Clin Physiol Funct Imaging (2014)
doi: 10.1111/cpf.12144
Hypotensive effects and performance responses between different resistance training intensities and exercise orders in apparently health women Claudio M. Bentes1, Pablo B. Costa2, Gabriel R. Neto1, Gabriel V. Costa e Silva1, Belmiro F. de Salles1, Humberto L. Miranda1 and Jefferson S. Novaes1 1
Physical Education Graduate Program, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil and 2Human Performance Laboratory, Department of Kinesiology, California State University, San Bernardino, CA, USA
Summary Correspondence Claudio M. Bentes, Department of Physical Education - Graduate Program, Federal University of Rio de Janeiro, Avenida Pau Brasil, 540. Ilha do Fund~ao. Rio de Janeiro – 21941-590, Brazil E-mail: [email protected]
Accepted for publication Received 18 November 2013; accepted 17 February 2014
Key words blood pressure; cardiovascular responses; postexercise responses; strength training
To compare the hypotensive effect and performance responses between different resistance training intensities and different exercise orders in apparently healthy women, thirteen apparently healthy women performed four resistance training sessions in randomized order. One group performed the resistance training exercises with 60% of 1RM (SeqA60%): leg press (LG), chest press (CP), leg extension (LE), lat pull down (PD), leg curl (LC) and biceps curl (BC). Another group performed the resistance training exercises with 80% of 1RM (SeqA80%) with the same exercise order. Two other groups performed the resistance training exercises with 60% (SeqB60%) and 80% of 1RM (SeqB80%), however, in another sequence of exercises: CP, PD, BC or LG, LE, LC. The blood pressure was measured before, and at every 15 min until 60 min postexercise. The different intensities and different exercise orders resulted in a significant hypotensive effect in systolic and diastolic blood pressures that remained until 15 min. In addition, significant reductions in systolic blood pressure were observed at 30 min for SeqA in both intensities and for SeqB with intensities of 80% of 1RM. However, there was no significant difference between intensities and different prescription orders (P>005). Although the current study showed significant decreases in systolic and diastolic blood pressures after different resistance training sessions, the manipulation of intensity and exercise sequence, such as those used in the present study, was not able to generate significant changes in the duration and magnitude of hypotensive effect.
Introduction Exercise generally promotes health benefits in healthy individuals of all ages, especially for blood pressure (BP) control and hypertension prevention (Nelson et al., 2007; Garber et al., 2011). During resistance training, BP rises fast, reaching significant elevated values (Simao et al., 2005). However, systolic blood pressure (SBP) and diastolic blood pressure (DBP) values tend to decrease below resting levels in a few seconds after the end of the resistance training session (Rezk et al., 2006; De Salles et al., 2010). Thus, exercise has been recommended as an important non-pharmacological intervention for the prevention and treatment for hypertension (ACSM, 2004; Braith & Stewart, 2006; Cornelissen & Smart, 2013), and resistance training is recommended and prescribed for the control of resting BP levels in hypertensive and normotensive individuals (Simao
et al., 2007; Queiroz et al., 2009; Rusby et al., 2013). Metaanalytical data suggest that resistance training of varying prescriptions can decrease mean resting BP by as much as 3–4 mmHg (Cornelissen & Fagard, 2005). In addition, BP also decreases acutely after resistance training sessions, phenomenon called postexercise hypotensive response. However, the BP reductions described in the literature vary considerably because of differences in prescription variables (e.g. intensities, training volume, exercise order and rest interval between sets) and health status of the participants (Melo et al., 2006; Jannig et al., 2009; Matos et al., 2013; Tibana et al., 2013). Although some authors suggest that resistance training sessions with higher intensities (100% of 6RM) could be more effective than moderate intensities (50% of 6RM) (Polito et al., 2003; Simao et al., 2005), the hypotensive effects after resistance training with different intensities have not yet been fully
