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Leutzinger TJ, Kingston DC, Dinkel DM, Wellsandt E, Knarr BA. Differences in knee joint moments between individuals who are living with obesity and those of a healthy weight when negotiating stairs. Knee 2024; 49:217-225. [PMID: 39043017 DOI: 10.1016/j.knee.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 05/29/2024] [Accepted: 07/03/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Individuals who are living with obesity often adopt alternative lower limb walking mechanics compared to persons with a healthy weight. Stair negotiation is a common activity of daily living that, when used consistently with diet and other physical activity, can help promote the reversal of health-related risk factors associated with people who are obese. The purpose of this study was to determine how stair negotiation affects normalized and non-normalized peak knee extension and abduction moments in young adults who live with obesity (BMI between 30 and 40 kg/m2) compared to adults with a healthy weight (BMI between 18.5 and 25 kg/m2). METHODS Fifteen young adults living with obesity and fifteen with a healthy weight performed stair ascent and descent walking trials on a 3-step instrumented staircase at a self-selected walking speed. A one-way ANCOVA (covariate: gait speed) was used to compare knee moment variables between groups. RESULTS No significant differences were found between groups in peak knee joint moments normalized to body mass. The individuals living with obesity demonstrated significantly larger non-normalized peak knee extension moments during stair ascent and descent but no differences in the non-normalized peak knee abduction moments for stair ascent or descent. CONCLUSION Results of this study indicate differences in non-normalized peak knee extension moments between BMI groups. The young age of the obese group may have contributed to minimal differences overall. Future research should determine how these findings differ in an older obese population and how using a handrail would affect these results.
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Affiliation(s)
- Todd J Leutzinger
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, United States.
| | - David C Kingston
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, United States
| | - Danae M Dinkel
- School of Health and Kinesiology, University of Nebraska, Omaha, NE, United States
| | - Elizabeth Wellsandt
- Department of Health and Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, United States
| | - Brian A Knarr
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, United States
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Tucker WJ, Sawyer BJ, Bhammar DM, Ware EW, Angadi SS, Gaesser GA. Treadmill walking economy is not affected by body fat and body mass index in adults. Physiol Rep 2024; 12:e16023. [PMID: 38760177 PMCID: PMC11101323 DOI: 10.14814/phy2.16023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/20/2024] [Accepted: 04/05/2024] [Indexed: 05/19/2024] Open
Abstract
To determine whether body fat and body mass index (BMI) affect the energy cost of walking (Cw; J/kg/m), ventilation, and gas exchange data from 205 adults (115 females; percent body fat range = 3.0%-52.8%; BMI range = 17.5-43.2 kg/m2) were obtained at rest and during treadmill walking at 1.34 m/s to calculate gross and net Cw. Linear regression was used to assess relationships between body composition indices, Cw, and standing metabolic rate (SMR). Unpaired t-tests were used to assess differences between sex, and one-way ANOVA was used to assess differences by BMI categories: normal weight, <25.0 kg/m2; overweight, 25.0-29.9 km/m2; and obese, ≥30 kg/m2. Net Cw was not related to body fat percent, fat mass, or BMI (all R2 ≤ 0.011). Furthermore, mean net Cw was similar by sex (male: 2.19 ± 0.30 J/kg/m; female: 2.24 ± 0.37 J/kg/m, p = 0.35) and across BMI categories (normal weight: 2.23 ± 0.36 J/kg/m; overweight: 2.18 ± 0.33 J/kg/m; obese: 2.26 ± 0.31, p = 0.54). Gross Cw and SMR were inversely associated with percent body fat, fat mass, and BMI (all R2 between 0.033 and 0.270; all p ≤ 0.008). In conclusion, Net Cw is not influenced by body fat percentage, total body fat, and BMI and does not differ by sex.
