças asmáticas. Metodologia: Pesquisa computorizada nas bases de dados Pubmed/Medline e B-on para identificar estudos randomizados controlados (RCT) que avaliem a influência do exercício na criança asmática. Resultados: Nesta revisão foram incluídos 13 RCT abrangendo 550 crianças, com uma qualidade metodológica de 5,5 na escala de Physiotherapy Evidence Database (PEDro), sendo que 4 destes avaliaram a intervenção de um treino aeróbio de baixa intensidade, 2 um treino aeróbio moderado, 4 um treino aeróbio submáximo e 3 combinaram treino aeróbio submáximo com fortalecimento muscular. Conclusão: Pode-se concluir que o exercício aeróbio, com intensidade moderada a elevada, pode ser uma mais-valia na relação com a asma e as suas exacerbações em particular nos asmáticos moderados a severos.<br>Objective: To ascertain the effects of exercise on asthmatic children. Methodology: Research on a computerized databases Pubmed/Medline and B-on to identify RCT that evaluated the influence of exercise on asthmatic children. Results: In this review their war included 13 RCT, involving 550 children, with a methodological quality of 5,5 on the PEDro scale, in 4 of them it was evaluate the intervention of a aerobic low intensity training, 2 had a moderate aerobic training, 4 had a aerobic sub maximal training and 3 combined a aerobic sub maximal training with muscular strength. Conclusion: It could be conclude that aerobic exercise with a moderate to a intensive intensity could have an added value on coping and the control of exacerbation of asthma, particularly on asthmatic moderate to severe children.

高齢者の健康づくり運動には，有酸素運動とレジスタンス運動の複合トレーニングが重要であり，この異なる運動をどのように組み合わせるのが安全で効果的かを検討する必要がある．本研究は，健常な高齢者を対象に，有酸素運動とレジスタンス運動の複合トレーニングにおける順序性が，体力や形態，動脈スティフネスに及ぼす影響について検討した．その結果，動脈スティフネスにおいて運動の順序性を考慮する必要があることが示唆された．<br>The purpose of this study is to examine the effects of exercise order of combined aerobic and resistance training into the same session on body composition, physical fitness, and arterial stiffness in the elderly. Based on our results, aerobic exercise after resistance training reduced arterial stiffness and a difference of exercise order was observed. We suggest that the exercise order may favorably affect arterial stiffness when combined aerobic exercise and resistance training is performed into the same session. Our findings support combined training for health promotion and have important health implications for the elderly.<br>博士(スポーツ健康科学)<br>Doctor of Philosophy in Health and Sports Science<br>同志社大学<br>Doshisha University

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-06-22T14:38:54Z No. of bitstreams: 1 marcelledepaularibeiro.pdf: 2385853 bytes, checksum: 5bb0fb2ea70927048b42aca6a6b0a326 (MD5)<br>Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-08-07T19:21:29Z (GMT) No. of bitstreams: 1 marcelledepaularibeiro.pdf: 2385853 bytes, checksum: 5bb0fb2ea70927048b42aca6a6b0a326 (MD5)<br>Made available in DSpace on 2017-08-07T19:21:29Z (GMT). No. of bitstreams: 1 marcelledepaularibeiro.pdf: 2385853 bytes, checksum: 5bb0fb2ea70927048b42aca6a6b0a326 (MD5) Previous issue date: 2014-03-24<br>CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior<br>INTRODUÇÃO: Em indivíduos com amputação traumática de membros inferiores, o aumento do risco de mortalidade por origem cardiovascular pode ser explicado pelos altos níveis de pressão arterial dessa população. Por outro lado, em diversas doenças, o exercício físico vem sendo adotado como conduta não-medicamentosa para o controle da pressão arterial, visto que uma única sessão de exercício físico aeróbio é capaz de reduzir a resistência vascular periférica e promover, consequentemente, queda significativa dos níveis pressóricos, fenômeno denominado hipotensão pós-exercício. No entanto, não é conhecido se amputados traumáticos apresentam, após uma única sessão de exercício físico, hipotensão pósexercício e se a ocorrência da hipotensão pós-exercício é acompanhada de redução da resistência vascular periférica. MATERIAIS E MÉTODOS: Nove indivíduos do sexo masculino com amputação traumática de membros inferiores participaram desse estudo. O protocolo experimental constou de duas sessões conduzidas em ordem aleatória: uma