Dissimilar responses of autonomic function and strength to different periodizations in aging adults Respostas dissimilares da função autônoma e ...
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Brazilian Journal of Development 33949
ISSN: 2525-8761
Dissimilar responses of autonomic function and strength to different
periodizations in aging adults
Respostas dissimilares da função autônoma e força para diferentes
periodizações em adultos idosos
DOI:10.34117/bjdv7n4-040
Recebimento dos originais: 07/03/2021
Aceitação para publicação: 03/04/2021
Ewertton de Souza Bezerra
Dr
Biomechanics Laboratory, Federal University of Santa Catarina, Florianopolis, Brazil
Human Performance Laboratory, Federal University of Amazonas, Manaus, Brazil
Endereço: Prédio Administrativo do Centro de Desportos – CDS, Campus Universitário
– Trindade, 88040-900 - Florianópolis – SC
E-mail: ewertton_bezerra@ufam.edu.br
Cristiano Dall’ Agnol
Me
Physical Effort Laboratory, Federal University of Santa Catarina, Florianopolis, Brazil
Endereço: Prédio Administrativo do Centro de Desportos – CDS, Campus Universitário
– Trindade, 88040-900 - Florianópolis – SC
E-mail: cristianodallagnol@hotmail.com
Lucas Bet da Rosa Orssatto
Me
Biomechanics Laboratory, Federal University of Santa Catarina, Florianopolis, Brazil
School of Exercise and Nutrition Sciences, Queensland University of Technology,
Brisbane, Australia; The College of Healthcare Sciences, James Cook University,
Queensland, Australia
Endereço: Prédio Administrativo do Centro de Desportos – CDS, Campus Universitário
– Trindade, 88040-900 - Florianópolis – SC
E-mail: lucasorssatto@gmail.com
Thiago Cesar Martins
Me
Biomechanics Laboratory, Federal University of Santa Catarina, Florianopolis, Brazil.
Endereço: Prédio Administrativo do Centro de Desportos – CDS, Campus Universitário
– Trindade, 88040-900 - Florianópolis – SC
E-mail: thiagocesarmartins@gmail.com
Roberto Simão
Dr
Physical Education and Sports School, Federal University of Rio de Janeiro, Brazil
Endereço: Av. Carlos Chagas Filho, 540 - Cidade Universitária da Universidade Federal
do Rio de Janeiro, Rio de Janeiro - RJ, 21941-599
E-mail: simao@phorte.com.br
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Fábio Yuzo Nakamura
Dr
Research Center in Sports Sciences, Health Sciences and Human Development,
CIDESD, University Institute of Maia, ISMAI, 4475-690 Maia, Portugal
Endereço: Av. Carlos de Oliveira Campos, 4475-690 Maia, Portugal
E-mail: fabioy_nakamura@yahoo.com.br
Antônio Renato Pereira Moro
Dr
Biomechanics Laboratory, Federal University of Santa Catarina, Florianopolis, Brazil
Endereço: Prédio Administrativo do Centro de Desportos – CDS, Campus Universitário
– Trindade, 88040-900 - Florianópolis – SC
E-mail: renatomoro60@gmail.com
RESUMO
Diferentes tipos de programas de treinamento resistido resultam em diferente estresse
metabólico e demandas cardiovasculares, o que poderia influenciar adaptações na
modulação autonômica cardíaca. O estímulo preciso do treinamento resistido e os
mecanismos responsáveis por promover a melhora na variabilidade da frequência
cardíaca (VFC) não são claros. Para examinar os efeitos na VFC após dois modelos de
periodização de treinamento resistido em adultos idosos. Vinte e dois sujeitos foram
divididos em dois grupos: periodização de sessão mista (MSP, n = 11) e periodização
tradicional (TP, n = 11). Os sujeitos foram testados antes e após 24 sessões de treinamento
resistido para VFC (tempo, frequência e análise não linear), cinco repetições máximas (5-
RM) para o leg press e flexora senatada. Apenas o TP melhorou a VFC. O RR médio
possivelmente aumentou com prováveis melhorias em RMSSD, SD1 e APEN. Muito
provavelmente mudanças positivas foram observadas em HF. As diferenças foram
associadas a tamanhos de efeito variando de 0,16 a 0,69. Para todos esses parâmetros
autonômicos cardíacos no grupo MSP, a magnitude das mudanças foi classificada como
trivial. A abordagem MSP resultou em prováveis ajustes autonômicos inferiores em RR,
HF, RMSSD, HF, SD1 e APEN médios. Ambos os grupos provavelmente aumentaram o
desempenho de força no leg press e na flexora sentada com possivelmente e
provavelmente maiores melhorias observadas no grupo MSP, respectivamente. Aumentos
graduais na intensidade prescrita pela abordagem TP podem fornecer melhores ajustes
autonômicos do que as intensidades repentinamente mais altas sugeridas pelo MSP. TP
parece ser mais eficaz para melhorias da função autonômica, enquanto MSP para força
em adultos idosos.
