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Dissertação apresentada à Escola Superior de Educação do Instituto Politécnico de Castelo Branco para o cumprimento dos requisitos necessários à obtenção do grau de Mestre em Atividade Física na especialização de Gerontomotricidade.

Introduction: The purpose of the present investigation was to evaluate the motivations and the impact of the hydro-gymnastics in the physical fitness of old people involved in a 16 weeks exercise program. Methods: Participants were 83 old people doing a community hydro-gymnastics exercise program. Motivations were assessed using the Sport Activity Motivation Questionnaire and physical fitness was evaluated using the Functional Fitness Test battery, in two separate moments with a 16 weeks interval. The assumption of normality was checked using the Kolmogorov-Smirnov test. Wilcoxon test was used to compare the group in different time moments. Results: Regarding motivations to hydro-gymnastics the items that scored higher were: “need to exercise”, “be with friends”, “make new friends” and “fun”. In terms of physical fitness variation, improvements in average were found in practically all fitness test between the 1st and 2nd evaluation, with significant statistical differences in 3 of the 5 tests applied. Conclusions: Old people´s major motives to participate in hydro-gymnastics are related to the motivational dimensions of physical fitness, general affiliation and pleasure. Additionally, hydro-gymnastics exercise programs have a positive impact to improve physical fitness in old people and play a determinant role on health promotion and successful aging.

Cardiometabolic diseases are one of the primary causes of mortality and morbidity worldwide and sedentary lifestyles are contributing factors to these pathologies. Physical exercise has been recognized as an important tool in the prevention and treatment of these diseases. However, there are still some doubts about the efficacy of certain type of physical exercise programs for older participants. The main goal of this study is to assess the impact of different aquatic-based physical exercise programs on risk markers of cardiometabolic diseases in older people. The study group will consist of non-institutionalized individuals, within the age group of 65 or older. The sample will be randomly divided into four groups, three experimental groups (EG) and one control group (CG). Participants fromthe EGs will be exposed to three physical aquatic-based exercise programs for a period of 28 weeks (continuous aerobic, interval aerobic and combined). The evaluated parameters include anthropometry, physical functions, mental health, cognitive function, carotid arteries intima-media thickness, heart rate variability and biochemical markers. The results will allow an interpretation of the impact of different aquatic-based physical exercise programs on cardiometabolic diseases markers and can also be used as a tool for professionals to prescribe adequate and more efficient physical exercise programs.

Considerando que a prática de hidroginástica pode contribuir para um envelhecimento mais ativo e saudável. O estudo teve como objetivo conhecer o impacto das aulas de hidroginástica frequentadas ao longo de 4 meses na aptidão física dos idosos. A amostra foi constituída por 83 idosos, utentes das aulas de hidroginástica e foi dividida em 3 grupos tendo em conta o número de aulas frequentadas (Menos de 15; 15 a 25; mais de 25). Para a recolha de dados usamos a bateria de testes Funcional Fitness Test (Rikli & Jones, 1999). A aptidão física foi avaliada pelo investigador seguindo o protocolo de provas, sendo os testes aplicados numa sala adequada para o efeito e pela mesma ordem nos dois momentos (início e final do estudo com um intervalo de 4 meses). Quanto às provas estatísticas, não se verificando uma distribuição normal dos dados, aplicamos o teste não paramétrico para duas variáveis emparelhadas de Wilcoxon que nos permitiu verificar as diferenças entre os dois momentos de avaliação. Os resultados revelaram melhorias em praticamente todos os testes entre a 1ª e a 2ª avaliação. No teste levantar e sentar na cadeira o nº de repetições passou de 13,40 para 14,43, no teste flexão do antebraço passou de 18,24 repetições para 18,92, no teste sentado e alcançar a média apesar de ser negativa, passou de -5,47 cm para -3,46, no teste sentado, caminhar 2,44 metros e voltar a sentar passou de 6,40 segundos para 6,31, no teste, alcançar atrás das costas passou de -17,07 cm para -15,61cm. Encontramos melhorias estatisticamente significativas no teste levantar e sentar na cadeira (sig. = 0,011), no teste sentado e alcançar (sig. = 0,001) e no teste alcançar atrás das costas (sig. = 0,001). O número de aulas frequentadas ao longo dos 4 meses entre os grupos não se mostrou diferenciadora para a melhoria obtida. O 1º grupo apresentou melhorias significativas em 3 provas (levantar e sentar na cadeira (sig. = 0,006), no teste sentado e alcançar (sig. = 0,004) e no teste alcançar atrás das costas (sig. = 0,002)).O 2º grupo apresentou melhorias significativas apenas numa prova (alcançar atrás das costas (sig. = 0,023)) e o 3º grupo apresentou melhorias significativas apenas numa prova (sentado e alcançar (sig. = 0,002)). Conclusões: prática de hidroginástica teve um impacto positivo na melhoria dos resultados da aptidão física nos idosos e o número de aulas frequentado não se mostrou diferenciador nos resultados obtidos.