sessão Controle (repouso) e outra de Exercício Físico (cicloergômetro de membros superiores, 30 minutos, intensidade equivalente à frequência cardíaca do primeiro limiar ventilatório, identificado a partir de teste de esforço submáximo). A pressão arterial clínica (método oscilométrico - DIXTAL® 2023), frequência cardíaca (Polar® RS800cx), fluxo sanguíneo do antebraço e resistência vascular do antebraço (pletismografia de oclusão venosa - Hokanson®), foram medidos antes e após a intervenção em cada sessão. Além disso, a pressão arterial e frequência cardíaca ambulatorial de 24 horas foram medidas após as sessões (CardioMapa®). Para a análise estatística, foi adotado como significativo o valor de p<0,05. RESULTADOS: O exercício físico promoveu redução da pressão arterial sistólica, diastólica e média, quando comparado aos valores pré-exercício e sessão Controle. A redução da pressão arterial foi acompanhada de redução significativa da resistência vascular do antebraço, elevação significativa do fluxo sanguíneo do antebraço e da frequência cardíaca, quando comparado aos valores pré-exercício e sessão Controle. Adicionalmente, o exercício físico resultou em redução significativa da média de 24 horas para pressão arterial sistólica, diastólica e média; redução da média de vigília para a pressão arterial diastólica; redução da média do sono para a pressão arterial sistólica, diastólica e média e; manutenção da frequência cardíaca para as médias de 24 horas, vigília e sono. CONCLUSÃO: Indivíduos com amputação traumática de membros inferiores apresentam, após uma única sessão de exercício físico aeróbio, hipotensão pós-exercício clínica e ambulatorial. A hipotensão pós-exercício clínica foi, pelo menos em parte, justificada pela redução da resistência vascular periférica.<br>INTRODUCTION: In patients with traumatic lower extremity amputations, the elevated cardiovascular mortality risk can be explained by the elevated blood pressure. However, in several diseases, physical exercise has been adopted as a non-pharmacological therapy to reduce blood pressure, since a single session of aerobic exercise can promote significant reduction in blood pressure, phenomenon called postexercise hypotension. Nevertheless, it is unknown if traumatic amputees presents after a single session of physical exercise, postexercise hypotension and if the occurrence of postexercise hypotension is accompanied by a reduction in peripheral vascular resistance. MATERIALS AND METHODS: Nine male subjects with traumatic lower extremity amputation participated in this study. The experimental protocol consisted of two sessions conducted in random order: one Control session (rest) and other of Physical Exercise (upper body cycle ergometer, 30 minutes, intensity equivalent to heart rate of the first ventilatory threshold). The clinic blood pressure (oscillometric method - DIXTAL® 2023), heart rate (Polar ® RS800CX), forearm blood flow and forearm vascular resistance (venous occlusion plethysmography - Hokanson®) , were measured before and after intervention in each session. Also, the ambulatory blood pressure and heart rate were measured for 24 hours after the sessions (CardioMapa®).The p<0,05 value was adopted as significant. RESULTS: Exercise induced a reduction in systolic, diastolic and mean arterial blood pressure values when compared to pre-exercise and Control session. The blood pressure reduction was accompanied by significant reduction of forearm vascular resistance, significant increase of forearm blood flow and heart rate when compared to pre-exercise values and Control session. In addition, exercise resulted in a significant reduction in 24-hour average for systolic, diastolic and mean arterial blood pressure; reduction in awake average for diastolic arterial blood pressure, reduction of asleep average for systolic, diastolic and mean arterial blood pressure and; maintenance of heart rate in 24-hours, awake and asleep average. CONCLUSION: Individuals with traumatic lower extremity amputation presents after a single session of aerobic exercise, clinic and ambulatory postexercise hypotension. Clinic postexercise hypotension was justified by a reduction in peripheral vascular resistance.

