VascuFit: Exercise and Vascular Aging
Condition: Endothelial Function; Aerobic Exercise; Middle-aged Adults Sedentary, Elevated CV-risk)
Study type: Interventional

Summary: 
      Exercise is a cornerstone of health care helping to improve and maintain a good organ
      functionality, including vascular function, in health and disease. About twenty years ago,
      the introduction of high-intensity training has been a milestone in the evolution of exercise
      therapy by demonstrating the trainability of individuals independent of age and state of
      disease. Today, its practical implementation still faces barriers, such as lower physical and
      mental tolerance of exercise, long-term adherence and lack of individualization of training
      for optimal adaptations.

      The proposed project is the logical next step to introduce non-linear periodized exercise
      training (NLPE), a method widely established in elite athletes, in exercise training of
      sedentary individuals. NLPE alternatingly involves person-centred periodization of training
      cycles and regeneration with high-intensity stimuli. It induces a broader range of
      physiological adaptations than moderate-intensity training while keeping a high compliance
      and without increasing the risk of overreaching. A study of patients with
      chronic-obstructive-pulmonary-disease and a study with resistance training of older adults
      indicated promising pulmonary and muscular effects. However, the effectiveness of NLPE to
      maintain and improve vascular function has not yet been assessed, although this may carry a
      huge clinical and socioeconomic potential by contributing to the reduction of cardiovascular
      morbidity and mortality.

      VascuFit applies an 8-week training intervention to assess the effects of NLPE on the
      function of the vascular endothelium, measured by the non-invasive gold-standard method
      brachial arterial flow-mediated dilation (baFMD), in a sample of sedentary aging adults with
      cardiovascular risk factors. In addition, it will be the first study to measure training
      effects on a cluster of micro-ribonucleic acids (miRNAs) regulating key molecular pathways of
      endothelial (dys-)function. Thus, VascuFit aims to explore the potential of clinical and
      molecular biomarkers for the monitoring of individual vascular adaptability to a specific
      type of exercise. As a first step, this pilot-project is supposed to deliver
      proof-of-concept. Furthermore, it will generate important hypotheses to be addressed by
      exercise physiologists, medical professionals and biologists concerned with the optimization
      of individual training adaptations as well as utility and implementation of targeted training
      approaches in the health care of aging adults.

      VascuFit aims to demonstrate the potential of NLPE as a training regimen to improve vascular
      function in sedentary individuals with elevated cardiovascular risk. This project may be the
      initial spark to raise exercise training to the next level, which is clearly necessary to
      sustainably strengthen the vascular capacities of "young" aging individuals.
    

Detailed description: 
      A detailed description of the study can be found at:

      DOI: 10.1186/s12872-022-02905-1
    

Intervention name(s): non-linear periodized exercise (NLPE); Exercise counselling
Intervention type(s): Other; Other
Intervention description(s): Aerobic training derived from professional sports, that is characterized by variable periodization of training frequency, volume and intensity according to individual factors, such as physical and mental readiness, training progress and performance level; Standard recommendations for exercise and physical activity, that are individualized according to a medical health and fitness profile
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized controlled training intervention (8-weeks) with assessment of changes in clinical and molecular vascular biomarkers compared to their baseline value before the intervention
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: endothelium; flow-mediated vasodilation; sedentary; cardiovascular risk; aerobic exercise; vascular ageing