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Affiliation(s)
- Wesley J. Tucker
- Department of Nutrition & Food SciencesTexas Woman's UniversityHoustonTexasUSA
- Institute for Women's Health, College of Health SciencesHoustonTexasUSA
| | - Brandon J. Sawyer
- Department of Kinesiology & Department of BiologyPoint Loma Nazarene UniversitySan DiegoCaliforniaUSA
| | - Dharini M. Bhammar
- Center for Tobacco Research, Division of Medical Oncology, Department of Internal MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Emma W. Ware
- Department of Nutrition & Food SciencesTexas Woman's UniversityHoustonTexasUSA
| | - Siddhartha S. Angadi
- Department of Kinesiology, School of Education and Human DevelopmentUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Glenn A. Gaesser
- College of Health SolutionsArizona State UniversityPhoenixArizonaUSA
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Peyré‐Tartaruga LA, Oliveira HB, Dewolf AH, Buzzachera CF, Martinez FG, Ivaniski‐Mello A. Pendular mechanism determinants and elastic energy usage during walking of obese and non-obese children. Exp Physiol 2023; 108:1400-1408. [PMID: 37723935 PMCID: PMC10988495 DOI: 10.1113/ep091408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/25/2023] [Indexed: 09/20/2023]
Abstract
The mechanical and metabolic responses of walking by obese children are not yet well understood. The objectives of this study were (1) to compare the pendular mechanism (recovery, phase shift by α and β values, and ratio between forward and vertical mechanical work), the maximum possible elastic energy usage and the bilateral coordination during walking between non-obese and obese children, and (2) to verify if the bilateral coordination could contribute to understanding the pendular mechanism and elastic energy usage in these populations. Nine obese (six female, 8.7 ± 0.5 years, 1.38 ± 0.04 m, 44.4 ± 6.3 kg and 24.1 ± 3.50 kg/m2 ) and eight non-obese (four female, 7.4 ± 0.5 years, 1.31 ± 0.08 m, 26.6 ± 2.1 kg and 16.4 ± 1.40 kg/m2 ) children were analysed during walking on a treadmill at five speeds: 1, 2, 3, 4 and 5 km/h. The results indicated that although the mechanical energy response of the centre of mass during walking is similar between obese and non-obese children, the obese children showed a lower pendulum-like mechanism and greater elastic energy usage during level walking. Therefore, obese children seem to use more elastic energy during walking compared to non-obese children, which may be related to their apparent higher positive work production during the double support phase. Finally, bilateral coordination presented high values at slow speeds in both groups and requires further attention due to its association with falls. NEW FINDINGS: What is the central question of this study? Are there any differences of the pendular and elastic mechanisms and bilateral coordination during walking between non-obese and obese children? What is the main finding and its importance? To our knowledge, this study is the first to analyse the mechanical energy usage and the bilateral coordination of obese and non-obese children during walking. Obese children had a lower pendular recovery mechanism and used more elastic energy compared to non-obese children. The bilateral coordination was higher at slow speeds in both groups and requires further attention due to its association with falls.
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Affiliation(s)
- Leonardo Alexandre Peyré‐Tartaruga
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and DanceUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
- Department of Public Health, Experimental Medicine and Forensic SciencesUniversity of PaviaPaviaItaly
| | - Henrique Bianchi Oliveira
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and DanceUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - Arthur H. Dewolf
- Laboratory of Biomechanics and Physiology of Locomotion, Institute of NeuroScienceUniversité Catholique de LouvainLouvain‐la‐NeuveBelgium
| | - Cosme Franklim Buzzachera
- Department of Public Health, Experimental Medicine and Forensic SciencesUniversity of PaviaPaviaItaly
| | - Flávia Gomes Martinez
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and DanceUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - André Ivaniski‐Mello
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and DanceUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
- Department of Public Health, Experimental Medicine and Forensic SciencesUniversity of PaviaPaviaItaly
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LaRowe LR, Bohlen LC, Gaudiano BA, Abrantes AM, Butryn ML, Dunsiger SI, Griffin E, Loucks EB, Uebelacker LA, Williams DM. Testing the Feasibility and Acceptability of an Acceptance and Commitment Therapy Intervention to Increase Physical Activity among Individuals with Depression: A Protocol Paper. Ment Health Phys Act 2022; 23:100475. [PMID: 37649877 PMCID: PMC10465112 DOI: 10.1016/j.mhpa.2022.100475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Engaging in regular physical activity (PA) is particularly important among individuals with depression, who are at heightened risk for a host of negative health outcomes. However, people with depression are 50% less likely to meet national guidelines for PA and face unique barriers to PA adherence, including lower distress tolerance and motivation for exercise. Acceptance and Commitment Therapy (ACT) may offer promise for increasing PA among adults with depressive symptoms due to its effects on distress tolerance and motivation. Therefore, we developed ACTivity, an ACT-based intervention designed to promote PA among low-active adults with elevated depressive symptoms. Prior to testing the efficacy of ACTivity in an RCT, an important first step is to conduct a preliminary trial to establish feasibility of study procedures for the ACTivity and comparison intervention programs, as well as to establish the credibility/acceptability of the intervention. The purpose of this paper is to describe the ACTivity intervention and the design of this feasibility trial. Method/Design We will conduct a feasibility RCT with two parallel groups and a 1:1 allocation ratio comparing ACTivity to a comparison intervention (relaxation training + PA promotion) among 60 low-active adults with elevated depressive symptoms. All study procedures will be conducted remotely. Discussion Results of this feasibility study will inform a subsequent RCT designed to test the efficacy of ACTivity. If shown to be efficacious, ACTivity will provide a treatment that can be widely disseminated to increase PA among adults with depressive symptoms and thereby decrease their risk for chronic disease.
