High-intensity aquatic exercises (HydrOS) improve physical function and reduce falls among postmenopausal women.
Menopause. 2013 Mar 25.
Denise Fernandes Moreira L, Fronza FC, Dos Santos RN, Teixeira LR, Kruel LF, Lazaretti-Castro M.
1 Division of Endocrinology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil;
2 School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil; and
3 Exercise Research Laboratory, School of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
OBJECTIVE: This study aims to investigate the effects of an aquatic exercise program (HydrOS) on neuromuscular function and falls among postmenopausal women.
METHODS: One hundred eight postmenopausal women (mean [SD] age, 58.8 [6.4] y) were randomly divided into the control group (CG; n = 44) and the aquatic exercise group (AEG; n = 64). Both groups received elementary calcium 500 mg/day and cholecalciferol 1,000 IU/day. For 24 weeks, the AEG participated in the aquatic exercise program, whereas the CG remained sedentary. The following variables were measured before and after the program: number of falls and fallers (7 mo before and after the intervention); flexibility, using Wells' Sit-and-Reach Test (FLEX); static balance, using the Unipedal Stance Test (UST); mobility, using the Timed-Up-and-Go test (TUG); handgrip strength of the dominant hand (HGS); and maximal isometric strength of back extensor muscles (SBE), strength of hip flexor muscles (SHF), and strength of knee extensor muscles (SKE). The muscle strength tests were considered the primary outcome, whereas the other neuromuscular tests, together with falls, were considered secondary outcomes. Results were significant when P ≤ 0.05.
RESULTS: Serum 25-hydroxyvitamin D significantly increased by 21% in the CG and by 23% in the AEG (P < 0.001). The number of falls and fallers after the program remained unchanged in the CG; in the AEG, the mean number of falls decreased from 2.00 to 0.29 (P < 0.0001), and the number of fallers decreased by 44% (P < 0.0001).
All neuromuscular variables significantly improved in the AEG: FLEX (26.6%; P < 0.0001), UST (14.1%; P < 0.001), TUG (23.7%; P < 0.001), HGS (13.4%; P < 0.001), SBE (26.2%; P < 0.001), SHF (18.5%; P = 0.039), and SKE (7.7%; P < 0.001).
In the CG, significant improvements in FLEX (12.2%; P = 0.009), UST (4.5%; P < 0.001), TUG (10%; P < 0.001), and SHF (5.7%; P = 0.039) were observed and could be explained by increasing serum 25-hydroxyvitamin D level attributable to supplementation.
CONCLUSIONS: The aquatic exercise program HydrOS is a safe and efficient way to improve physical function and to reduce falls among postmenopausal women.
|Measure||Vitamin D + Ca||Add hydroaerobics|
|flexibility, using Wells' Sit-and-Reach Test (FLEX)||12%||27%|
|static balance, using the Unipedal Stance Test (UST)||4.5%||14%|
|mobility, using the Timed-Up-and-Go test (TUG)||10%||24%|
|Handgrip strength of the dominant hand (HGS)||-||13%|
|maximal isometric strength of back extensor muscles (SBE)||-||26%|
|strength of hip flexor muscles (SHF)||5.7%||19%|
|strength of knee extensor muscles (SKE)||-||8%|
- Using more vitamin D, not just 1,000 IU - many participants probably did not get any increase in serum levels of vitamin D
- Using a loading dose - many participants probably did not get vitamin D benefit until near the end of the study
- Using cofactors to build bones - such as Magnesium and Vitamin K2
- Using Omega-3 - see below
- Some seniors do not repond to 1600 IU of vitamin D
- Physical performance of seniors increases with vitamin D up to 30 ng – Jan 2013
- Seniors with higher vitamin D levels have better physical performance – Sept 2012
- Vitamin D Omega 3 and Exercise are being used in controlled trial to support healthy ageing – Feb 2012
- Vitamin D and falls – editorial May 2011
- Fraser Health in Canada will be giving 20000 IU vitamin D weekly to reduce falls – Nov 2011
- Overview Fractures and Falls and Vitamin D generally need 2,000 IU if have not added exercise
- Vitamin D may prevent falls and fractures without Calcium – an overview of 9 meta-analysis – Oct 2012