A NAFLD é uma das principais patologias de fígado. Estudos reportam o exercício físico como um dos principais alvos terapêuticos para esta doença. Verificamos se o treinamento melhora a resistência à insulina, inflamação e esteatose hepática causados pela dieta hiperlipídica (HF) e se o PPAR-alpha está envolvido neste processo. Animais selvagens C57BL6 (WT) e knockout para PPAR&alpha; (KO) foram alimentados com dieta padrão ou HF durante 12 semanas e treinados por 8 semana. Metade dos animais KO treinados receberam rosiglitazona. A dieta HF aumentou TAG hepático, e resistência periférica à insulina levando a NALFD. O treinamento foi eficiente em reduzir esses parâmetros em ambos genótipos. O desenvolvimento da NAFLD não foi associado à inflamação hepática, entretanto animais KO treinados apresentaram uma resposta inflamatória exacerbada, causada pela redução de PPAR&gamma;. Quando eles receberam rosi apresentaram melhora no quadro inflamatório hepático e na resistência à insulina. O exercício diminuiu os danos causados pela dieta HF independente do PPAR&alpha;; a ausência do PPAR&alpha; junto com exercício leva a queda na expressão de PPAR&gamma;, e a uma resposta inflamatória exacerbada, que é revertida pela administração da rosiglitazona.<br>NAFLD is one of the main liver diseases. Studies have shown the beneficial effects of exercise on reverse NAFLD. We verify whether exercise improve insulin resistance, liver inflammation and steatohepatitis caused by a high fat diet (HF) and whether PPAR&alpha; is involved in these actions. C57BL6 wild type (WT) and PPAR-&alpha; knockout (KO) mice were fed with a standard (SD) or HF during 12 weeks and trained on a treadmill during 8 weeks, half of KO trained animals received 15mg/kg/day of rosiglitazone. HF diet increased TAG in the liver and peripheral insulin resistance leading to NAFLD. Exercise reduced all this parameters in both animals genotype. NAFLD was not associated with inflammation, however KO mice when trained presented an inflammatory response that was caused by a decrease on PPAR&gamma;. When these mice were treated with rosiglitazone, they presented decrease on inflammatory cytokines as well as improvement on insulin sensitivity. Exercise improved the damage caused by a HF independently of PPAR&alpha; and the absence of PPAR&alpha; together with exercise leads to decrease on PPAR&gamma; expression and an inflammatory response, which was attenuated by rosiglitazone administration.

Introdução: O treinamento físico melhora a capacidade funcional e a qualidade de vida em pacientes com insuficiência cardíaca (IC) crônica. Entretanto, a aderência ao treinamento físico supervisionado é baixa por diversas razões. Como alternativa, o treinamento domiciliar tem sido proposto. Objetivo: Comparar os efeitos de um programa de treinamento domiciliar (domiciliar) com um programa de treinamento supervisionado (supervisionado) sobre a capacidade funcional, comportamento sedentário e qualidade de vida em pacientes com IC crônica ao longo de 12 semanas. Métodos: Este estudo incluiu 23 pacientes com IC (classe funcional da New York Heart Association II e III, fração de ejeção do ventrículo esquerdo 31±6%) randomizados em grupos de treinamento domiciliar (n=11) ou supervisionado (n=12). Durantes 12 semanas os pacientes exercícios aeróbicos (60-70% da frequência cardíaca de reserva): caminhadas para o grupo domiciliar e exercício em cicloergômetro para o supervisionado, combinados ao exercício resistido (50% de uma repetição máxima). No momento basal e após 12 semanas mensuramos variáveis do teste cardiopulmonar, teste da caminhada de seis minutos (TC6M), pressões respiratórias máximas, força muscular do quadríceps e de preensão palmar, atividade física e comportamento sedentário por meio de acelerometria, qualidade de vida e aderência. Resultados: Os grupos domiciliar e supervisionado tiveram altas taxas de adesão, com aumentos (p=0,037) similares no consumo de oxigênio pico (0,8 e 3,7 ml/kg/min, respectivamente, p=0,085), ventilação máxima (11,5 e 15,6 l/min, respectivamente, p=0,775), distância percorrida no TC6M (9% e 5%, respectivamente, p=0,805), força muscular do quadríceps (21% e 11%, respectivamente, p=0,155) e qualidade de vida avaliada por meio do questionário Minnesota Living with Heart Failure (1 e 13, respectivamente, p=0,092). O comportamento sedentário reduziu (p=0,05) nos dois grupos (p=0,472). Entretanto, o treinamento supervisionado foi mais efetivo em melhorar a força muscular inspiratória (p=0,042), o número de passos/dia (p=0,001) e o componente de saúde mental do questionário SF-36 (p=0,001). Conclusões: O programa de treinamento domiciliar pode ser uma alternativa ao treinamento supervisionado para reduzir o comportamento sedentário e melhorar a capacidade funcional e qualidade de vida em pacientes com IC crônica. Entretanto, o treinamento supervisionado, além dos benefícios acima citados para o grupo domiciliar, é superior em aumentar a força muscular inspiratória, número de passos/dia e melhora de aspectos de saúde mental em pacientes com IC crônica, quando comparado ao treinamento supervisionado<br>Background: Exercise training improves functional capacity and quality of life in chronic heart failure (HF) patients. However, centre-based adherence is lower for several reasons. As an alternative, home-based training has been proposed. Objective: To compare the effects of home-based program (home-based) and centre-based (centre-based) training programs on functional capacity, sedentary behavior and quality of life in HF patients along 12 weeks. Methods: This study included 23 chronic HF patients (New York Heart Association functional class II and III, left ventricular ejection fraction 31±6%) randomized to home-based (n=11) or centre-based (n=12) training programs. Patients underwent a 12-week period of aerobic training (60-70% reserve heart rate): walking outdoor for home-based and supervised cycling for centre-based, both combined with resistance training (50% of one maximum repetition). At baseline and after 12 weeks of training, we assessed cardiopulmonary test measures, six minute walk (6MW) test distance, maximal respiratory pressures, quadriceps muscle strength, handgrip strength, physical activity and sedentary behavior (accelerometer), quality of life and adherence. Results: Home-based and centre-based had high adherence rate and similar improvements (p=0.037) in peak oxygen consumption (0.8 and 3.7 ml/kg/min, respectively, p=0.085), maximal ventilation (11.5 and 15.6 L/min, respectively, p=0.775), 6MW test distance (9% and 5%, respectively, p=0.805), quadriceps muscle strength (21% and 11%, respectively, p=0.155) and quality of life assessed by Minnesota Living with Heart Failure questionnaire (1 and 13, respectively, p=0.092). Sedentary behavior reduced (p=0.05) in both groups (p=0.472). However, centre-based program was markedly effective in improving inspiratory muscle strength (p=0.042), number of steps/day (p=0.001) and mental health component of SF-36 questionnaire (p=0.001). Conclusion: Home-based program can be an alternative to centre-based program to reduce sedentary behavior and to improve functional capacity and quality of life in patients with chronic HF. However, the centre-based training, in addition to the benefits mentioned above to home-based training, is superior in increasing the inspiratory muscle strength, number of steps/day and mental health in chronic heart faiure patients compared to home-based training

Despite the increasing prevalence of obesity and the array of treatment modalities available, maintenance of reduced-weight in the long-term is uncommon. The reason(s) why weightregain is so commonplace remains contentious. The primary purpose of this dissertation was to determine the extent to which weight-loss in obese adults, when the intervention included an optimal exercise prescription, resulted in adaptations that may be considered aberrant and reflect risk of weight-regain. Unique to this investigation was the multifactorial approach to addressing the issue of adaptation through consideration of metabolic, physiological, and psychosocial factors. Accurate body composition assessment is a fundamental requirement upon which evaluation of adaptation to weight-loss is based. An additional purpose of the dissertation was to evaluate multi-frequency bioelectrical impedance analysis (MFBIA) as a technique for use in assessing body composition change of obese adults during weight-loss. Further, optimal weight management requires an incorporation of effective exercise prescription. Therefore, a final aim of the dissertation was to determine the optimal exercise intensity for weight management. Together the goals of this thesis were addressed through a series of studies, the first three relate to use of bioelectrical impedance analysis; the fourth and fifth studies were associated with exercise prescription for obese adults; and the final study, incorporating three components, dealt with adaptation to weight-loss in the obese. In the first study, twenty-nine young healthy adults, 17 males and 12 females (mean± SEM; 21.8 ± 0. 