Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials
- Miller, Kyle, Areerob, Pinyadapat, Hennessy, Declan, Gonçalves-Bradley, Daniela, Mesagno, Christopher, Grace, Fergal
- Authors: Miller, Kyle , Areerob, Pinyadapat , Hennessy, Declan , Gonçalves-Bradley, Daniela , Mesagno, Christopher , Grace, Fergal
- Date: 2020
- Type: Text , Journal article
- Relation: F1000Research Vol. 9, no. (2020), p. 1-51
- Full Text:
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- Description: Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years. Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12 th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups. Results: The systematic review included 81 RCTs, with 69 meeting eligibility for the network meta-analysis ( n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges' g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges' g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges' g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges' g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment. Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults, irrespective of severity. Registration: PROSPERO CRD42018115866 (23/11/2018). © 2020 Miller KJ et al.
- Authors: Miller, Kyle , Areerob, Pinyadapat , Hennessy, Declan , Gonçalves-Bradley, Daniela , Mesagno, Christopher , Grace, Fergal
- Date: 2020
- Type: Text , Journal article
- Relation: F1000Research Vol. 9, no. (2020), p. 1-51
- Full Text:
- Reviewed:
- Description: Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years. Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12 th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups. Results: The systematic review included 81 RCTs, with 69 meeting eligibility for the network meta-analysis ( n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges' g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges' g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges' g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges' g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment. Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults, irrespective of severity. Registration: PROSPERO CRD42018115866 (23/11/2018). © 2020 Miller KJ et al.
Cardiac response to exercise in normal ageing : What can we learn from masters athletes?
- Beaumont, Alexander, Campbell, Amy, Grace, Fergal, Sculthorpe, Nicholas
- Authors: Beaumont, Alexander , Campbell, Amy , Grace, Fergal , Sculthorpe, Nicholas
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Current Cardiology Reviews Vol. 14, no. 4 (2018), p. 245-253
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- Description: Background: Ageing is associated with an inexorable decline in cardiac and vascular function, resulting in an increased risk of Cardiovascular Disease (CVD). Lifestyle factors such as exercise have emerged as a primary therapeutic target in the prevention of CVD, yet older individuals are frequently reported as being the least active, with few meeting the recommended physical activity guidelines. In contrast, well trained older individuals (Masters athletes) have superior functional capacity than their sedentary peers and are often comparable with young non-athletes. Therefore, the 'masters' athlete may be viewed as a unique non-pharmacological model which may allow researchers to disentangle the inexorable from the preventable and the magnitude of the unavoidable 'true' reduction in cardiac function due to ageing. Conclusion: This review examines evidence from studies which have compared cardiac structure and function in well trained older athletes, with age-matched controls but otherwise healthy. © 2018 Bentham Science Publishers.
- Authors: Beaumont, Alexander , Campbell, Amy , Grace, Fergal , Sculthorpe, Nicholas
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Current Cardiology Reviews Vol. 14, no. 4 (2018), p. 245-253
- Full Text:
- Reviewed:
- Description: Background: Ageing is associated with an inexorable decline in cardiac and vascular function, resulting in an increased risk of Cardiovascular Disease (CVD). Lifestyle factors such as exercise have emerged as a primary therapeutic target in the prevention of CVD, yet older individuals are frequently reported as being the least active, with few meeting the recommended physical activity guidelines. In contrast, well trained older individuals (Masters athletes) have superior functional capacity than their sedentary peers and are often comparable with young non-athletes. Therefore, the 'masters' athlete may be viewed as a unique non-pharmacological model which may allow researchers to disentangle the inexorable from the preventable and the magnitude of the unavoidable 'true' reduction in cardiac function due to ageing. Conclusion: This review examines evidence from studies which have compared cardiac structure and function in well trained older athletes, with age-matched controls but otherwise healthy. © 2018 Bentham Science Publishers.