Palavras-chave: regulação cardíaca, função autonômica, modelo de treinamento,
treinamento resistido.
ABSTRACT
Different types of resistance training programs result in different metabolic stress and
cardiovascular demands, which could influence adaptations in the cardiac autonomic
modulation. The precise resistance training stimulus and mechanisms responsible for
promoting improvement in heart rate variability (HRV) are unclear. To examine the
effects on HRV following two resistance training periodization models in aging adults.
Twenty-two subjects were divided into two groups: mixed session periodization (MSP,
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n=11) and traditional periodization (TP, n=11). Subjects were tested before and after 24
sessions of resistance training for HRV (time, frequency, and nonlinear analysis), five
repetitions maximum (5-RM) for the leg press and seated leg curl. Only TP improved
HRV. The mean RR possibly increased with likely improvements in RMSSD, SD1, and
APEN. Very likely positive changes were observed in HF. The differences were
associated with effect sizes ranging from 0.16 to 0.69. For all these cardiac autonomic
parameters in the MSP group the magnitude of changes were rated as unclear. The MSP
approach resulted in likely inferior autonomic adjustments in mean RR, HF, RMSSD, HF,
SD1, and APEN. Both groups most likely increased strength performance in the leg press
and seated leg curl with possibly and likely higher enhancements observed in the MSP
group, respectively. Gradual increases in intensity prescribed by the TP approach could
provide better autonomic adjustments than the suddenly higher intensities suggested by
MSP. TP seems to be more effective for autonomic function improvements whereas MSP
for strength in aging adults.
Keywords: cardiac regulation, autonomic function, training model, resistance training.
1 INTRODUCTION
Heart rate variability (HRV) corresponds to the RR interval variations deriving
from the QRS wave on electrocardiographic tracings. HRV has been considered an
acceptable method to non-invasively estimate cardiac autonomic system function in
different situations (e.g., seated rest and ambulatory activity) (KIVINIEMI et al., 2004).
A reduction in HRV is related to decreased parasympathetic activity and/or elevated
sympathetic modulation; thus, low levels of HRV are found to be associated with higher
values of blood pressure, autonomic dysfunction, cardiovascular diseases, and the risk of
acute cardiovascular events (SCHROEDER et al., 2003; THAYER; YAMAMOTO;
BROSSCHOT, 2010). Factors such as sedentary behavior, advanced age, unhealthy diets,
and psychological stress are well known to have detrimental effects on HRV. Non-
pharmacological interventions and lifestyle changes, including regular physical exercise,
can promote improvement in cardiac autonomic function in participants of different ages
and fitness levels (KIVINIEMI et al., 2007; MCKUNE et al., 2017). However, differently
from aerobic training, less evidence has been reported for resistance training regarding
the beneficial effects on HRV of healthy young people, and even less explored in older
individuals (FIGUEROA et al., 2008; KARAVIRTA et al., 2013; MADDEN; LEVY;
STRATTON, 2006).
The lack of evidence on resistance training responses can be explained due to few
variations in experimental protocols. For example, healthy young and adult men
submitted to constant load (COOKE; CARTER, 2005) and linear periodization
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(HEFFERNAN et al., 2007) did not demonstrate any alterations in HRV. In spite of some
criticisms (LOTURCO; NAKAMURA, 2016), training periodization strategies have been
used in different populations. Conversely, it is not uncommon for improvements in
parasympathetic modulation in middle-aged (27–60 y) or elderly (>60 y) populations
following a resistance training intervention (CARUSO et al., 2015; FIGUEROA et al.,
2008; RICCI-VITOR et al., 2013; TAYLOR et al., 2003). A plausible explanation for
these different effects is that several studies applied constant load (i.e., 2x15reps; 50 to
60% of 1RM) (WANDERLEY et al., 2013) or 3x10 repetitions (COLLIER et al., 2009)
with under-reporting of load adjustments during the experimental protocol. Another
potential explanation for the lack of changes could be related to the baseline HRV (i.e.,
the presence of autonomic dysfunction) (KINGSLEY; FIGUEROA, 2014). Only one
study performed load adjustments using a linear periodization model (i.e., initial intensity
was set at 50% to 60% and progressed to 75% to 85% of 1RM), although there was no
modification in sets or number of repetitions (3x12 reps) (KINGSLEY; MCMILLAN;
FIGUEROA, 2010).