7 yrs and 20.3 ± 0.3 yrs) were recruited to assess the technical reliability (i.e., interinstrument and inter-operator reliability) of three MFBIA monitors. Technical reliability was assessed for both errors of measurement and associated analyses. In addition, intra-operator and intra-instrument variability was evaluated for repeat measures over a 4-hour period. The measured impedance values from a range of resistance-capacitance circuits were accurate to within 3 percent of theoretical values over a range of 50- 800 ohms. Similarly, phase was measured over the range 1 degrees-19 degrees with a maximum deviation of 1.3 degrees from the theoretical value. The extrapolated impedance at zero frequency was equally well determined (+/-3 percent). However, the accuracy of the extrapolated value at infinite frequency was decreased, particularly at impedances below 50 ohms (approaching the lower limit of the measurement range of the instrument). The inter-instrument/operator variation for whole body measurements were recorded on human volunteers with biases of less than +/-1 percent for measured impedance values and less than 3 percent for phase. The variation in the extrapolated values of impedance at zero and infinite frequencies included variations due to operator choice of the analysis parameters but was still less than +/-0.5 percent. The second study investigated the effect of moving from standing to lying supine on blood and plasma volumes, serum electrolyte concentrations, and measurements of whole-body impedance using MFBIA over a 60 minute period in 12 subjects (8 males, 4 females) 26.7 ± 5.5 yrs, 172.3 ± 6.9 em, and 71.0 ± 7.7 kg. While no significant differences were found in serum sodium, chloride or potassium concentrations as a function of the posture change, estimates of both blood and plasma volumes increased during the 60 minutes spent supine. Blood volume increased by 10.5 (4.2 to 16.4)percent and plasma volume increased 10.5 (5.0 to 17.6)percent. Similarly, whole-body resistivity measured at 50 kHz increased significantly by 24.1 (6.3 to 36.5) Q in absolute values across the hour supine, with the measurement at 60 minutes reflecting a 4. 7 ( 1.3 to 6. 7)percent increase in resistivity from the baseline measure. Although the weight lost across the hour was only 0.11 (0.05 to 0.15) kg, the change in total body water estimated from resistivity measures is likely to be significantly larger. The results from this study reflect the need for implementation of a standardised preparatory rest time prior to taking BIA measurements, and demonstrate the limitations associated with a single frequency, whole-body approach for assessing body-fluid distribution. The purpose of the third study was to validate the use of MFBIA to determine change in body composition of obese adults during weight reduction by direct comparison with total body water as measured by stable-isotope dilution. Specifically, the study had three parts. Firstly, from the data obtained on the total sample at baseline, the aim was to develop a prediction equation for the estimation ofTBW from MFBIA. The second aim was to validate the prediction equation in a subsample during (wk-5) and after the completion of a 12-wk weight-loss intervention. The final aim of the study was to determine whether intervention type influenced the accuracy of TBW predicted by MFBIA. Multiple regression analysis revealed that the MFBIA-derived prediction equation prior to weight-loss was able to determine TBW with a SEE of 1.9L by combining the impedance index (Ht2/R10o), age, gender, and body weight. However, during weight-loss, the comparison of TBW predicted by MFBIA and measured with deuterium dilution had a much larger bias than after completion of the weight-loss intervention. It was further revealed that the magnitude of the bias was influenced by the intervention mode, with those individuals on a very-low-energy diet recording greater measurement bias. These