Morbid Obesity, Sports Physical Therapy
Conditions
Keywords
Morbid obesity, Exercise training, Metabolic syndrome, Concurrent training, Exercise order
Brief summary
Concurrent training (CT, characterised by the inclusion of two exercise modalities), is recognised to improve metabolic syndrome (MetS) markers, but little is known about order session effect on interindividual variability. The purpose of the present study was to describe the effects, and the interindividual variability, of 20 weeks of CT in different order at (i.e., high intensity interval training (HIIT) plus resistance training (RT), compared with another group doing RT plus HIIT) in women with severe/morbidly obesity at risk of MetS.
Detailed description
Morbid obesity, defined as a body mass index (BMI) of 40 kg/m2 (class III obesity), is a chronic disease with life-threatening cardiometabolic consequences such as elevated blood pressure (systolic \[SBP\] or diastolic BP \[DBP\]), fasting plasma glucose (FPG), triglycerides (Tg), and low high-density lipoprotein cholesterol (HDL-c), all summarised as metabolic syndrome (MetS). In this sense, exercise training as resistance training (RT), defined as any exercise that causes voluntary skeletal muscle contraction by using external weights such as dumbbells and metal bars, is a known non-pharmacotherapy strategy for improving muscle strength and functional capacity in obese patients undergoing bariatric surgery. Similarly, high-intensity interval training (HIIT), defined as several and brief bouts of high-intensity effort usually by cycling/running, interspersed by recovery periods ), has produced strong evidence for the improvement of cardiometabolic risk factors for type 2 diabetes mellitus, arterial hypertension, central arterial stiffness and, vascular function, and cardiorespiratory fitness. Thus, in individuals with morbid obesity, for example, exercise training has proven to be effective for inducing clinically significant weight loss (5-10%), and for the reduction of cardiovascular risk, following the standard recommendations for these cohorts prior to bariatric surgical. However, some inconsistencies have been described after CT, which are directly concerned with the 'order' (i.e. starting the CT session with MICT followed by RT, or vice versa) of the CT session. However, little is known about the interindividual variability of exercise training (IVET) in relation to different order sessions of CT in morbidly obese populations and health-related outcomes, such as MetS markers. Briefly, IVET means that some subjects achieve benefits after training, and are termed responders (Rs), while others exhibit a worsened or unchanged response, and that is commonly known termed as nonresponders (NRs).
Interventions
BEHAVIORALHIIT+RT experimental group
Each experimental group will be compared with their another contrast order session group
BEHAVIORALRT+HIIT experimental group
Each experimental group will be compared with their another contrast order session group
Sponsors
Universidad de La Frontera
Cristian Alvarez
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)
Masking description
According to availability and the feasibility of the enrolment's requirements, patients will be allocated to aHIIT+RT group with morbid obesity, or to another exercise group of RT+HIIT with morbid obesity.
Intervention model description
We will compare a concurrent training group (HIIT+RT) with morbid obesity with another experimental group of concurrent training with morbid obesity, but with another exercise order (RT+HIIT).
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* being a candidate for bariatric surgery * aged between 18 and 60 years * tobe medically authorised * with a body mass index (BMI) ≥40 kg/m2 or ≥35 kg/m2 * with additional comorbidities (i.e. diabetes, hypertension, insulin resistance) controlled by pharmacotherapy
Exclusion criteria
* having physical limitations preventing the performance of exercise (e.g. restricting injuries of the musculoskeletal system) * having exercise-related dyspnoea or respiratory alterations * having chronic heart disease with any worsening in the last month * adhering to less than 80% of the total interventions (these results were excluded from the statistical analyses)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fasting glucose | Baseline to 20-weeks of concurrent training | Component of metabolic syndrome risk factors |
| Waist circumference | Baseline to 20-weeks of concurrent training | Component of metabolic syndrome risk factors |
| Systolic blood pressure | Component of metabolic syndrome risk factors | Component of metabolic syndrome risk factors |
| Diastolic blood pressure | Baseline to 20-weeks of concurrent training | Component of metabolic syndrome risk factors |
| High-density lipoprotein cholesterol | Baseline to 20-weeks of concurrent training | Component of metabolic syndrome risk factors |
| Triglycerides | Baseline to 20-weeks of concurrent training | Component of metabolic syndrome risk factors |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Body mass (kg) | Baseline to 20-weeks of concurrent training | Anthropometry parameter related with health and intervention effects. This outcome will be measured by a bio-impedance scale (TANITATM, model 331, Tokyo, Japan). |
| Body mass index (height/m2) | Baseline to 20-weeks of concurrent training | Anthropometry parameter related with health and intervention effects |
| Body fat percentage (%) | Baseline to 20-weeks of concurrent training | Anthropometry parameter related with health and intervention effects |
| Body fat (kilograms) | Baseline to 20-weeks of concurrent training | Anthropometry parameter related with health and intervention effects |
| Skeletal muscle mass (kg) | Baseline to 20-weeks of concurrent training | Body composition parameter related with health and intervention effects. This outcome will be measured by a bio-impedance scale (TANITATM, model 331, Tokyo, Japan). |
| Lean mass (kg) | Baseline to 20-weeks of concurrent training | Body composition parameter related with health and intervention effects. This outcome will be measured by a bio-impedance scale (TANITATM, model 331, Tokyo, Japan). |
| Total cholesterol | Baseline to 20-weeks of concurrent training | Metabolic parameter related with health and intervention effects |
| Low-density lipoprotein cholesterol | Baseline to 20-weeks of concurrent training | Metabolic parameter related with health and intervention effects |
| Handgrip muscle strength (kg) | Baseline to 20-weeks of concurrent training | Physical fitness outcome related with health and intervention effects. This outcome will be measure using a digital dynamometer (BaselineTM Hydraulic Hand Dynamometers, USA), |
| Six minutes walking test | Baseline to 20-weeks of concurrent training | Physical fitness outcome related with health and intervention effects |
Countries
Chile
Outcome results
None listed