Caucasian and south Asian men show equivalent improvements in surrogate biomarkers of cardiovascular and metabolic health following 6-weeks of supervised resistance training
- Knox, Allan, Sculthorpe, Nicholas, Grace, Fergal
- Authors: Knox, Allan , Sculthorpe, Nicholas , Grace, Fergal
- Date: 2018
- Type: Text , Journal article
- Relation: F1000Research Vol. 7, no. (2018), p. 1-16
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- Description: Background: The South Asian population have greater cardiovascular risk than their age-matched Caucasian counterparts, characterized by unfavorable biomarkers. South Asians may also be partially resistant to the pleiotropic benefits of physical activity on cardiovascular health. There is a current absence of studies that compare markers of cardio-metabolic health between Caucasians and South Asians employing resistance exercise. This study set out to compare the response in biomarkers of cardio-metabolic health in Caucasians and South Asians in response to resistance exercise. Methods: Caucasian (n=15, 25.5 ± 4.8 yrs) and South Asian (n=13, 25.4 ± 7.0 yrs) males completed a 6-week progressive resistance exercise protocol. Fasting blood glucose, insulin, and their product insulin resistance (HOMA-IR), triglycerides (TRIGS), low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (TC), vascular endothelial growth factor (VEGF), asymmetric dimythylarginine (ADMA), L-arginine (L-ARG) and C-reactive protein (CRP) were established at baseline and following resistance exercise. Results: There were significant improvements in fasting glucose, TC, LDL, HDL and VEGF in both groups following resistance exercise ( p<0.05, for all). No change was observed in insulin, HOMA-IR, TRIGS, ADMA, L-ARG following resistance exercise ( p>0.05, in both groups). CRP increased in the South Asian group ( p<0.05) but not the Caucasian group ( p>0.05) Conclusions: The cardio-metabolic response to resistance exercise is comparable in young Caucasian and South Asian males though inflammatory response to exercise may be prolonged in South Asians.
- Authors: Knox, Allan , Sculthorpe, Nicholas , Grace, Fergal
- Date: 2018
- Type: Text , Journal article
- Relation: F1000Research Vol. 7, no. (2018), p. 1-16
- Full Text:
- Reviewed:
- Description: Background: The South Asian population have greater cardiovascular risk than their age-matched Caucasian counterparts, characterized by unfavorable biomarkers. South Asians may also be partially resistant to the pleiotropic benefits of physical activity on cardiovascular health. There is a current absence of studies that compare markers of cardio-metabolic health between Caucasians and South Asians employing resistance exercise. This study set out to compare the response in biomarkers of cardio-metabolic health in Caucasians and South Asians in response to resistance exercise. Methods: Caucasian (n=15, 25.5 ± 4.8 yrs) and South Asian (n=13, 25.4 ± 7.0 yrs) males completed a 6-week progressive resistance exercise protocol. Fasting blood glucose, insulin, and their product insulin resistance (HOMA-IR), triglycerides (TRIGS), low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (TC), vascular endothelial growth factor (VEGF), asymmetric dimythylarginine (ADMA), L-arginine (L-ARG) and C-reactive protein (CRP) were established at baseline and following resistance exercise. Results: There were significant improvements in fasting glucose, TC, LDL, HDL and VEGF in both groups following resistance exercise ( p<0.05, for all). No change was observed in insulin, HOMA-IR, TRIGS, ADMA, L-ARG following resistance exercise ( p>0.05, in both groups). CRP increased in the South Asian group ( p<0.05) but not the Caucasian group ( p>0.05) Conclusions: The cardio-metabolic response to resistance exercise is comparable in young Caucasian and South Asian males though inflammatory response to exercise may be prolonged in South Asians.
Comparative effectiveness of three exercise types to treat clinical depression in older adults : a systematic review and network meta-analysis of randomised controlled trials
- Miller, Kyle, Gonçalves-Bradley, Daniela, Areerob, Pinyadapat, Hennessy, Declan, Mesagno, Christopher, Grace, Fergal
- Authors: Miller, Kyle , Gonçalves-Bradley, Daniela , Areerob, Pinyadapat , Hennessy, Declan , Mesagno, Christopher , Grace, Fergal
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Ageing Research Reviews Vol. 58 (2020).