Training periodization in resistance training for older persons is usually designed
to optimize different types of skeletal muscle adaptations (e.g., muscle hypertrophy,
maximum strength, and power) (BEZERRA et al., 2018). While the precise resistance
training stimulus and mechanisms responsible for promoting improvement in HRV are
unclear (CARUSO et al., 2015; RICCI-VITOR et al., 2013; TAYLOR et al., 2003),
different types of RT programs result in different metabolic stress and cardiovascular
demands (IGLESIAS-SOLER et al., 2015), which could result in different adaptations in
the cardiac autonomic modulation. To the best of our knowledge, no studies have
analyzed the chronic effects of different high-intensity periodization models on resting
HRV in older individuals.
The use of mixed session periodization (MSP) would improve maximum strength,
power, functional capacity, and body composition enhancement in aging subjects. This
type of training progression plan is characterized by mixing, within the same training
session, hypertrophic, maximum strength, and power training methods, differently from
traditional periodization (TP), which is characterized by training each one of these
methods in different training periods (e.g., weeks or months). Using the MSP loading,
contraction velocity, and repetitions volume vary within the same days, whereas in TP
these vary after each training period (BEZERRA et al., 2018). Therefore, the purpose of
the present study was to examine the effects of a resistance training program consisting
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of two distinct periodization models (TP and MSP) on HRV and muscle strength in older
adults. It was hypothesized that the MSP model should be similar to the TP model for
strength parameter(s). Furthermore, considering the age and presence of autonomic
dysfunction, both groups would present increases in HRV.
2 MATERIALS AND METHODS
2.1 STUDY DESIGN
This study was a randomized trial aiming to compare different training
organization schemes on HRV and muscle strength in older participants. The selected
participants were randomly assigned into two different groups according to the training
method adopted during the experimental period: TP and MSP. Pre-training heart rate
variability measures, repetition maximum tests were taken. Test and retest were
performed on 2 nonconsecutive days in a randomized order. Following the pre-training
test, 27 training sessions of either the TP or MSP scheme were performed over nine
weeks. Post-testing was conducted in the same order as pre-testing for each participant,
and all tests were performed at least 48 hours after the final training session.
2.2 SUBJECTS
Twenty-two older adults (men=15 and women=7) were randomly assigned to the
TP (n=11, men=8 and women=3; 65.0±4.2 years; 74.6±16.0 kg and 1.66±0.1 m) or MSP
(n=11, men=7 and women=4; 64.3±5.3; 1.70±0.1 and 81.0±15.7 kg) groups. All subjects
completed a specific health history and physical activity questionnaires and met the
following inclusion criteria: age ≥55 years, physically independent, controlled cardiac
disease (i.e. no cardiovascular disease that could make the exercise harmful to their
health), free from orthopedic dysfunction, and not performing any regular resistance
exercise for the six months preceding the beginning of the study. All subjects performed
100% of the total sessions. Three subjects in the MSP group and two in the TP group did
not take hypertensive or diabetic medicine; however, for those who did take this
medication, the dosing was not controlled. Moreover, six subjects reported hypertension
associated with diabetes (TP=3, MSP=3), four subjects stated the use of beta-blockers
(TP=2, MSP=2), and one reported diabetes alone (TP=1). No subject reported any
changes in medication intake during the intervention period. Subjects were oriented not
to change their habitual exercise practice during the intervention. Written informed
consent was obtained from all subjects after a detailed description of study procedures
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had been provided. All procedures performed in this study were approved by a local
Institutional Ethics Committee (#1.657.414) and followed the ethical guidelines of the
Declaration of Helsinki (64th WMA General Assembly, Fortaleza, Brazil, October 2013).