© 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd
1
2 Hypotension and resistance exercise, C. M. Bentes et al.
understood (Cornelissen & Fagard, 2005). Additionally, there are important methodological variables in resistance training, such as exercise order which received less attention regarding his potential hypotensive effects (Jannig et al., 2009; Simao et al., 2012; Matos et al., 2013). The hypotensive responses after resistance training sessions were observed in some studies (Simao et al., 2005; Mohebbi et al., 2009; Matos et al., 2013). The studies conducted by Simao et al. (2005) and Polito et al. (2003) suggest that resistance training sessions with higher intensities (6RM to failure) are more effective than moderate intensities (12 repetitions at 50% of 6RM) programmes resulting in a longer postexercise hypotensive response in trained participants. Mohebbi et al. (2009) compared different intensities of resistance training (40% and 80% of 1RM) and different training volumes in normotensive men. Similarly, Matos et al. (2013) compared three session of different resistance training intensities (70%, 80% and 90% of 1RM) in healthy males on BP. Both studies showed reductions in systolic blood pressure (SBP), while diastolic blood pressure (DBP) did not change after resistance training. To our knowledge, only one study investigated the effects of exercise order on the hypotensive response (Jannig et al., 2009). Jannig et al. (2009) analysed the effects of exercise order on the hypotensive response in the elderly and demonstrated a significant decrease in BP after resistance training sessions with different exercise orders resulting in different hypotensive durations. Women’s health is an important area of knowledge and must be further investigated (Olson et al., 2006; Ciccolo et al., 2010), specifically in resistance training for postmenopausal women (Saquib et al., 2013), depression and anxiety (Laios et al., 2013), and climacteric women (Doubova et al., 2013). Nevertheless, regarding resistance training for women, the effects of different intensities (60% and 80% of 1RM) in combination with different exercise orders on BP response after resistance training requires further investigation such that their benefits and proper applications can become clear. The resistance training methods used in this study are routinely applied in fitness centres for women, and scarcity in the current literature surrounding the use of this methodology suggests the need of further examination of its use and impact. Thus, the aim of the present study was to compare the hypotensive effects and performance responses between different resistance training intensities (60% and 80% of 1RM) and different exercise orders in apparently health women.
Methods Subjects Thirteen women with at least 5 years of recreational experience in resistance training volunteered for the study (age: 2984 11 years, body mass: 6352 422 kg, height: 1670 005 cm, body mass index: 2278 199, SBP: 12031 1143 mmHg and DBP: 8053 987 mmHg).
Prior to subject participation and data collection, all participants answered the Physical Activity Readiness Questionnaire and signed an informed consent form according to the Declaration of Helsinki. The exclusion criteria for the study were as follows: (i) use of medication affecting their cardiovascular responses, (ii) existence of musculoskeletal or cardiovascular problems that might influence the performance of the proposed exercises and (iii) not being pregnant. All of the participants were asked to not ingest caffeine or alcohol during the 24-h period before any of the testing protocols and not perform any vigorous physical activity during the 48 h prior to any testing protocols. All participants did not have any recent history of upper or lower body injury. During the experiment, participants were instructed to maintain their typical diet throughout the course of the study to avoid any abrupt changes in resting metabolism. This research project was approved by the University Ethics Committee (014/08). Experimental design To investigate the effects of resistance training sessions with different intensities and different exercises orders on the hypotensive postexercise responses, participants performed four resistance training sessions. This study was a quasi-experimental design trial. The two different exercise orders used in this experiment were as follows: sequence A (SeqA) alternated between upper body versus lower body with the following exercise order: leg press (LG), chest press (CP), leg extension (LE), lat pull down (PD), leg curl (LC) and biceps curl (BC), and sequence B (SeqB) progressed from the upper body to the lower body exercises with the following exercise order: CP, PD, BC and LG, LE, LC. After 1RM loads were determined for each exercise of the sequence in a test and retest, participants were randomly assigned to: sequence A with a 60% or 80% of 1RM (SeqA60%, SeqA80%); sequence B with a 60% or 80% of 1RM (SeqB60%, SeqB80%). BP was measured at rest, immediately after the end of the training session, and at 15, 30, 45, and 60 min after the resistance training sessions. The participants performed three sets of each exercise, performed the exercises bilaterally and rested for 2-min periods between sets and exercises (De Salles et al., 2010). One repetition maximum testing The One repetition maximum testing (1RM) test to measure muscle strength was performed to determine maximum strength (Kraemer & Ratamess, 2004). For better reliability, 1RM test and re-test were conducted for all exercises during two non-consecutive days. During the 1RM test, each subject performed a maximum of three 1RM attempts for each exercise with 5-min rest periods between attempts. After the 1RM load in a specific exercise was determined, a rest period of at least 10 min was allowed before the 1RM attempt of the next exercise. Standard exercise techniques were followed for each exercise (Ploutz-Snyder & Giamis, 2001).
