***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The hypothesis that the adaptive capacity is higher in human upper- than lower-body skeletal muscle was tested . Furthermore , the hypothesis that more pronounced adaptations in upper-body musculature can be achieved by " low-volume high-intensity " compared with " high-volume low-intensity " exercise training was evaluated . A group of sedentary premenopausal women aged 45 ± 6 yr ( ± SD ) with expected high adaptive potential in both upper- and lower-extremity muscle groups participated . After r and om allocation to high-intensity swimming ( HIS , n = 21 ) , moderate-intensity swimming ( MOS , n = 21 ) , soccer ( SOC , n = 21 ) or a nontraining control group ( CON , n = 20 ) , the training groups completed three workouts per week for 15 wk . Resting muscle biopsies were obtained from the vastus lateralis muscle and deltoideus muscle before and after the intervention . After the training intervention , a larger ( P < 0.05 ) increase existed in deltoideus muscle of the HIS group compared with vastus lateralis muscle of the SOC group for citrate synthase maximal activity ( 95 ± 89 vs. 27 ± 34 % ) , citrate synthase protein expression ( 100 ± 29 vs. 31 ± 44 % ) , 3-hydroxyacyl-CoA dehydrogenase maximal activity ( 35 ± 43 vs. 3 ± 25 % ) , muscle glycogen content ( 63 ± 76 vs. 20 ± 51 % ) , and expression of mitochondrial complex II , III , and IV . Additionally , HIS caused higher ( P < 0.05 ) increases than MOS in deltoideus muscle citrate synthase maximal activity , citrate synthase protein expression , and muscle glycogen content . In conclusion , the deltoideus muscle has a higher adaptive potential than the vastus lateralis muscle in sedentary women , and " high-intensity low-volume " training is a more efficient regime than " low-intensity high-volume " training for increasing the aerobic capacity of the deltoideus muscle Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Parra et al. ( Acta Physiol . Sc and 169 : 157 - 165 , 2000 ) showed that 2 wk of daily sprint interval training ( SIT ) increased citrate synthase ( CS ) maximal activity but did not change " anaerobic " work capacity , possibly because of chronic fatigue induced by daily training . The effect of fewer SIT sessions on muscle oxidative potential is unknown , and aside from changes in peak oxygen uptake ( Vo(2 peak ) ) , no study has examined the effect of SIT on " aerobic " exercise capacity . We tested the hypothesis that six sessions of SIT , performed over 2 wk with 1 - 2 days rest between sessions to promote recovery , would increase CS maximal activity and endurance capacity during cycling at approximately 80 % Vo(2 peak ) . Eight recreationally active subjects [ age = 22 + /- 1 yr ; Vo(2 peak ) = 45 + /- 3 ml.kg(-1).min(-1 ) ( mean + /- SE ) ] were studied before and 3 days after SIT . Each training session consisted of four to seven " all-out " 30-s Wingate tests with 4 min of recovery . After SIT , CS maximal activity increased by 38 % ( 5.5 + /- 1.0 vs. 4.0 + /- 0.7 mmol.kg protein(-1).h(-1 ) ) and resting muscle glycogen content increased by 26 % ( 614 + /- 39 vs. 489 + /- 57 mmol/kg dry wt ) ( both P < 0.05 ) . Most strikingly , cycle endurance capacity increased by 100 % after SIT ( 51 + /- 11 vs. 26 + /- 5 min ; P < 0.05 ) , despite no change in Vo(2 peak ) . The coefficient of variation for the cycle test was 12.0 % , and a control group ( n = 8) showed no change in performance when tested approximately 2 wk apart without SIT . We conclude that short sprint interval training ( approximately 15 min of intense exercise over 2 wk ) increased muscle oxidative potential and doubled endurance capacity during intense aerobic cycling in recreationally active individuals OBJECTIVE To investigate the effects of 4-months intensive aquatic resistance training on body composition and walking speed in post-menopausal women with mild knee osteoarthritis ( OA ) , immediately after intervention and after 12-months