2.3 HEART RATE VARIABILITY
The RR-interval recordings were obtained using a heart rate sensor H7 Polar®
(Polar Electro Oy, Finland) continuously for 10 minutes (5-minutes of stabilization
followed by 5-minutes of recording) in the seated position. The data transmission was
intermediated by a simple pair of earphones attached to the central region of the heart rate
sensor. These were connected to a Pavillion HP® portable computer (Hewlett-Packard,
USA) at the entrance to the microphones, so the headsets transmitted the data at a
sampling rate of 44.1 KHz to the open-source software for cardiovascular biofeedback
Biomind© (Florianópolis, Brazil). The data processing and final values were performed
according to the recommendations available on the developers’ website of the
(http://www.neuroacademia.org/). Different measures of HRV were obtained to compare
modifications in autonomic cardiac regulation. The mean RR interval, root mean square
of successive differences (RMSSD) corresponding to difference in variation between
adjacent RR intervals, and the percentage of adjacent RR differing more than 50 ms
(pNN50) were used as time domain measures of HRV. The high frequency (HF-0.15 to
0.40 Hz) spectral power (ms2) was derived by default using Fast Fourier Transformation
(FFT). The HF band reflects the respiratory sinus rhythm from centrally mediated cardiac
vagal control (MALIK et al., 1996). In the non-linear domain, the SD1 value which is
similar in mathematical calculation to the RMSSD, is able to provide a measure of
instantaneous beat-to-beat variability, while the approximate entropy (APEN) was
utilized to identify the regularity of the RR interval series with irregularity resulting in
high and regularity resulting in low values) (CARUSO et al., 2015; SHAFFER;
MCCRATY; ZERR, 2014). The room was isolated, with the temperature set at 25±1ºC.
The subjects were advised to maintain their normal routine during the day before
assessment. All assessments occurred between 8 and 11 a.m.
2.4 REPETITION MAXIMAL TEST
Five-repetitions maximum (-RM) tests for the leg press and seated leg curl and
12-RM testing for the seated row were performed (Righetto®, São Paulo, SP, Brazil). RM
tests were performed to determine changes in muscle strength after 27 sessions. 5-RM
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and 12-RM were performed as described previously by Bezerra et al., (DE SOUZA
BEZERRA et al., 2018). Prior to the assessment all subjects were familiarized during 3
sessions (48h between them) that consisted of 3 sets (15, 10, and 5 repetitions) for each
lower limb exercise and 3 sets of 12 repetitions for upper limb exercises, not performed
to concentric failure.
2.5 TRAINING PROCEDURES
Following the pre-testing assessments, both groups trained for 9 weeks,
completing 27 sessions (at least 48h between them). All training sessions were preceded
by mobility and body weight exercises for both groups.
The TP and MSP groups performed the leg press and seated leg curl exercises as
suggested by Bezerra et al., (2018). Training method sets were classified into three types
according to their goal: Hypertrophy (10-12 RM); Strength (3-5 RM), and Power (4-6
repetitions). During the first period of training, the TP group (1st to 9th sessions) performed
3 sets of the hypertrophy method per exercise per session, in the second period (10th to
18th sessions) the TP performed 3 sets of the strength method per session, and in the final
period (19th to 27th sessions) the TP performed 3 sets of the power method. The MSP
group performed 1 set of each different method per exercise for all sessions (1st to 27th).
The hypertrophy and strength methods were performed with sets to voluntary
concentric failure. During these methods, verbal encouragement was provided to ensure
concentric failure and control the training cadence. The power method was performed
with as fast as possible concentric contractions, with verbal encouragement to perform
contractions as fast as possible in all repetitions.
A two minute rest interval was adopted between sets for both groups, for all
methods, periods, and exercises. During all sessions, physical education professionals
personally supervised subjects to help ensure consistent and safe performance. A
complementary resistance-training program was performed by both groups, which
consisted of three sets of 12 RM of the seated row, cable crossover chest press, biceps
and triceps curl with 1 minute between sets. The absolute volume load was calculated
(sets*repetitions*weight lifted kg) (SCOTT et al., 2016).
2.6 STATISTICAL ANALYSIS
Data are presented as mean ± standard deviation (SD). Data in the Figures are
presented with SD or confidence intervals (CI). The distribution of each variable was
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examined with the Shapiro-Wilk normality test. Thereafter, all data were log-transformed
to reduce bias arising from non-uniformity errors.