- Full Text:
- Reviewed:
- Description: Background: Few studies have directly compared the effects of different exercise therapies on clinical depression in older adults. Thus, we conducted a systematic review and network meta-analysis of current evidence from randomised controlled trials (RCTs) to compare the effectiveness of three major exercise types (aerobic, resistance, and mind-body exercise) in clinically depressed older adults. Methods: We followed PRISMA-NMA guidelines and searched databases for eligible RCTs (inception – September 12th, 2019). RCTs were eligible if they included clinically depressed adults aged >65 years, implemented one or more exercise therapy arms using aerobic, resistance, or mind-body exercise, and assessed depressive symptoms at baseline and follow-up using a validated clinical questionnaire. Results: A network meta-analysis was performed on 15 eligible RCTs comprising 596 participants (321 treatment and 275 controls), including aerobic (n = 6), resistance (n = 5), and mind-body (n = 4) exercise trials. Compared with controls, mind-body exercise showed the largest improvement on depressive symptoms (g = −0.87 to −1.38), followed by aerobic exercise (g = −0.51 to −1.02), and resistance exercise (g = −0.41 to −0.92). Notably, there were no statistically significant differences between exercise types: aerobic versus resistance (g = −0.10, PrI = −2.23, 2.03), mind-body versus aerobic (g = −0.36, PrI = −2.69, 1.97), or mind-body versus resistance (g = −0.46, PrI = −2.75, 1.83). Conclusions: These findings should guide optimal exercise prescription for allied health professionals and stakeholders in clinical geriatrics. Notably, clinically depressed older adults may be encouraged to self-select their preferred exercise type in order to achieve therapeutic benefit on symptoms of depression. In coalition with high levels of compliance, these data provide encouraging evidence for the antidepressant effect of either aerobic, resistance, or mind-body exercise as effective treatment adjucts for older adults presenting with clinical depression. © 2019
- Authors: Miller, Kyle , Gonçalves-Bradley, Daniela , Areerob, Pinyadapat , Hennessy, Declan , Mesagno, Christopher , Grace, Fergal
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Ageing Research Reviews Vol. 58 (2020).
- Full Text:
- Reviewed:
- Description: Background: Few studies have directly compared the effects of different exercise therapies on clinical depression in older adults. Thus, we conducted a systematic review and network meta-analysis of current evidence from randomised controlled trials (RCTs) to compare the effectiveness of three major exercise types (aerobic, resistance, and mind-body exercise) in clinically depressed older adults. Methods: We followed PRISMA-NMA guidelines and searched databases for eligible RCTs (inception – September 12th, 2019). RCTs were eligible if they included clinically depressed adults aged >65 years, implemented one or more exercise therapy arms using aerobic, resistance, or mind-body exercise, and assessed depressive symptoms at baseline and follow-up using a validated clinical questionnaire. Results: A network meta-analysis was performed on 15 eligible RCTs comprising 596 participants (321 treatment and 275 controls), including aerobic (n = 6), resistance (n = 5), and mind-body (n = 4) exercise trials. Compared with controls, mind-body exercise showed the largest improvement on depressive symptoms (g = −0.87 to −1.38), followed by aerobic exercise (g = −0.51 to −1.02), and resistance exercise (g = −0.41 to −0.92). Notably, there were no statistically significant differences between exercise types: aerobic versus resistance (g = −0.10, PrI = −2.23, 2.03), mind-body versus aerobic (g = −0.36, PrI = −2.69, 1.97), or mind-body versus resistance (g = −0.46, PrI = −2.75, 1.83). Conclusions: These findings should guide optimal exercise prescription for allied health professionals and stakeholders in clinical geriatrics. Notably, clinically depressed older adults may be encouraged to self-select their preferred exercise type in order to achieve therapeutic benefit on symptoms of depression. In coalition with high levels of compliance, these data provide encouraging evidence for the antidepressant effect of either aerobic, resistance, or mind-body exercise as effective treatment adjucts for older adults presenting with clinical depression. © 2019
Evidence of direct cardiac damage following high-intensity exercise in chronic energy restriction : A case report and literature review
- Baird, Marianne, Grace, Fergal, Sculthorpe, Nicholas, Graham, Scott, Fleming, Audrey, Baker, Julien
- Authors: Baird, Marianne , Grace, Fergal , Sculthorpe, Nicholas , Graham, Scott , Fleming, Audrey , Baker, Julien
- Date: 2017
- Type: Text , Journal article
- Relation: Medicine Vol. 96, no. 27 (2017), p. 1-7
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- Description: Rationale: Following prolonged endurance events such as marathons, elevated levels of cardiospecific biomarkers are commonly reported. Although transiently raised levels are generally not considered to indicate clinical myocardial damage, comprehension of this phenomenon remains incomplete. The popularity of high-intensity interval training highlights a paucity of research measuring cardiac biomarker response to this type of exercise. This a posteriori case report discusses the elevation of cardiac troponins (cTn) associated with short interval, high-intensity exercise. Patient concerns: In this case report, an apparently healthy 29-year-old recreationally active female presented clinically raised cardiac troponin I (cTnI) levels (>0.04 ng/mL), after performing high-intensity cycle ergometer sprints. As creatine kinase (CK) is expressed by multiple organs (e.g., skeletal muscle, brain, and myocardium), cTnI assays were performed to determine any changes in total serum CK levels not originating from skeletal muscle damage. Diagnosis: A posteriori the individual's daily energy expenditure indicated chronically low-energy availability. Psychometric testing suggested that the individual scored positive for disordered eating, highly for fatigue levels, and low in mental health components. Outcomes: The current case report provides novel evidence of elevated cTnI occurring as a result of performing short duration, high intensity, cycle ergometer exercise in an individual with self-reported chronically depleted energy balance. A schematic to identify potentially “at risk” individuals is presented. Lessons: Considering this as a case report, results cannot be generalized; however, the main findings suggest that individuals who habitually restrict their calorie intake below their bodies’ daily energy requirements, may have elevated biomarkers of exercise induced myocardial stress from performing high-intensity exercise.
