Cardiovascular and functional adaptations, health-related outcomes and safety of different intensities of community-based exercise in older women under socioeconomic vulnerability: The COmmunity-Based EXercise in OLD age (COBEX-OLD) randomized clinic

Abstract Background: Older women under socioeconomic vulnerability are at high risk of several poor health-related outcomes, including cardiovascular diseases and frailty. Physical exercise is a well-established tool to counteract numerous age-related disorders, and community-based exercise programs (CBEP) may be an effective strategy to reduce some barriers to exercise in people experiencing socioeconomic vulnerability. However, most studies on CBEP have lacked adequate methodological designs, and have assessed only a few risk factors and/or physical fitness parameters. Purpose: To investigate the effects of CBEP and its intensity on cardiovascular health, cardiovascular and physical functional adaptations, underlying physiological mechanisms and safety of the exercise program in older women under socioeconomic vulnerability. Methods: One hundred and forty-one older women will undergo assessments of cardiovascular health, arterial and venous hemodynamic function, physiological parameters underlying cardiovascular health, physical functional capacity, quality of life and mental health markers. Participants will then be randomized to high-intensity interval training associated with resistance training (HIIT+RT, n=47), moderate-intensity continuous training associated with RT (MICT+RT, n=47) or control (n=47) groups and will be reevaluated after six and 12 months of follow-up. The safety of CBEPs will be assessed throughout the follow-up. CBEPs will consist of two weekly sessions that will include 5 min of warm-up, 20 to 50 min (progressive volume throughout the session) of specific training (HIIT+RT or MICT+RT) and a 5 min cool-down. Discussion: The findings of the present study may help optimize the exercise prescription to improve cardiovascular health and functional capacity in older women under socioeconomic vulnerability. Clinical trial registration: Background: Older women under socioeconomic vulnerability are at high risk of several poor health-related outcomes, including cardiovascular diseases and frailty. Physical exercise is a well-established tool to counteract numerous age-related disorders, and community-based exercise programs (CBEP) may be an effective strategy to reduce some barriers to exercise in people experiencing socioeconomic vulnerability. However, most studies on CBEP have lacked adequate methodological designs, and have assessed only a few risk factors and/or physical fitness parameters. Purpose: To investigate the effects of CBEP and its intensity on cardiovascular health, cardiovascular and physical functional adaptations, underlying physiological mechanisms and safety of the exercise program in older women under socioeconomic vulnerability. Methods: One hundred and forty-one older women will undergo assessments of cardiovascular health, arterial and venous hemodynamic function, physiological parameters underlying cardiovascular health, physical functional capacity, quality of life and mental health markers. Participants will then be randomized to high-intensity interval training associated with resistance training (HIIT+RT, n=47), moderate-intensity continuous training associated with RT (MICT+RT, n=47) or control (n=47) groups and will be reevaluated after six and 12 months of follow-up. The safety of CBEPs will be assessed throughout the follow-up. CBEPs will consist of two weekly sessions that will include 5 min of warm-up, 20 to 50 min (progressive volume throughout the session) of specific training (HIIT+RT or MICT+RT) and a 5 min cool-down. Discussion: The findings of the present study may help optimize the exercise prescription to improve cardiovascular health and functional capacity in older women under socioeconomic vulnerability. Clinical trial registration: https://ensaiosclinicos.gov.br/rg/RBR-7n2srw8