Main training effects within and between groups were assessed by a mixed model
(time [pre vs. post] x two groups [TP vs. MSP]). An alpha level of p ≤ 0.05 was used to
determine statistical significance. All statistical procedures were completed utilizing
SPSS 21 for Windows (Statistical Package for the Social Science, IBM, Chicago, Ill,
USA).
Additionally, data were then analyzed for practical significance using magnitude-
based inferences (MBI) (26). We used this qualitative approach as traditional statistical
approaches (null-hypothesis significance testing) often do not indicate the magnitude of
an effect, which is typically more relevant to clinical outcomes than any statistically
significant effect. MBI analysis was also used to examine the differences in autonomic
cardiac function pre- to post-intervention using a customized spreadsheet
[http://www.sportsci.org/]. The smallest worthwhile change was calculated (i.e., 0.2 x by
the between-subjects standard deviation SD) and 90% confidence intervals (CI) were
determined. The quantitative chances of higher, similar, or lower differences were
evaluated qualitatively as follows: 99%, almost certain. The true difference was assessed as unclear when the chances of
having positive and negative results were both >5%. Threshold values for Cohen’s effect
size (ES) statistics were >0.2 (small), >0.5 (moderate), and >0.8 (large) (HOPKINS et al.,
2009).
3 RESULTS
According to the qualitative statistical analysis method, mean RR possibly
increased together with likely improvements in RMSSD, SD1, and APEN. Very likely
positive changes were rated for HF. There were no differences in cardiac autonomic
parameters for the MSP group at rest in the seated position. With the exception of the
variable PNN50, the subjects of the TP group demonstrated increases in all
parasympathetic parameters after the training period (table 1). The pre to post assessment
revealed most likely improvements in all strength parameters for both groups, with a
higher effect size shown by the MSP.
Between-groups differences in the change in cardiac autonomic and strength
parameters between treatments (±90%CI) are displayed in figure 1. The MSP approach
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resulted in possibly inferior autonomic results in mean RR (ES=-0.28, 90%CI=-0.65 to
0.09), RMSSD (ES=-0.28, 90%CI=-0.74 to 0.17), HF (ES=-0.28, 90%CI=-0.75 to 0.19),
SD1 (ES=-0.36, 90%CI=-0.82 to 0.10), and APEN (ES=-0.16, 90%CI=-0.50 to 0.19), in
addition to possibly and likely superior adaptation in the leg press (ES=0.15, 90%CI=-
0.13 to 0.43) and seated leg curl (ES=0.46, 90%CI=0.19 to 0.73), respectively, when
compared to the TP. Unclear effects were rated for pNN50 (ES=-0.11, 90%CI=-0.56 to
0.33) and the seated row (ES=0.01, 90%CI=-0.55 to 0.57).
The absolute volume load did not show meaningful difference between groups
after the training period (MSP: 15065±2667 a.u. vs. TP: 12696±3987 a.u, p=0.14).
Figure 1- Comparisons of the heart rate variability–derived indices and strength parameters using an
approach based on standardized differences between the 2 periodization models. Right column, percentage
(%) chance rating as (positive effect to TP/trivial/positive effect to MSP). TP, traditional periodization
group; MSP, mixed session periodization group; LPress, leg press 5-RM; SLC, seated leg curl 5-RM; *SR,
seated row 12-RM.
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Table 1. Heart rate variability and strength parameters evaluated pre- and post-intervention. Mean ± standard deviation.