The elderly population is constantly growing worldwide. One of the characteristics of aging is the decrease in functional fitness and cognitive function, leading to the appearance of cardiometabolic disorders. Methodology: The aim of this study is to verify the association between aerobic capacity, handgrip strength and cognition with risk markers for cardiometabolic diseases and mental health in community dwelling elderly. The study consists of a cross-sectional analysis of baseline data from a 28-week randomized controlled trial, with a sample of 102 participants (mean age 72.32 ± 5.25 years). The sample was evaluated for anthropometry, functional fitness, heart rate variability, carotid artery intima and mean thickness (IMT), cognitive function, mental health and biochemical markers. Correlations were evaluated using Pearson's statistical analysis and interpreted according to Cohen's (1988). Results: Statistically significant correlations were found between aerobic capacity (2m-ST) and markers of functional, cardiovascular, biochemical, cognitive function and mental health fitness. Handgrip strength (HG) was statistically significantly correlated with anthropometric measurements, various indicators of functional fitness, biochemical markers, cognitive function, and mental health variables. Finally, cognitive function (MMSE) was correlated with anthropometric measures, functional fitness, cardiovascular and biochemical markers, and mental health. These data suggest that aerobic capacity, handgrip strength and cognitive function may be hypothetically associated with cardiovascular disease risk markers.

Scientific evidence has shown that physical exercise is an effective way of improving several cardiovascular disease markers. However, few studies have tested its effectiveness whenperformed in aquatic environments. The purpose of this study was to test the impact of different aquatic exercise programs on the intima-media thickness of carotid arteries (IMT) and hemodynamic and biochemical markers of cardiovascular diseases in community-dwelling older persons. A total of 102 participants were randomly allocated into four groups: an aerobic exercise group (AerG) (n = 25, 71.44 ± 4.84 years); an aerobic interval group (IntG) (n = 28, 72.64 ± 5.22 years); a combined group (ComG) (n = 29, 71.90 ± 5.67 years); and a control group (CG) (n = 20, 73.60 ± 5.25 years). The AerG, IntG, and ComG participants took part in three different aquatic exercise programs for 28 weeks. The CG participants maintained their usual routines. All participants were evaluated for IMT, blood pressure, lipid profile, and MCP-1 and MIP-1α chemokines, pre- and post-intervention. Significant differences were found in the AerG for diastolic diameter (DD), in the IntG for peak systolic velocity (PSV), and in the ComG for DD and end-diastolic velocity (EDV). Regarding blood pressure, significant differences were found in AerG for systolic blood pressure (SBP) and diastolic blood pressure (DBP); in IntG for DBP; and in ComG for SBP, DBP, and heart rate (HR). Significant differences were found in the AerG and IntG for glucose (GLU). Lower plasma levels of monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein (MIP-1α) were found in the AerG and in the ComG for MCP-1 after the intervention. Aquatic physical exercise appears to improve cardiovascular health, regardless of the type of the program adopted. Aerobic programs (combined and continuous aerobic exercises) seemed to have a more beneficial effect in reducing important cardiovascular risk markers.

Evidence shows that physical exercise is important in maintaining an efficient immune system during ageing. However, there are few studies that test the impact of aquatic exercise programs on the immune system. This study aims to analyze the impact of different physical exercise programs in aquatic environment on the systemic hematological and inflammatory markers of community dwelling elderly. One hundred and two elderly were randomly allocated into four groups: a continuous aerobic exercise group (AerG) (n = 25, 71.44 ± 4.84 years); an interval aerobic exercise group (IntG) (n = 28, 72.64 ± 5.22 years); a combined exercise group (ComG) (n = 29, 71.90 ± 5.67 years); a control group (CG) (n = 20, 73.60 ± 5.25 years). The AerG, IntG and ComG participants took part in three different aquatic exercise programs over a 28- weeks period. The CG participants maintained their usual routines during the same time period. Blood samples were collected from all participants in order to access hematologic indicators, by means of cell count, and the inflammatory profile by ELISA. After 28 weeks, significant differences were found for several hematologic variables in the AerG, IntG and ComG with increases in mean corpuscular hemoglobulin (MCH), mean corpuscular hemoglobulin concentration (MCHC), and hemoglobulin (Hb). Decreases in TNF-α levels were found for all exercising groups. An increase in IL-10 levels, granulocytes to lymphocytes ratio (GLR) and a decrease in the TNF-α/IL 10 ratio, were found for the IntG. For the ComG decreases were also found for the TNF-α, IL-1ß/IL-1ra ratios. The present study suggests that aquatic exercise programs were able to improve the inflammatory profile of the participants. Those in the exercise intervention groups showed a shift towards lower pro-inflammatory levels while the non-exercising group showed the opposite behaviour. The IntG and the ComG aquatic exercise programs appeared to be more effective than the AerG program in decreasing chronic low-grade inflammation by mediating the production of higher levels of anti-inflammatory cytokines. However, the differences found between the exercising groups were small and may not have clinical significance.