results raise concern for the accuracy of MFBIA during periods of weight-loss in obese adults. In particular, weight-loss elicited through severe restriction in dietary intake appears most problematic. In contrast, the post-intervention TBW measures determined from the MFBIAequation derived at baseline had a mean difference of only 0.9L relative to the group mean derived by deuterium dilution. Further, using the impedance index alone post-intervention, the mean TBW measures were within 0.5L of the mean reference measure. In the fourth study the relative and absolute levels of exercise intensity corresponding with the lactate threshold (LT) and ventilatory threshold (Tvent) were determined in forty-two sedentary obese adults, 23 females and 19 males (42.9±1.8 yrs; 36.8±0.9 kg.m-2 ). Subjects were obese but otherwise healthy and taking no medication known to modifY heart rate. Subjects were required to attend a testing session each week for three weeks scheduled for the same time of day, and day of the week. The three sessions involved: (1) a treadmill test to assist in subject familiarisation. The test enabled researchers to gauge working capacity and enable subjects to become accustomed with the treadmill and gas analysis apparatus; (2) a discontinuous graded treadmill test to assess cardiorespiratory function; and (3) assessment of body composition and resting metabolic rate. On two separate occasions subjects undertook a discontinuous graded treadmill walking test consisting of 4-minute work stages separated by 2-minute rest periods. During the last 30 seconds of each work stage, subjects rated perceived exertion (RPE) using the Borg 6-20 scale. Immediately on completion of each work stage, duplicate blood samples were collected by finger prick, haemolysed in 1 OO)ll of chilled perchloric acid, and stored for later blood lactate analysis. Throughout both tests HR was recorded and respiratory gases were collected and analysed. Resting metabolic rate was assessed by indirect calorimetry using a ventilated hood system. The major finding of this study was that corresponding with LT and Tvent respectively, the relative intensities defined as percentV02R (63.4±1.4 percent; 63.8±1.8 percent), percent HRR (65.2±1.6 percent; 66.6±1.5 percent) and percent HRpeak (78.2±1.0 percent; 79.2±1.0 percent), and the absolute intensity defined by METs calculated physiologically would be categorised as "hard" by the current guidelines. In contrast, at L T and T vent the relative intensity defined by RPE (12.6±0 .2; 12.8±0.3), and absolute intensity defined by METs calculated from mechanical parameters (4.8±0.2; 5.0±0.2), fall into the "moderate" intensity category. Therefore, there is a need to redefine the descriptors of exercise intensity for the obese population. Further, linear regression analysis revealed a relatively strong negative relationship (r=-0.58, P<0.001) between HRLT and age , and the addition of gender to the regression analysis improved the strength of the prediction equation (HRLr = 145.6- 0.623* Age(yrs) + 9.824*Gender (M=l, F=2) r=-0.70, P<0.001). Importantly, the intensity thresholds tested were at a level well tolerated by the obese population, and considered to be of moderate intensity. The purpose of the fifth study was to identify optimal aerobic exercise intensity for obese adults and to compare this with the relative and absolute intensity categories outlined in current guidelines provided by the Surgeon General (U.S. Dept. HHS, 1996) and American College of Sports Medicine (ACSM, 1995; 1998). In particular, the equivalence between submaximal markers of exercise intensity, challenged recently in studies of trained and recreational athletes and chronic obstructive pulmonary disease sufferers, was evaluated for the first time in obese adults. Using a testing procedure outlined in Study 4, data was assessed from 32 obese adults (15 males and 17 females), 42.1 ± 1.7 yrs and 37.4 ± 1.0 kg.m-2. The study showed that in the obese [1] the percent HRpeak-percent V02peak relationship was significantly greater than ACSM recommendations; [2] the percent HRR was equivalent with percent V02R not percent V02peak; and [3] exercise prescription at fixed percentages of V02peak or HRpeak corresponded with wide ranges of exercise intensities in relation to LT. These results together with those from Study 4 demonstrated for the