Traditional periodization Mixed Session periodization
PRE POST ES % chance (Rating) PRE POST ES % chance (Rating)
Mean RR 852.3±101.0 868.6±68.6 0.15 39/57/04 (Possibly) 871.0±101.2 830.8±134.3 -0.36 07/25/67 (Unclear)
RMSSD 16.8±10.4 24.6±5.6 0.69 93/06/01 (Likely) 17.4±11.3 19.5±7.0 0.17 47/39/14 (Unclear)
pNN50 3.3±5.2 4.2±4.6 0.16 45/43/12 (Unclear) 2.6±4.1 2.6±3.8 -0.02; 28/40/31 (Unclear)
HF (ms2) 103.2±112.7 178.6±11.3 0.62 96/04/00 (Very Likely) 106.7±117.3 123.0±98.5 0.13; 43/35/22 (Unclear)
SD1 11.9±7.4 17.4±4.0 0.69 93/06/01 (Likely) 13.2±7.3 13.8±4.9 0.07 36/43/21 (Unclear)
APEN 0.95±0.19 1.03±0.10 0.40 79/20/02 (Likely) 1.00±0.15 1.03±0.12 0.19 49/43/08 (Unclear)
LPress 93.7±28.7 122.3±36.6 0.82 100/00/00 (Most Likely) 108.8±25.1 138.6±28.4 1.09 100/00/00 (Most Likely)
SLC 72.6±20.9 87.6±23.1 0.66 100/00/00 (Most Likely) 75.6±17.8 99.8±18.1 1.24 100/00/00 (Most Likely)
SR 35.9±9.8 51.0±13.6 1.43 100/00/00 (Most Likely) 34.4±7.5 49.6±12.3 1.88; 100/00/00 (Most Likely)
Mean RR= mean RR interval; RMSSD = root mean square of successive differences of intervals between heart beats; Pnn50= percentage of adjacent RR differing more than
50 ms; HF= high-frequency bands; SD1= the standard deviation of the RR intervals; APEN= approximate entropy; LPress= leg press; SLC=seated leg curl; SR= seated row;
ES= effect size; % chance (Rating), Beneficial/Trivial/Harmful.
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4 DISCUSSION
The main finding of this study is that when comparing the post-intervention period to
baseline, TP demonstrated more favorable outcomes on parasympathetic-related indices of
HRV in the resting state than the MSP model. While the TP showed a possible increment in
mean RR, likely increase in RMSSD, SD1, APEN, and very likely improvement in the spectral
index HF, no change was found in the MSP group. TP demonstrated a possibly superior delta
change compared to the MSP for mean RR, RMSSD, HF, SD1, and APEN. Furthermore, after
the training intervention, the strength of lower limbs showed likely superior values for both
exercises and periodization models, however, in contrast to the HRV pattern, the MSP showed
delta change values possibly superior in the leg press and likely superior in the seated leg curl
exercises.
This is the first study to investigate the effects of different models of resistance training
periodization with total volume equalized on autonomic nervous system function.
Improvement in the autonomic control was only evidenced in the TP, with no variation in the
MSP group. The mechanisms that explain these improvements are not clear, although it is
known that exercise intensity and type of contraction present different cardiovascular overload.
Moreover, although the total overload imposed did not differ between groups at the end of the
training intervention, significant differences were found between phases, where the TP was
submitted to markedly higher overload than the MSP group in the first phase, and this was
inverted in the final phase.
Considering the fundamental role of arterial stiffness on arterial baroreflex sensitivity
and therefore on HRV (SHAFFER; MCCRATY; ZERR, 2014), controversial results have been
reported regarding changes in arterial stiffness induced by resistance training (MIYACHI,
2013). Previous meta-analysis reported an association between high-intensity resistance
training and an increase in arterial stiffness (MIYACHI, 2013), with no alteration for moderate
intensities, and, interestingly, the model of overload could have affected the observed results.
For instance, healthy adults that performed high volume and high intensity resistance training
(CORTEZ-COOPER et al., 2005; MIYACHI et al., 2004) demonstrated an increment in arterial
stiffness, whereas healthy subjects submitted to resistance training with progressive intensity
during the sessions did not show any change related to the central arterial compliance and
cardiac dimension (RAKOBOWCHUK et al., 2005). Acutely, a resistance training session
which reaches muscle failure or higher relative intensities could support the higher arterial
stiffness observed (KINGSLEY et al., 2016).
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Among the studies which reported an increase in HRV indices after resistance training
interventions, women with fibromyalgia syndrome, classified as pre-hypertensive, submitted
to 16 weeks of training consisting of a single set of 8-12 repetitions at 50-80% 1RM in nine
multi-joint exercises, demonstrated an increase in physiological indices related to the
regulation of the cardiac autonomic nervous system RMSSD, and a tendency to increase in
spectral HF (p=0.08) (MALIK et al., 1996). Aging adults with chronic obstructive pulmonary
disease reported increments in LF (ms2), HF (ms2), SDNN, and RMSSD (p=0.08) following
24 training sessions with progressive intensities of 60-80% 1RM. In addition to the
improvement in parasympathetic activity, the authors also reported an increment in strength
and functional tests (RICCI-VITOR et al., 2013). The geometric indices of HRV (TINN, SD1,
and SD2) were also sensitive to predict the improvement in autonomic modulation for this
population after a resistance training intervention (SANTOS et al., 2017). Higher values of
normalized HF (HFnu) were shown after three months of resistance training of moderate
intensity (controlled by HR monitoring: 3 sessions/week) with efforts ranging from 0.5-2
minutes of arm and leg cycling and stair climbing, elbow extension/flexion (30s), knee
extension/flexion (30s), and shoulder press/pull (30s) in patients with chronic heart failure
(SELIG et al., 2004).