- Authors: Baird, Marianne , Grace, Fergal , Sculthorpe, Nicholas , Graham, Scott , Fleming, Audrey , Baker, Julien
- Date: 2017
- Type: Text , Journal article
- Relation: Medicine Vol. 96, no. 27 (2017), p. 1-7
- Full Text:
- Reviewed:
- Description: Rationale: Following prolonged endurance events such as marathons, elevated levels of cardiospecific biomarkers are commonly reported. Although transiently raised levels are generally not considered to indicate clinical myocardial damage, comprehension of this phenomenon remains incomplete. The popularity of high-intensity interval training highlights a paucity of research measuring cardiac biomarker response to this type of exercise. This a posteriori case report discusses the elevation of cardiac troponins (cTn) associated with short interval, high-intensity exercise. Patient concerns: In this case report, an apparently healthy 29-year-old recreationally active female presented clinically raised cardiac troponin I (cTnI) levels (>0.04 ng/mL), after performing high-intensity cycle ergometer sprints. As creatine kinase (CK) is expressed by multiple organs (e.g., skeletal muscle, brain, and myocardium), cTnI assays were performed to determine any changes in total serum CK levels not originating from skeletal muscle damage. Diagnosis: A posteriori the individual's daily energy expenditure indicated chronically low-energy availability. Psychometric testing suggested that the individual scored positive for disordered eating, highly for fatigue levels, and low in mental health components. Outcomes: The current case report provides novel evidence of elevated cTnI occurring as a result of performing short duration, high intensity, cycle ergometer exercise in an individual with self-reported chronically depleted energy balance. A schematic to identify potentially “at risk” individuals is presented. Lessons: Considering this as a case report, results cannot be generalized; however, the main findings suggest that individuals who habitually restrict their calorie intake below their bodies’ daily energy requirements, may have elevated biomarkers of exercise induced myocardial stress from performing high-intensity exercise.
Observation of age-related decline in the performance of the transverse abdominis muscle
- Davies, Paul, Grace, Fergal, Lewis, Mark, Sculthorpe, Nicholas
- Authors: Davies, Paul , Grace, Fergal , Lewis, Mark , Sculthorpe, Nicholas
- Date: 2016
- Type: Text , Journal article
- Relation: Physical Medicine and Rehabilitation Vol. 8, no. 1 (2016), p. 45-50
- Full Text: false
- Reviewed:
- Description: BACKGROUND: Previous research has shown that the performance of skeletal muscle declines with advancing age. Coordination of the transverse abdominis (TrA), a deep postural muscle, has been shown to be reduced in persons with low back pain. No previous research has studied the effect of age on the activation on this muscle. OBJECTIVE: To assess the effect of age on TrA activation in response to rapid arm abduction. DESIGN: Cross-sectional cohort study. SETTING: University exercise physiology laboratory. PARTICIPANTS: A total of 18 adult men (aged 27 +/- 7.0 years) for the younger group and 11 older adults (5 men and 6 women, aged 59.6 +/- 4.0 years) were recruited for this study. METHOD: Participants were positioned on a treatment table and performed a series of rapid arm abduction movements with their right arm while the activation of the TrA muscle was recorded using ultrasound imaging. Onset of arm abduction was measured using surface electromyography and synchronized with the ultrasound through the ultrasound unit's electrocardiogram channel. The mean time difference between the 2 events was calculated during post-hoc analysis. MAIN OUTCOME MEASUREMENTS: A Mann-Whitney test was performed to test for differences in the onset performance of the TrA muscle between the 2 groups. RESULTS: Results showed that the older group was significantly slower than the younger group in engaging their TrA in response to the rapid arm abduction (P = .036). A separate analysis of the older group data showed that no significant differences existed between the male and female participants that could potentially have acted as a confounding factor for the main finding (P = .126). CONCLUSIONS: This study shows that older adults were slower than younger adults in activating their TrA muscle in response to rapid arm abduction. This delay has the potential to lead to increased occasions when the low back is unprotected, increasing the likelihood of injury or low back pain.