© 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd
Hypotension and resistance exercise, C. M. Bentes et al. 3
criterion). The BP demonstrated normal distribution and homoscedasticity (P>005). Two-way repeated-measures ANOVAs [group (SeqA60 versus SeqA 80 versus SeqB60 versus SeqB80) 9 time (rest versus immediately after versus 15 versus 30 versus 45 versus 60 min)] followed by Tukey’s post hoc test were used for the analysis of possible differences in SBP and DBP. Total work (TW) was calculated by multiplying the total repetitions (1st set + 2nd set + 3rd set) by the workload (kg). The level of significance was set at P
doi: 10.1111/cpf.12144
Hypotensive effects and performance responses between different resistance training intensities and exercise orders in apparently health women Claudio M. Bentes1, Pablo B. Costa2, Gabriel R. Neto1, Gabriel V. Costa e Silva1, Belmiro F. de Salles1, Humberto L. Miranda1 and Jefferson S. Novaes1 1
Physical Education Graduate Program, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil and 2Human Performance Laboratory, Department of Kinesiology, California State University, San Bernardino, CA, USA
Summary Correspondence Claudio M. Bentes, Department of Physical Education - Graduate Program, Federal University of Rio de Janeiro, Avenida Pau Brasil, 540. Ilha do Fund~ao. Rio de Janeiro – 21941-590, Brazil E-mail: [email protected]
Accepted for publication Received 18 November 2013; accepted 17 February 2014
Key words blood pressure; cardiovascular responses; postexercise responses; strength training
To compare the hypotensive effect and performance responses between different resistance training intensities and different exercise orders in apparently healthy women, thirteen apparently healthy women performed four resistance training sessions in randomized order. One group performed the resistance training exercises with 60% of 1RM (SeqA60%): leg press (LG), chest press (CP), leg extension (LE), lat pull down (PD), leg curl (LC) and biceps curl (BC). Another group performed the resistance training exercises with 80% of 1RM (SeqA80%) with the same exercise order. Two other groups performed the resistance training exercises with 60% (SeqB60%) and 80% of 1RM (SeqB80%), however, in another sequence of exercises: CP, PD, BC or LG, LE, LC. The blood pressure was measured before, and at every 15 min until 60 min postexercise. The different intensities and different exercise orders resulted in a significant hypotensive effect in systolic and diastolic blood pressures that remained until 15 min. In addition, significant reductions in systolic blood pressure were observed at 30 min for SeqA in both intensities and for SeqB with intensities of 80% of 1RM. However, there was no significant difference between intensities and different prescription orders (P>005). Although the current study showed significant decreases in systolic and diastolic blood pressures after different resistance training sessions, the manipulation of intensity and exercise sequence, such as those used in the present study, was not able to generate significant changes in the duration and magnitude of hypotensive effect.
Introduction Exercise generally promotes health benefits in healthy individuals of all ages, especially for blood pressure (BP) control and hypertension prevention (Nelson et al., 2007; Garber et al., 2011). During resistance training, BP rises fast, reaching significant elevated values (Simao et al., 2005). However, systolic blood pressure (SBP) and diastolic blood pressure (DBP) values tend to decrease below resting levels in a few seconds after the end of the resistance training session (Rezk et al., 2006; De Salles et al., 2010). Thus, exercise has been recommended as an important non-pharmacological intervention for the prevention and treatment for hypertension (ACSM, 2004; Braith & Stewart, 2006; Cornelissen & Smart, 2013), and resistance training is recommended and prescribed for the control of resting BP levels in hypertensive and normotensive individuals (Simao
et al., 2007; Queiroz et al., 2009; Rusby et al., 2013). Metaanalytical data suggest that resistance training of varying prescriptions can decrease mean resting BP by as much as 3–4 mmHg (Cornelissen & Fagard, 2005). In addition, BP also decreases acutely after resistance training sessions, phenomenon called postexercise hypotensive response. However, the BP reductions described in the literature vary considerably because of differences in prescription variables (e.g. intensities, training volume, exercise order and rest interval between sets) and health status of the participants (Melo et al., 2006; Jannig et al., 2009; Matos et al., 2013; Tibana et al., 2013). Although some authors suggest that resistance training sessions with higher intensities (100% of 6RM) could be more effective than moderate intensities (50% of 6RM) (Polito et al., 2003; Simao et al., 2005), the hypotensive effects after resistance training with different intensities have not yet been fully
