Cardiometabolic Adaptations to Concurrent Training: Effect of Effort Configuration on Postmenopausal Women (CARE+E)

Universidade da Coruña

Status: Begins enrollment this month

Conditions: Hypertension; Postmenopausal

Treatments: Other: Concurrent Training Program

Study type: Interventional

Funder types: Other

Identifiers

NCT07377383

PID2024-156481OB-I00

Details and patient eligibility

About

The main objectives of this project are to assess the effects of a 20-week concurrent training program on neuromuscular adaptations, body composition, cardiometabolic health, quality of life, mood state, physical self-perception, and menopause-related symptoms in physically active postmenopausal women, and to compare the adaptations resulting from different combinations of endurance and resistance training programs with varying effort configurations.

Additionally, this project aims to examine the longitudinal interaction and potential interference effects between endurance and resistance training effort configurations throughout the training program and to determine the optimal combination of effort configurations that maximizes health benefits in concurrent training programs for physically active postmenopausal women.

Full description

Menopause has a deleterious effect on women's health. The withdrawal of estrogens is associated with changes in body fat distribution, reduced glucose tolerance, abnormal lipid profiles, increased blood pressure, heightened sympathetic tone, endothelial dysfunction, and vascular inflammation. Training programs that combine endurance and resistance exercises-commonly referred to as concurrent training (CT) - at an optimal dose are recommended to counteract or even reverse some of the adverse effects of menopause.

This project builds upon a previous study conducted as part of a previous research project (PID2021-124277OB-I00), which examined the cardiovascular, metabolic, neuromuscular, and perceptual responses and adaptations of postmenopausal women to resistance training programs with different set configurations. The present proposal (CARE+E) extends this line of research by systematically incorporating the endurance component into CT programs and by manipulating effort configuration in both resistance and endurance exercises, thereby addressing a major limitation of the previous project, in which the cardiorespiratory training component was not experimentally controlled.

The inclusion of endurance training within a controlled CT framework enables the analysis of how resistance and endurance stimuli interact over time. In this context, the interference phenomenon, defined as the attenuation of adaptations induced by one exercise modality when it is combined with another within a concurrent training program, has been widely discussed but remains insufficiently understood, particularly with respect to the role of training load distribution. Effort configuration, defined as the duration of exercise sets relative to the maximal effort that can be sustained at a given intensity, may represent a key factor influencing this interaction. Nevertheless, the combined cardiometabolic and neuromuscular effects of different effort configurations in CT programs have not been systematically investigated, and evidence in physically active postmenopausal women is currently lacking.

By implementing a 20-week intervention, this project extends beyond the short- and medium-term durations typically used in postmenopausal populations, allowing for the evaluation of chronic adaptations to concurrent training. Periodic assessments throughout the program will provide insight into the longitudinal evolution of interactions between endurance and resistance training and will enable the identification of combinations of effort configurations that maximize health-related benefits. In this way, the project will generate novel evidence to inform the design of optimized concurrent training prescriptions tailored to the specific physiological characteristics of physically active postmenopausal women.

Enrollment: 60 estimated patients

Sex: Female

Ages: 46 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• At least one year since the last menstrual period.
• Physically active, defined as engaging in 150-300 minutes of moderate physical activity per week or at least 75 minutes of vigorous activity per week.
• Three or fewer traditional cardiovascular risk factors.
• Asymptomatic and without cardiovascular (except controlled hypertension), metabolic, or renal diseases.
• In the case of hypertensive participants, well-controlled grade 1 hypertension managed with a single medication.

Exclusion criteria

• Diagnosis of grade 2 or grade 3 hypertension.
• Hypertension managed with more than one medication or with a drug that could interfere with cardiovascular responses to exercise (e.g., beta-blockers).
• Current or prior use of hormone replacement therapy.
• Hypertensive response to exercise.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 6 patient groups

Short Set Configuration (4S) + Moderate-Intensity Continuous Training (MICT)

Experimental group

Description:

Postmenopausal women perform a resistance training protocol with a Short Set Configuration (4 sets × 9 repetitions, 45 s inter-set rest, 4 min between exercises) and moderate-intensity continuous cycling (30 min at \~85% of anaerobic threshold).

Treatment:

Other: Concurrent Training Program

Concurrent Training: Long Set Configuration (9S) + Moderate-Intensity Continuous Training (MICT)

Experimental group

Description:

Postmenopausal women perform a resistance training protocol with a Long Set Configuration (9 sets × 4 repetitions, 120 s inter-set rest, 4 min between exercises) and moderate-intensity continuous cycling (30 min at \~85% of anaerobic threshold).

Treatment:

Other: Concurrent Training Program

Concurrent Training: Short Set Configuration (4S) + Aerobic Interval Training, 30% TTE (AIT30)

Experimental group

Description:

Postmenopausal women perform a resistance training protocol with a Short Set Configuration (4 sets × 9 repetitions, 45 s inter-set rest, 4 min between exercises) and aerobic interval training at low effort configuration (work intervals = 30% TTE, rest intervals adjusted to maintain work-to-rest ratio).

Treatment:

Other: Concurrent Training Program

Concurrent Training: Long Set Configuration (9S) + Aerobic Interval Training, 30% TTE (AIT30)

Experimental group

Description:

Postmenopausal women perform a resistance training protocol with a Long Set Configuration (9 sets × 4 repetitions, 120 s inter-set rest, 4 min between exercises) and aerobic interval training at low effort configuration (work intervals = 30% TTE, rest intervals adjusted to maintain work-to-rest ratio).

Treatment:

Other: Concurrent Training Program

Concurrent Training: Short Set Configuration (4S) + Aerobic Interval Training, 75% TTE (AIT75)

Experimental group

Description:

Postmenopausal women perform a resistance training protocol with a Short Set Configuration (4 sets × 9 repetitions, 45 s inter-set rest, 4 min between exercises) and aerobic interval training at high effort configuration (work intervals = 75% TTE, 1:1 work-to-rest ratio).

Treatment:

Other: Concurrent Training Program

Concurrent Training: Long Set Configuration (9S) + Aerobic Interval Training, 75% TTE (AIT75)

Experimental group

Description:

Postmenopausal women perform a resistance training protocol with a Long Set Configuration (9 sets × 4 repetitions, 120 s inter-set rest, 4 min between exercises) and aerobic interval training at high effort configuration (work intervals = 75% TTE, 1:1 work-to-rest ratio).

Treatment:

Other: Concurrent Training Program