One session of high-intensity interval training (HIIT) every 5 days, improves muscle power but not static balance in lifelong sedentary ageing men : A randomized controlled trial
- Sculthorpe, Nicholas, Herbert, Peter, Grace, Fergal
- Authors: Sculthorpe, Nicholas , Herbert, Peter , Grace, Fergal
- Date: 2017
- Type: Text , Journal article
- Relation: Medicine (United States) Vol. 96, no. 6 (2017), p. 1-8
- Full Text:
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- Description: Background: Declining muscle power during advancing age predicts falls and loss of independence. High-intensity interval training (HIIT) may improve muscle power, but remains largely unstudied in ageing participants. Methods: This randomized controlled trial (RCT) investigated the efficacy of a low-frequency HIIT (LfHIIT) intervention on peak muscle power (peak power output [PPO]), body composition, and balance in lifelong sedentary but otherwise healthy males. Methods: Thirty-Three lifelong sedentary ageing men were randomly assigned to either intervention (INT; n=22, age 62.3±4.1 years) or control (n=11, age 61.6±5.0 years) who were both assessed at 3 distinct measurement points (phase A), after 6 weeks of conditioning exercise (phase B), and after 6 weeks of HIIT once every 5 days in INT (phase C), where control remained inactive throughout the study. Results: Static balance remained unaffected, and both absolute and relative PPO were not different between groups at phases A or B, but increased significantly in INT after LfHIIT (P<0.01). Lean body mass displayed a significant interaction (P<0.01) due to an increase in INT between phases B and C (P<0.05). Conclusions: 6 weeks of LfHIIT exercise feasible and effective method to induce clinically relevant improvements in absolute and relative PPO, but does not improve static balance in sedentary ageing men. Abbreviations: ACSM = American College of Sports Medicine, CON = control group, GP = general medical practitioner, HIIT = high-intensity interval training, HRR = heart rate reserve, INT = intervention group, LfHIIT = low-frequency high-intensity interval training, PAR-Q = Physical Activity Readiness Questionnaire, PPO = peak power output, rPPO = relative peak power output, rPPOFFM = rPPO relative to fat free mass, VO2 max = maximal oxygen uptake. © 2017 the Author(s).
- Authors: Sculthorpe, Nicholas , Herbert, Peter , Grace, Fergal
- Date: 2017
- Type: Text , Journal article
- Relation: Medicine (United States) Vol. 96, no. 6 (2017), p. 1-8
- Full Text:
- Reviewed:
- Description: Background: Declining muscle power during advancing age predicts falls and loss of independence. High-intensity interval training (HIIT) may improve muscle power, but remains largely unstudied in ageing participants. Methods: This randomized controlled trial (RCT) investigated the efficacy of a low-frequency HIIT (LfHIIT) intervention on peak muscle power (peak power output [PPO]), body composition, and balance in lifelong sedentary but otherwise healthy males. Methods: Thirty-Three lifelong sedentary ageing men were randomly assigned to either intervention (INT; n=22, age 62.3±4.1 years) or control (n=11, age 61.6±5.0 years) who were both assessed at 3 distinct measurement points (phase A), after 6 weeks of conditioning exercise (phase B), and after 6 weeks of HIIT once every 5 days in INT (phase C), where control remained inactive throughout the study. Results: Static balance remained unaffected, and both absolute and relative PPO were not different between groups at phases A or B, but increased significantly in INT after LfHIIT (P<0.01). Lean body mass displayed a significant interaction (P<0.01) due to an increase in INT between phases B and C (P<0.05). Conclusions: 6 weeks of LfHIIT exercise feasible and effective method to induce clinically relevant improvements in absolute and relative PPO, but does not improve static balance in sedentary ageing men. Abbreviations: ACSM = American College of Sports Medicine, CON = control group, GP = general medical practitioner, HIIT = high-intensity interval training, HRR = heart rate reserve, INT = intervention group, LfHIIT = low-frequency high-intensity interval training, PAR-Q = Physical Activity Readiness Questionnaire, PPO = peak power output, rPPO = relative peak power output, rPPOFFM = rPPO relative to fat free mass, VO2 max = maximal oxygen uptake. © 2017 the Author(s).
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