This study supports the importance of a combined self-management and exercise intervention to improve functional lower limb strength and aerobic capacity in a Portuguese sample. Additionally, pain and other symptoms have improved clinically.

BackgroundAquatic exercise is recommended by the Osteoarthritis Research Society (OARSI), by the American College of Rheumatology (ACR) and by the European League Against Rheumatism (EULAR) as a nonpharmacological method of controlling the knee osteoarthritis (KOA) symptoms. Moreover, given that weight loss results in a reduction of the load that is exerted upon the knee during daily activities, obesity is also considered to be a modifiable risk factor for the development and or exacerbation of KOA. The implementation of an exercise based weight loss program may, however, itself be limited by the symptoms of KOA. The aquatic program against osteoarthritis (termed “PICO” in Portuguese) prioritizes the control of symptoms and the recovery of functionality, with an attendant increase in the patient’s physical activity level and, consequently, metabolic rate. Our laboratory is assessing the effectiveness of 3 months of PICO on the symptoms of KOA, on physical function, on quality of life and on gait. In addition, PICO shall examine the effects of said exercise intervention on inflammatory biomarkers, psychological health, life style and body composition.Methods/DesignThe trial is a prospective, single-blinded, randomized controlled trial, and involves 50 overweight and obese adults (BMI = 28–43.5 kg/m2; age 40–65 yrs) with radiographic KOA. The participants are randomly allocated into either an educational attention (control) group or an aquatic (exercise program) group. This paper describes the experimental protocol that is used in the PICO project.DiscussionThe PICO program shall provide insight into the effectiveness of an aquatic exercise program in the control of KOA symptoms and in the improvement of the quality of life. As such, they are likely to prove a useful reference to health professionals who intend to implement any kind of therapeutic intervention based around aquatic exercise.Trial registrationNCT01832545.

The aim of the study was to compare the maximal physiological responses during three protocols: maximal test on land cycle ergometer, maximal test on water cycling in an indoor pool at 27 °C (WC27) and at 31 °C (WC31). Moreover, the submaximal physiological responses were compared according cycling cadences and water temperatures during the water protocols. Ten young men were included and performed the protocols in separate days. Blood lactate (BL) concentration, heart rate (HR), oxygen uptake (VO2), ventilation (VE) and thermal comfort (TC) were collected during the exercise. The maximal HR and VO2 showed no significant differences between the protocols: HRmax: 189 ± 7 (Land), 188 ± 14 (WC27), 185 ± 9 bpm (WC31) and VO2max: 4.2 ± 0.4 (Land), 4.1 ± 0.5 (WC27) and 4.3 ± 0.5 l min(-1) (WC31). However, the maximal BL demonstrated significant lower values during the water protocols compared to the land protocol (p=0.018). All the submaximal physiological responses showed significant differences between the cadences (60, 70, 80 and 90 rpm). The effect of water temperature was significant for TC response (p=0.001) showing higher values at 31 °C than 27 °C (TCW27: 7 ± 1 and TCW31:9 ± 1). In conclusion, higher physiological responses were showed by increasing the cadence by 10 rpm and the subjects were more comfortable when cycling in the lower water temperature.

The aim of this study was to identify correlated factors which explain the recommended level of leisure time physical activity (LTPA) among Portuguese adults. Subjects aged 31-60 years (972 males, 1195 females) were categorized, based on LTPA data obtained using a questionnaire, into two groups according to the PA recommendation for PA: ≥ 10 or < 10 MET · hr · wk(-1). Chi-square and logistic regression analyses were applied to the results. For men, the perception of an active lifestyle [odds ratio (OR) = 4.61, 95% CI:3.13-6.81, p <0.001], having an excellent perception of health (OR = 3.14, 95% CI:1.28-7.71, p =0.013), perception of being sufficiently active (OR = 2.16, 95% CI:1.53-3.05, p <0.001), and having a high socio-economic status (SES) (OR = 1.86, 95% CI:1.22-2.81, p =0.004) were associated with attaining the recommended level of PA. For women, the perception of an active lifestyle (OR = 3.68, 95% CI:2.63-5.15, p <0.001), and middle SES (OR = 1.50, 95% CI:1.07-2.11, p =0.018) were positive and associated with meeting PA recommendations. Unlike men, women with body mass index (BMI) 25-29.9 kg/m(2) were more likely to attain the recommended level of PA than those with BMI <25 kg/m(2). The incidence of adults that met the recommended amount of PA is low. Men and women had different patterns of psychological and socio-demographic correlates. An intervention designed to improve the levels of PA among Portuguese adults may take these correlates into account.

This study aims to assess awareness of physical activity levels among adults and to investigate the variables associated with different types of awareness. The participants were 1042 men and 1316 women aged 31-60 years old (43.3 ± 6.1). Data were collected on physical activity behaviour, physical activity awareness, perceptions and psychological factors. Awareness was assessed by comparing self-rated physical activity with achieving physical activity guidelines. Chi-square and logistic regression analyses were applied to the results. About 32.4% were considered active. Moreover, 61% accurately reported their physical activity (38.3% realistic inactive and 22.7% realistic active), 29.2% overestimated their physical activity (overestimators) and 9.7% incorrectly described themselves as inactive (underestimators). Perception of an excellent health status (odds ratio, OR = 4.07, 95% confidence interval, CI: 2.07-8.00, p < 0.001) was the strongest positive association with being realistic active, followed by having a high socio-economic status (SES) (OR = 1.53, 95% CI: 1.10-2.12, p < 0.05). Overestimator participants were more likely to have an excellent perception of health (OR = 2.58, 95% CI: 1.47-4.52, p < 0.01) and had a good experience in physical education (OR = 1.46, 95% CI:1.03-2.08, p < 0.05). Almost half of these participants erroneously perceived themselves as physically active. Gender, body mass index (BMI) and the quality of physical education at school were associated with those who misperceived their physical activity.