Aging, Physical Inactivity
Conditions
Brief summary
This research project aims to determine whether post exercise hot water immersion can improve vascular and cardiometabolic health to a greater extent than post exercise thermoneutral water immersion in healthy middle-aged adults. The study will take place over an 8 week period where participants will do a combination of aerobic exercise and water immersion 3 times per week. The study will be a randomised controlled trial comparing 8-weeks of post exercise hot water immersion (EX+HWI) to post exercise thermoneutral water immersion (EX+TNWI).
Detailed description
The exercise component of each intervention will be 30 minutes of moderate intensity aerobic exercise consisting of 10 minutes cycling, jogging and rowing, three times per week. Exercise intensity will be maintained at a heart rate equivalent of 65% of maximal heart rate. All exercise sessions will take the form of supervised group exercise sessions (\<4 participants) at Coventry University. After 30 minutes of exercise, participants will either complete 30 minutes of whole-body hot water immersion at 40°C or thermoneutral immersion at 34°C in the control condition (similar protocols are known to be well tolerated in older adults) (Akerman et al. 2019; Brunt et al. 2016). In order to ensure progression, exercise intensity will be increase to 75% of maximal heart rate according to the maximal exercise test at 4 weeks. Assessment sessions will take place before session 1 and \>48hrs after session 12 and 24. Prior to arriving at the lab participants will complete an overnight fast. Participants will also refrain from consuming alcoholic and caffeinated beverages, nitrate high sources and any form of strenuous exercise in the 24hr time period prior to testing. All testing laboratory visits will be completed in the morning and where possible at the same time of day to help standardise for any potential variations that the circadian rhythm may have on the measured variables. Assessments will be completed over two days. The outcome measures for this study comprise a range of physiological psychological measures which are known to inform the risk of cardiovascular disease. These measures fall into the following broad categories 1) vascular health; 2) cardiometabolic and inflammatory blood markers; 3) maximal exercise test and 4) cardiovascular disease risk prediction. In addition, measures of intervention acceptability and basic physiological heat acclimation measures will also be assessed.
Interventions
OTHERAerobic exercise + hot water immersion
Light to moderate intensity aerobic exercise for 30 minutes, followed by 30 minutes of hot water immersion at 40°C.
OTHERAerobic exercise + thermoneutral water immersion
Light to moderate intensity aerobic exercise for 30 minutes, followed by 30 minutes of thermoneutral water immersion at 34°C.
Sponsors
British Society for Research on Ageing
Coventry University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
45 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Aged between 45 - 65 years * If female and post-menopausal (12 months without a period and not taking HRT) * Body mass index (BMI) 18.5 - 34.9kg/m2 * Participated in less than 150 mins of moderate intensity physical activity or 75 mins of vigorous or a combination of both over the last 6 months.
Exclusion criteria
* Previous myocardial infarction or cerebrovascular event * Any signs or symptoms of cardiovascular issues * High blood pressure: SBP \>180 mmHg and / or DBP \>100 mmHg * Orthostatic hypotension: Drop of SBP \> 20mmHg and / or DBP \>10 mmHg upon standing. * Changed blood pressure medication in the 6-month period prior to the study * Plan to change any form of relevant medication during study period * Suffers from diabetes * Suffers from severe asthma * Currently have any infections or symptoms of an infection (e.g. COVID-19 etc) * Suffers from a neurodegenerative disease * Cannot understand and/or fully cooperate with the study protocol * Exercise-limiting comorbidity (e.g. angina, chronic lung disease, arthritis etc) * Severe peripheral neuropathy (cannot sense temperature) * Current smoker or have stopped in the last 3 months * Any skin conditions including ulcerations * Exposed to high temperatures in the last 4-weeks (e.g. holiday, spa, sun beds etc) * Use of antioxidant supplements in the last 6-weeks
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in circulating basal glucose (mmol/L) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Circulating serum Monocyte chemoattractant protein-1 (pg/ml) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating serum Matrix metallopeptidase-2 (pg/ml) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating serum Matrix metallopeptidase-9 (pg/ml) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating total cholesterol (mmol/L) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating low density lipoproteins (mmol/L) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating high density lipoproteins (mmol/L) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating Triglycerides (mmol/L) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating glycated haemoglobin (%) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in resting systolic blood pressure (mmHg) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Measured using an automated blood pressure cuff |
| Change in resting diastolic blood pressure (mmHg) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Measured using an automated blood pressure cuff |
| Change in resting mean arterial blood pressure (mmHg) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Measured using an automated blood pressure cuff |
| Change in flow mediated dilation (%) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Terason ultrasound recording after brachial artery occlusion |
| Change in pulse wave velocity (ms-1) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | SphygmoCor XCEL measuring carotid to femoral arterial stiffness |
| Change in intima-media thickness (mm) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Terason ultrasound image to measure wall thickness from the lumen-intima interface to the media-adventitia interface of the brachial and femoral arteries |
| Change in beta stifnness index | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Calculated using systolic, diastolic blood pressure from automated blood pressure cuff and vessel diameter from Terason ultrasound image of brachial and femoral arteries |
| Change in dynamic arterial compliance (mm2) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Calculated using pulse pressure from automated blood pressure cuff and vessel diameter from Terasol ultrasound image of brachial and femoral arteries |
| Change in maximal oxygen uptake (ml/kg/min) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Maximal oxygen uptake |
| Change in glucose tolerance (mmol/L) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Oral glucose tolerance test through fingertip capillary blood samples at 15 minute intervals for the first 1 hour and 30 minute intervals for the second hour |
| Change in circulating serum Interleukin-6 (pg/ml) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating serum TNF-α (pg/ml) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating serum Interleukin-8 (pg/ml) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating serum Interleukin-10 (pg/ml) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating serum Interleukin-1Ra (pg/ml) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
| Change in circulating Endothelin-1 (pg/ml) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Venous blood sample |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in rectal core temperature (°C) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Measured using a rectal probe attached to a squirrel data logger |
| Change in resting heart rate (bpm) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Measured using a heart rate monitor |
| Body mass index (kg/m²) | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Calculated through height and weight |
| Change in thermal comfort | Measurements taken pre and post visit 1, 12 (4 weeks) and 24 (8 weeks) | Thermal comfort Likert scale from a positive score of +5 very comfortable (maximum) to a negative score of -5 very uncomfortable (minimum) |
| Change in thermal sensation | Measurements taken pre and post visit 1, 12 (4 weeks) and 24 (8 weeks) | Thermal sensation Likert scale from a positive score of +5 hot (maximum) to a negative score of -5 cold (minimum) |
| Change in basic affect | Measurements taken pre and post visit 1, 12 (4 weeks) and 24 (8 weeks) | Basic affect Likert scale from a positive score of +5 very good (maximum) to a negative score of -5 very bad (minimum) |
| Change in physical activity enjoyment | Measurements taken pre and post visit 1, 12 (4 weeks) and 24 (8 weeks) | Feelings about exercise and / or passive heating on a Likert scale from a positive score of 1 (maximum) to a negative score of 7 (minimum) |
| Change in Framingham risk score | Measurements taken the week before the study, >48hrs after 4 weeks and >48hrs after 8 weeks | Calculation based on age, gender, total cholesterol, HDL cholesterol, smoker, diabetes status and systolic blood pressure |
Countries
United Kingdom
Outcome results
None listed