follow-up . Additionally , influence of leisure time physical activity ( LTPA ) will be investigated . DESIGN This r and omised clinical trial assigned eighty-seven volunteer postmenopausal women into two study arms . The intervention group ( n = 43 ) participated in 48 supervised intensive aquatic resistance training sessions over 4-months while the control group ( n = 44 ) maintained normal physical activity . Eighty four participants continued into the 12-months ' follow-up period . Body composition was measured with dual-energy X-ray absorptiometry ( DXA ) . Walking speed over 2 km and the knee injury and osteoarthritis outcome score ( KOOS ) were measured . LTPA was recorded with self-reported diaries . RESULTS After the 4-month intervention there was a significant decrease ( P = 0.002 ) in fat mass ( mean change : -1.17 kg ; 95 % CI : -2.00 to -0.43 ) and increase ( P = 0.002 ) in walking speed ( 0.052 m/s ; 95 % CI : 0.018 to 0.086 ) in favour of the intervention group . Body composition returned to baseline after 12-months . In contrast , increased walking speed was maintained ( 0.046 m/s ; 95 % CI 0.006 to 0.086 , P = 0.032 ) . No change was seen in lean mass or KOOS . Daily LTPA over the 16-months had a significant effect ( P = 0.007 ) on fat mass loss ( f2 = 0.05 ) but no effect on walking speed . CONCLUSIONS Our findings show that high intensity aquatic resistance training decreases fat mass and improves walking speed in post-menopausal women with mild knee OA . Only improvements in walking speed were maintained at 12-months follow-up . Higher levels of LTPA were associated with fat mass loss . TRIAL REGISTRATION NUMBER IS RCT N65346593 OBJECTIVE To study the efficacy of aquatic resistance training on biochemical composition of tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis ( OA ) . DESIGN Eighty seven volunteer postmenopausal women , aged 60 - 68 years , with mild knee OA ( Kellgren-Lawrence grade s I/II and knee pain ) were recruited and r and omly assigned to an intervention ( n = 43 ) and control ( n = 44 ) group . The intervention group participated in 48 supervised aquatic resistance training sessions over 16 weeks while the control group maintained usual level of physical activity . The biochemical composition of the medial and lateral tibiofemoral cartilage was estimated using single-slice transverse relaxation time ( T2 ) mapping and delayed gadolinium-enhanced magnetic resonance imaging of cartilage ( dGEMRIC index ) . Secondary outcomes were cardiorespiratory fitness , isometric knee extension and flexion force and knee injury and OA outcome ( KOOS ) question naire . RESULTS After 4-months aquatic training , there was a significant decrease in both T2 -1.2 ms ( 95 % confidence interval ( CI ) : -2.3 to -0.1 , P = 0.021 ) and dGEMRIC index -23 ms ( -43 to -3 , P = 0.016 ) in the training group compared to controls in the full thickness posterior region of interest ( ROI ) of the medial femoral cartilage . Cardiorespiratory fitness significantly improved in the intervention group by 9.8 % ( P = 0.010 ) . CONCLUSIONS Our results suggest that , in postmenopausal women with mild knee OA , the integrity of the collagen-interstitial water environment ( T2 ) of the tibiofemoral cartilage may be responsive to low shear and compressive forces during aquatic resistance training . More research is required to underst and the exact nature of acute responses in dGEMRIC index to this type of loading . Further , aquatic resistance training improves cardiorespiratory fitness . TRIAL REGISTRATION NUMBER IS RCT N65346593 Underst and ing of what constitutes a training load adequate to induce training effects in patients with chronic obstructive pulmonary disease ( COPD ) is still evolving . The present study investigated whether interval training ( IT ) is effective in terms of inducing measurable improvements in physiological response and compared its effects on exercise tolerance ( ET ) and quality of life to those of