first time that current exercise prescription guidelines for the obese are too conservative, particularly where optimising the exercise-induced benefits for weight management are concerned. The final study was based upon the hypothesis that weight-regain is attributed more to behavioural adaptations than to compensatory metabolic processes. The purpose of this randomised-control intervention was to ascertain the extent to which metabolic, physiological, and psychosocial factors adapt in obese adults during a period of weight decrement. Additionally, it was hypothesised that metabolic adaptation is related to the rate of weight-loss, the mode facilitating the energy deficit responsible for the weight-loss, and the tissue composition of the weight that is lost. In particular the study goal was to determine what evidence there is that loss of body weight results in metabolic, physiological, or psychosocial adaptations that are aberrant. Forty-eight obese adults (22 males and 26 females) on average 42.9 ± 1.8 years, 107.2 ± 3.4 kg, and 36.8 ± 0.9 kg.m-2 were recruited. Subjects were matched for gender, age, and BMI before being randomly assigned to very-low-energy diet plus exercise (VLED+Ex), low-fat diet plus exercise (LF+Ex), or control (C) groups. In the first two weeks, subjects undertook two treadmill tests to determine cardiorespiratory capacity and the relationship between submaximal markers of exercise intensity at increasing workloads. In the third week, all subjects underwent testing of baseline measures of resting metabolic rate, body composition, thyroid hormone function, blood lipid profile, body satisfaction and self-reported health. After this period, subjects followed the VLED+Ex, LF+Ex or C program for the following 12 weeks. For VLED+Ex and LF+Ex body composition and metabolic measures were repeated after the 4th and 8th week of the intervention. All measurements were repeated in the week following completion of the intervention, week 16 of the study program. Forty-two subjects completed the 16-week study. Collectively, the results from the weight-loss intervention do not support the notion that weightloss in obese adults results in aberrant changes in metabolic, physiological or psychosocial variables that would in turn place the reduced-obese adult at risk of weight regain. In particular, perception of size for both males and females post-intervention was strongly related with body weight (r = 0.71 and r = 0.89 for males and females respectively), relative weight (r = 0.81, r = 0.86), and BMI (r = 0.81, r = 0.84). While positive correlations were found between the magnitudes of change in body size and body satisfaction, self-reported health improved and limitations to daily physical activity were reduced in both intervention groups when compared with the control group at the completion of the intervention period. Overall, there was no evidence with respect to psychosocial factors that the intervention and concomitant change in body size was perceived negatively, and in many respects the greater the change in body size the greater the perceived benefit. In terms of physiological adaptation, participation in 12 weeks of aerobic endurance and resistance weight training was positively reflected in improvements in cardiorespiratory fitness, with an average improvement in maximal aerobic capacity (L.min-1 ) of 17.7 percent and 13.1 percent in the VLED+Ex and LF+Ex groups respectively. The energy-cost of exercise at LT did not change significantly with weight-loss and thus exercise prescribed at LT for the reduced-obese adult would as effective for increasing energy expenditure through physical activity as was shown at baseline. Although not reaching statistical significance, the time required to expend the energy suggested as necessary for weight maintenance was reduced by an average of 9 percent and 8 percent in the VLED+Ex and LF+Ex groups respectively. In terms of metabolic adaptation, the findings were somewhat conflicting depending upon the manner of comparing energy expenditure in people before and after a change in body size. Data was analysed via four different statistical approaches cited in the literature. Analysis of covariance with FFM (the variable most strongly explaining the variance in RMR measures) as the covariate revealed no significant differences in RMR between groups at any time