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Affiliation(s)
- Lisa R. LaRowe
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Lauren Connell Bohlen
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Brandon A. Gaudiano
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
- Butler Hospital, Providence, RI, 02906, USA
| | - Ana M. Abrantes
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
- Butler Hospital, Providence, RI, 02906, USA
| | - Meghan L. Butryn
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, 19104, USA
| | - Shira I. Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Elizabeth Griffin
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Eric B. Loucks
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Lisa A. Uebelacker
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
- Butler Hospital, Providence, RI, 02906, USA
| | - David M. Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
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Udomittipong K, Thabungkan T, Nimmannit A, Tovichien P, Charoensitisup P, Mahoran K. Obesity Indices for Predicting Functional Fitness in Children and Adolescents With Obesity. Front Pediatr 2021; 9:789290. [PMID: 34976898 PMCID: PMC8714884 DOI: 10.3389/fped.2021.789290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/15/2021] [Indexed: 12/30/2022] Open
Abstract
Objectives: We aimed to determine the obesity indices that affect 6-min walk test (6-MWT) distance in children and adolescents with obesity and to compare the 6-MWT distance of obese subjects with that of normal-weight subjects. Methods: Obese children and adolescents aged 8-15 years and normal-weight age- and gender-matched controls were enrolled. All participants performed the 6-MWT; respiratory muscle strength (RMS), including maximal inspiratory pressure and maximal expiratory pressure; and spirometry. Data between groups were compared. In the obesity group, correlation between obesity indices and pulmonary function testing (6-MWT, RMS, and spirometry) was analyzed. Results: The study included 37 obese and 31 normal-weight participants. The following parameters were all significantly lower in the obesity group than in the normal-weight group: 6-MWT distance (472.1 ± 66.2 vs. 513.7 ± 72.9 m; p = 0.02), forced expiratory volume in one second/forced vital capacity (FEV1/FVC) (85.3 ± 6.7 vs. 90.8 ± 4.5%; p < 0.001), forced expiratory flow rate within 25-75% of vital capacity (FEF25-75%) (89.8 ± 23.1 vs. 100.4 ± 17.3 %predicted; p = 0.04), and peak expiratory flow (PEF) (81.2 ± 15 vs. 92.5 ± 19.6 %predicted; p = 0.01). The obesity indices that significantly correlated with 6-MWT distance in obese children and adolescents were waist circumference-to-height ratio (WC/Ht) (r = -0.51; p = 0.001), waist circumference (r = -0.39; p = 0.002), body mass index (BMI) (r = -0.36; p = 0.03), and chest circumference (r = -0.35; p = 0.04). WC/Ht was the only independent predictor of 6-MWT distance by multiple linear regression. Conclusions: Children and adolescents with obesity had a significantly shorter 6-MWT distance compared with normal-weight subjects. WC/Ht was the only independent predictor of 6-MWT distance in the obesity group.
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Affiliation(s)
- Kanokporn Udomittipong
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Teerapat Thabungkan
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Akarin Nimmannit
- Division of Clinical Epidemiology, Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Prakarn Tovichien
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pawinee Charoensitisup
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Khunphon Mahoran
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Nuckols RW, Lee S, Swaminathan K, Orzel D, Howe RD, Walsh CJ. Individualization of exosuit assistance based on measured muscle dynamics during versatile walking. Sci Robot 2021; 6:eabj1362. [PMID: 34757803 DOI: 10.1126/scirobotics.abj1362] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Variability in human walking depends on individual physiology, environment, and walking task. Consequently, in the field of wearable robotics, there is a clear need for customizing assistance to the user and task. Here, we developed a muscle-based assistance (MBA) strategy wherein exosuit assistance was derived from direct measurements of individuals’ muscle dynamics during specific tasks. We recorded individuals’ soleus muscle dynamics using ultrasonographic imaging during multiple walking speeds and inclines. From these prerecorded images, we estimated the force produced by the soleus through inefficient concentric contraction and designed the exosuit assistance profile to be proportional to that estimated force. We evaluated this approach with a bilateral ankle exosuit at each measured walking task. Compared with not wearing a device, the MBA ankle exosuit significantly reduced metabolic demand by an average of 15.9, 9.7, and 8.9% for level walking at 1.25, 1.5, and 1.75 meters second−1, respectively, and 7.8% at 1.25 meters second−1 at 5.71° incline while applying lower assistance levels than in existing literature. In an additional study (n = 2), we showed for multiple walking tasks that the MBA profile outperforms other bioinspired strategies and the average profile from a previous optimization study. Last, we show the feasibility of online assistance generation in a mobile version for overground outdoor walking. This muscle-based approach enables relatively rapid (~10 seconds) generation of individualized low-force assistance profiles that provide metabolic benefit. This approach may help support the adoption of wearable robotics in real-world, dynamic locomotor tasks by enabling comfortable, tailored, and adaptive assistance.