Aquatic physical exercise programs have become progressively more popular among elderly people. Some of the major physical exercise program disadvantages on land are minimized due to the specific properties of the aquatic environment. The purpose of the present randomized controlled study is to verify the effects of different aquatic physical exercise programs on body composition, functional fitness and cognitive function in non-institutionalized elderly people. For this study, 102 elderly individuals were randomly allocated into four different groups: AerG (n = 25, 71.44 ± 4.84 years); IntG (n = 28, 72.64 ± 5.22 years); ComG (n = 29, 71.90 ± 5.67 years) and CG (n = 20, 73.60 ± 5.25 years). Individuals from the groups AerG, IntG and ComG participated in three different aquatic physical exercise programs for a period of 28 weeks. The CG participants kept to their usual routines. All participants were evaluated for body composition, functional fitness and cognitive function at two time moments, i.e., pre- (M1) and post-intervention (M2). Significant differences for body composition were found between M1 and M2 for FM (p < 0.001), LBM (p < 0.001) and WCir (p < 0.01) in the AerG, for BMI (p < 0.05), FM (p < 0.05), LBM (p < 0.001) and LCir-R (p < 0.05) in the IntG, and for WGT (p < 0.01), FM (p < 0.05), LBM (p < 0.01), LCir-R (p < 0.05) and LCir-L (p < 0.01) in the ComG groups. For functional fitness, differences were found between M1 and M2 for 2m-ST (p < 0.000), 30s-CS (p < 0.000), 30s-AC (p < 0.05), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the AerG, for 2m-ST (p < 0.05), BS-R (p < 0.05), 30s-CS (p < 0.000), 30s-AC(p < 0.01), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the IntG, and for 30s-CS (p < 0.000), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the ComG groups. The present study evidenced the beneficial effects of physical exercise in an aquatic environment on body composition, functional fitness and cognitive function in non-institutionalized elderly adults. The ComG water-based exercise program showed more beneficial effects in the improvement of body composition and cognitive function variables, while the IntG and AerG programs were more effective in the improvement of functional fitness.

This study aimed to analyze the effects of a combined training (CT) program performed during the first national lockdown due to the COVID-19 pandemic on body composition, metabolic profile, quality of life and stress in sedentary workers, and examines whether changes in the metabolic profile are associated with changes in health-related outcomes which are modifiable by exercise. We evaluated 31 sedentary workers (48.26 ± 7.89 years old). Participants were randomly assigned to a CT group (i.e., performed 16 weeks of exercise) or to a non-exercise control group. The CT program consisted of 16-week of resistance and aerobic exercise. Body composition, glycemic and lipidic profiles, cardiorespiratory fitness (CRF), health-related quality of life and stress levels were assessed pre- and post-intervention. After the intervention period, the CT group demonstrated significantly lower waist and hip circumference (p < 0.05) values than the control group. The control group significantly increased the fasting glucose and HOMA-IR after 16 weeks follow-up (+4.74 mg/dL, p = 0.029; and +0.41 units, p = 0.010, respectively), whiles no significant changes were observed in the CT group in the same parameters (+3.33 mg/dL, p = 0.176; and +0.04 units, p = 0.628, respectively). No changes were observed in the lipid profile for either group (p > 0.05). A significant positive relationship was detected between the change in BMI with the changes in insulin and HOMA-IR (r = 0.643, p = 0.024; and r = 0.605, p = 0.037, respectively). In addition, the changes in CRF were negatively associated with the changes in total cholesterol (r = −0.578, p = 0.049). We observed differences between groups on perceived stress levels and physical, psychological, and environmental domains of quality of life, with the CT group showing better results. Moreover, the CT group improved perceived life satisfaction (+3.17 points, p = 0.038). The findings of the present study suggest that the participants who remained physically active during the first pandemic-related lockdown were able to mitigate the deleterious effects associated with a sedentary lifestyle.