continuous training ( CT ) . Thirty-six COPD patients , with a forced expiratory volume in one second of 45±4 % of the predicted value ( mean±sem ) , were r and omly assigned to CT ( exercise at 50 % of baseline peak work-rate ) or IT ( work for 30 s at 100 % of peak work-rate alternating with 30‐s rest intervals ) groups that cycled 40 min·day−1 and 2 days·week−1 for 12 weeks . After training , both groups showed significantly improved ET ( IT , 57±6 to 71±8 W ; CT , 57±5 to 70±6 W ) and total quality -of-life score of the Chronic Respiratory Disease Question naire ( IT , 77±3 to 88±2 ; CT , 78±3 to 93±2 ) . At identical levels of exercise , minute ventilation was significantly reduced ( IT , 35.8±2.5 to 31.7±2.5 L·min−1 ; CT , 36.4±2.7 to 32.5±2.7 L·min−1 ) . The magnitude of improvement in these variables was not significantly different among groups . The present data exp and on the principles of exercise prescription for chronic obstructive pulmonary disease patients by demonstrating that interval training elicits substantial training effects , which are similar in magnitude to those produced by continuous training at half the exercise intensity but double the exercise time Purpose The present study examined the effects of 15 weeks of soccer training and two different swimming training protocol s on bone turnover in sedentary middle-aged women . Methods Eighty-three premenopausal mildly hypertensive women [ age : 45 ± 6 ( ±SD ) years , height : 165 ± 6 cm , weight : 80.0 ± 14.1 kg , body fat : 42.6 ± 5.7 % , systolic blood pressure/diastolic blood pressure : 138 ± 6/85 ± 3 mmHg ] were r and omized into soccer training ( SOC , n = 21 ) , high-intensity intermittent swimming ( HS , n = 21 ) , moderate-intensity swimming ( MS , n = 21 ) intervention groups , and a control group ( C , n = 20 ) . The training groups completed three sessions per week for 15 weeks . DXA scans were performed and resting blood sample s were drawn pre- and post-intervention . Results In SOC , plasma osteocalcin , procollagen type I N propeptide and C-terminal telopeptide increased ( P < 0.05 ) by 37 ± 15 , 52 ± 23 and 42 ± 18 % , respectively , with no changes in MS , HS and C. The intervention-induced increase in SOC was larger ( P < 0.05 ) than in MS , HS and C. In SOC , leg BMC increased ( P < 0.05 ) by 3.1 ± 4.5 % , with a larger increase in SOC than in C. Femoral shaft and trochanter bone mineral density ( BMD ) increased ( P < 0.05 ) by 1.7 ± 1.9 and 2.4 ± 2.9 % , respectively , in SOC , with a greater ( P < 0.05 ) change in SOC than in MS and C , whereas total body and total leg BMD did not change in any of the groups . Conclusion In conclusion , 15 weeks of soccer training with sedentary middle-aged women caused marked increases in bone turnover markers , with concomitant increases in leg bone mass . No changes in bone formation and resorption markers were seen after prolonged submaximal or high-intensity intermittent swimming training . Thus , soccer training appears to provide a powerful osteogenic stimulus in middle-aged women L and -based exercise is often difficult for people with chronic obstructive pulmonary disease ( COPD ) who have coexisting obesity or musculoskeletal or neurological conditions . This r and omised controlled trial aim ed to determine the effectiveness of water-based exercise training in improving exercise capacity and quality of life compared to l and -based exercise training and control ( no exercise ) in people with COPD and physical comorbidities . Participants referred to pulmonary rehabilitation were r and omly allocated to a water-based exercise , l and -based exercise or the control group . The two exercise groups trained for 8 weeks , completing three sessions per week . 45 out of 5 
    Output:
    
No differences were seen in measures of body composition or the number of adverse events .
Conclusion : In a non-athletic population , A-HIIT was safe and may have improved aerobic performance and lower limb strength .