point during the study. Comparing the actual RMR-FFM regression lines for each group before and after the intervention revealed that the slopes and intercepts of the RMR-FFM relationships did not alter significantly after weight-loss. In contrast, the third and fourth series of analyses in which predicted and observed measures ofRMR were compared pre and post intervention, and the change in FFM related to change in resting oxygen consumption were compared, were conflicting. However, it was proposed that these somewhat conflicting results may be explained by the influence of the energetic contribution of organ tissue to total FFM energetics. As would be expected, during the intervention changes in RQ reflected the nature of the dietary intervention. However, unexpectedly at the completion of the intervention the group that lost weight most rapidly had an RQ that was not significantly different from the values at baseline. The findings do not support the notion purported by previous research that weight-loss, and in particular rapid weight-Joss, increases the reliance on carbohydrate oxidation in the reduced-obese state and thus increasing the risk of weight regain. It may be concluded from the RMR and RQ data that as a function of endurance exercise training the adverse consequences cited in studies where weight is lost through dietary restriction alone are ameliorated. Finally, the VLED+Ex group had significantly reduced concentrations offT4, T4, T3 and IT3 at the completion of the intervention relative to baseline. However, the change in hormone concentration was not related to the change in body weight or FFM for any of the hormones. Further, all subjects were euthyroid throughout the intervention. Therefore, while rapid weightloss results in statistically significant reductions in thyroid hormones, determining whether this reflects clinically significant and persistent down-regulation of endocrine function, and thus reduced metabolic potential, requires further investigation.

Breast cancer is the most common malignancy among females. Although considerable progress in disease detection and treatment has greatly improved survival, this entails the endurance of sequential treatment combinations. Such treatments are associated with cancer related fatigue (CRF), a debilitating form of fatigue that often persists for months or years post treatment, and a reduction in cardiovascular health that increases the risk of cardiovascular disease.

Regelmessig fysisk aktivitet bedrer den fysiske formen, og er dokumentert å være en viktig bidragsyter med tanke på å redusere forekomsten av sykdom og dødelighet. Det maksimale oksygenopptaket, som er det beste målet på arbeidskapasitet, er vist å være en svært sterk indikator på dødelighet både hos friske og hos pasienter med hjerte-karsykdom. Regelmessig utholdenhetstrening for å øke maksimalt oksygenopptak er derfor anbefalt for bedret helse og økt livslengde. Selv om dette er etablert kunnskap, vet man lite om hvilken intensitet kondisjonstreningen bør gjennomføres med for å oppnå best mulig helsegevinst. Hensikten med denne doktorgradsavhandlingen var derfor å kartlegge hvilken intensitet i kondisjonstreningen som gir best effekt med tanke på å øke det maksimale oksygenopptaket blant pasienter med koronarsykdom. Vi ønsket også å studere hvorvidt intensiteten er viktig for å bedre fysisk form og redusere risikofaktorer for hjerte-karsykdom hos pasienter med metabolsk syndrom, som har en sterk opphopning av disse risikofaktorene. Derfor sammenliknet vi aerob intervalltrening med høy intensitet (80-90 % av maksimalt oksygenopptak) med kontinuerlig kondisjonstrening med moderat intensitet (50-60 % av maksimalt oksygenopptak) der total treningsmengde var lik. Videre ønsket vi å undersøke hvordan blodårenes funksjon og elastisitet ble påvirket av ulik type trening, både blant unge trente og utrente, og blant pasienter med metabolsk syndrom. Resultatene viste at trening med høy intensitet ga bedre effekter enn moderat intensitet for å bedre aerob kapasitet og redusere kjente risikofaktorer forbundet med hjerte-karsykdom, inkludert blodårefunksjonen. Avhandlingen kan derfor bidra med ny innsikt med tanke på bruk av aerob intervalltrening for mer effektivt å bedre kondisjonen og dermed helsen, både blant hjertesyke og hos individer med forhøyet risiko for fremtidig hjerte-karsykdom