© 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd
1
2 Hypotension and resistance exercise, C. M. Bentes et al.
understood (Cornelissen & Fagard, 2005). Additionally, there are important methodological variables in resistance training, such as exercise order which received less attention regarding his potential hypotensive effects (Jannig et al., 2009; Simao et al., 2012; Matos et al., 2013). The hypotensive responses after resistance training sessions were observed in some studies (Simao et al., 2005; Mohebbi et al., 2009; Matos et al., 2013). The studies conducted by Simao et al. (2005) and Polito et al. (2003) suggest that resistance training sessions with higher intensities (6RM to failure) are more effective than moderate intensities (12 repetitions at 50% of 6RM) programmes resulting in a longer postexercise hypotensive response in trained participants. Mohebbi et al. (2009) compared different intensities of resistance training (40% and 80% of 1RM) and different training volumes in normotensive men. Similarly, Matos et al. (2013) compared three session of different resistance training intensities (70%, 80% and 90% of 1RM) in healthy males on BP. Both studies showed reductions in systolic blood pressure (SBP), while diastolic blood pressure (DBP) did not change after resistance training. To our knowledge, only one study investigated the effects of exercise order on the hypotensive response (Jannig et al., 2009). Jannig et al. (2009) analysed the effects of exercise order on the hypotensive response in the elderly and demonstrated a significant decrease in BP after resistance training sessions with different exercise orders resulting in different hypotensive durations. Women’s health is an important area of knowledge and must be further investigated (Olson et al., 2006; Ciccolo et al., 2010), specifically in resistance training for postmenopausal women (Saquib et al., 2013), depression and anxiety (Laios et al., 2013), and climacteric women (Doubova et al., 2013). Nevertheless, regarding resistance training for women, the effects of different intensities (60% and 80% of 1RM) in combination with different exercise orders on BP response after resistance training requires further investigation such that their benefits and proper applications can become clear. The resistance training methods used in this study are routinely applied in fitness centres for women, and scarcity in the current literature surrounding the use of this methodology suggests the need of further examination of its use and impact. Thus, the aim of the present study was to compare the hypotensive effects and performance responses between different resistance training intensities (60% and 80% of 1RM) and different exercise orders in apparently health women.
Methods Subjects Thirteen women with at least 5 years of recreational experience in resistance training volunteered for the study (age: 2984 11 years, body mass: 6352 422 kg, height: 1670 005 cm, body mass index: 2278 199, SBP: 12031 1143 mmHg and DBP: 8053 987 mmHg).
Prior to subject participation and data collection, all participants answered the Physical Activity Readiness Questionnaire and signed an informed consent form according to the Declaration of Helsinki. The exclusion criteria for the study were as follows: (i) use of medication affecting their cardiovascular responses, (ii) existence of musculoskeletal or cardiovascular problems that might influence the performance of the proposed exercises and (iii) not being pregnant. All of the participants were asked to not ingest caffeine or alcohol during the 24-h period before any of the testing protocols and not perform any vigorous physical activity during the 48 h prior to any testing protocols. All participants did not have any recent history of upper or lower body injury. During the experiment, participants were instructed to maintain their typical diet throughout the course of the study to avoid any abrupt changes in resting metabolism. This research project was approved by the University Ethics Committee (014/08). Experimental design To investigate the effects of resistance training sessions with different intensities and different exercises orders on the hypotensive postexercise responses, participants performed four resistance training sessions. This study was a quasi-experimental design trial. The two different exercise orders used in this experiment were as follows: sequence A (SeqA) alternated between upper body versus lower body with the following exercise order: leg press (LG), chest press (CP), leg extension (LE), lat pull down (PD), leg curl (LC) and biceps curl (BC), and sequence B (SeqB) progressed from the upper body to the lower body exercises with the following exercise order: CP, PD, BC and LG, LE, LC. After 1RM loads were determined for each exercise of the sequence in a test and retest, participants were randomly assigned to: sequence A with a 60% or 80% of 1RM (SeqA60%, SeqA80%); sequence B with a 60% or 80% of 1RM (SeqB60%, SeqB80%). BP was measured at rest, immediately after the end of the training session, and at 15, 30, 45, and 60 min after the resistance training sessions. The participants performed three sets of each exercise, performed the exercises bilaterally and rested for 2-min periods between sets and exercises (De Salles et al., 2010). One repetition maximum testing The One repetition maximum testing (1RM) test to measure muscle strength was performed to determine maximum strength (Kraemer & Ratamess, 2004). For better reliability, 1RM test and re-test were conducted for all exercises during two non-consecutive days. During the 1RM test, each subject performed a maximum of three 1RM attempts for each exercise with 5-min rest periods between attempts. After the 1RM load in a specific exercise was determined, a rest period of at least 10 min was allowed before the 1RM attempt of the next exercise. Standard exercise techniques were followed for each exercise (Ploutz-Snyder & Giamis, 2001).
© 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd
Hypotension and resistance exercise, C. M. Bentes et al. 3
criterion). The BP demonstrated normal distribution and homoscedasticity (P>005). Two-way repeated-measures ANOVAs [group (SeqA60 versus SeqA 80 versus SeqB60 versus SeqB80) 9 time (rest versus immediately after versus 15 versus 30 versus 45 versus 60 min)] followed by Tukey’s post hoc test were used for the analysis of possible differences in SBP and DBP. Total work (TW) was calculated by multiplying the total repetitions (1st set + 2nd set + 3rd set) by the workload (kg). The level of significance was set at P