Several studies (FORTE; DE VITO; FIGURA, 2003; GERHART et al., 2017;
KARAVIRTA et al., 2013; KINGSLEY; FIGUEROA, 2014; MELO et al., 2008) have reported
increments in strength levels after resistance training, however, with no improvements in the
autonomic condition in healthy elderly. Thus, the presence of autonomic dysfunction has been
suggested as a possible pre-training condition capable of explaining the improvement in HRV
after a resistance training intervention (FIGUEROA et al., 2008; KINGSLEY; FIGUEROA,
2014). In agreement with Kingsley and Figueroa (KINGSLEY; FIGUEROA, 2014), it is
probable the presence of autonomic dysfunction provides a favorable environment for positive
changes in HRV after resistance training interventions. However, even considering this
condition, we demonstrated that the different stress levels induced by different overloads of
resistance training programs could provide divergent results on HRV in elderly patients.
Considering that low HRV is associated with a progression of atherosclerosis
(HUIKURI et al., 1999) and diabetes (SCHROEDER et al., 2005), we assumed here not the
reestablished of cardiac health or inhibition of a specific cardiac disorder but the reduction of
progression derived from the low HRV condition. The relevance is still higher when
investigated the dose response as measured in a meta-regression study that reported 1%
increase of SDNN capable to reduces the risk of fatal or non-fatal cardiovascular disease at the
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ISSN: 2525-8761
same extent (HILLEBRAND et al., 2013). Moreover, individuals with lowered HRV have an
increased risk of cardiovascular mortality 24-h after out-of-hospital cardiac arrest when
compared with subjects with high HRV (CHEN et al., 2009) and higher incidence stroke for
diabetic individuals (FYFE-JOHNSON et al., 2016).
Interestingly, in contrast to the expected results, the MSP presented higher increases in
strength than TP. This outcome could be explained by the frequent exposure to elevated
overload during all training periods, which was markedly different from the TP that trained
with elevated overload only in the second period of training. Higher increases in maximum
strength are observed when training intensities are performed at near maximal relative
intensities (BUCKNER et al., 2016). A limitation of the current study resides in the fact that
we did not evaluate the dosage of medication, as we were not allowed to interfere in the
treatment of the patients. We also understand that homogenization of the sample profile and
control of medication during the intervention would increase the external validity of the study.
Another possible limitation was the absence of HRV measures during the intervention, mainly
to understand the load variation effect. Moreover, the lack of a true control group and the small
sample could limit extrapolation of the outcomes to the aging population.
Results of this study have potential implications for exercise prescription and
progression with respect to the resistance training. We provide evidence indicating that
different periodization models can result in different outcomes in strength and autonomic
function. The TP seems to demonstrate better results for HRV indices. Improvements in the
cardiac autonomic system after resistance training interventions result in higher autonomic
control due to the increase in parasympathetic activity in the resting condition.
5 CONCLUSIONS
In conclusion, the TP adopted in the present study seems to be more effective for
autonomic function improvements whereas MSP is more effective for dynamic strength
improvements in aging adults. These results indicate that TP should be prioritized when the
objective is to improve autonomic function. On the other hand, MSP should be emphasized for
strength gain purposes.
ACKNOWLEDGEMENTS
The authors thank the Foundation for Research Support of the State of Amazonas
(FAPEAM) for PhD scholarship conceded to Ewertton de Souza Bezerra and Coordination for
the Improvement of Higher Education Personnel (CAPES) for MSc scholarship conceded to
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ISSN: 2525-8761
Lucas Bret da Rosa Orssatto. Dr. Roberto Simão would thank the Brazilian National Board for
Scientific and Technological Development (CNPq). The authors would like to express their
thanks to Anderson Santiago Teixeira for his valuable support during statistical analyses.
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ISSN: 2525-8761
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