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Affiliation(s)
- R W Nuckols
- John A. Paulson School of Engineering and Applied Sciences and Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - S Lee
- John A. Paulson School of Engineering and Applied Sciences and Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - K Swaminathan
- John A. Paulson School of Engineering and Applied Sciences and Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - D Orzel
- John A. Paulson School of Engineering and Applied Sciences and Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - R D Howe
- John A. Paulson School of Engineering and Applied Sciences and Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - C J Walsh
- John A. Paulson School of Engineering and Applied Sciences and Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
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7
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Malatesta D, Favre J, Ulrich B, Hans D, Suter M, Favre L, Fernández Menéndez A. Effect of very large body mass loss on energetics, mechanics and efficiency of walking in adults with obesity: mass-driven versus behavioural adaptations. J Physiol 2021; 600:979-996. [PMID: 34505286 PMCID: PMC9293213 DOI: 10.1113/jp281710] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/26/2021] [Indexed: 11/18/2022] Open
Abstract
Abstract Understanding the mechanisms involved in the higher energy cost of walking (NCw: the energy expenditure above resting per unit distance) in adults with obesity is pivotal to optimizing the use of walking in weight management programmes. Therefore, this study aimed to investigate the mechanics, energetics and mechanical efficiency of walking after a large body mass loss induced by bariatric surgery in individuals with obesity. Nine adults (39.5 ± 8.6 year; BMI: 42.7 ± 4.6 kg m–2) walked at five fixed speeds before (baseline) and after the bariatric surgery (post 1 and post 2). Gas exchanges were measured to obtain NCw. A motion analysis system and instrumented treadmill were combined to assess total mechanical work (Wtot). Mechanical efficiency (Wtot NCw–1) was also calculated. Participants lost 25.7 ± 3.4% of their body mass at post 1 (6.6 months; P < 0.001) and 6.1 ± 4.9% more at post 2 (12 months; P = 0.014). Mass‐normalized NCw was similar between baseline and post 1 and decreased at post 2 compared to that at baseline (−6.2 ± 2.7%) and post 1 (−8.1 ± 1.9%; P ≤ 0.007). No difference was found in mass‐normalized Wtot during follow‐up (P = 0.36). Mechanical efficiency was similar at post 1 and post 2 when compared to that at baseline (P ≥ 0.19), but it was higher (+14.1 ± 4.6%) at post 2 than at post 1 (P = 0.013). These findings showed that after a very large body mass loss, individuals with obesity may reorganize their walking pattern into a gait more similar to that of lean adults, thus decreasing their NCw by making their muscles work more efficiently.
![]() Key points A higher net (above resting) energy cost of walking (lower gait economy) is observed in adults with obesity compared to lean individuals. Understanding the mechanisms (i.e. mass driven, gait pattern and behavioural changes) involved in this extra cost of walking in adults with obesity is pivotal to optimizing the use of walking to promote daily physical activity and improve health in these individuals. We found that very large weight loss induced by bariatric surgery significantly decreased the energy cost of walking per kg of body mass after 1 year with similar total mechanical work per kg of body mass, resulting in an increased mechanical efficiency of walking. Individuals with obesity may reorganize their walking pattern into a gait more similar to that of adults of normal body mass, thus decreasing their energy cost of walking by making their muscles work more efficiently.
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Affiliation(s)
- Davide Malatesta
- Institute of Sport Sciences of the University of Lausanne (ISSUL), University of Lausanne, Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Baptiste Ulrich
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Didier Hans
- Center for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Michel Suter
- CHUV, Service de chirurgie viscérale, Bâtiment hospitalier du CHUV, Lausanne, Switzerland
| | - Lucie Favre
- Consultation de prévention et traitement de l'obésité, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Aitor Fernández Menéndez
- Institute of Sport Sciences of the University of Lausanne (ISSUL), University of Lausanne, Lausanne, Switzerland
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Assessment of aerobic exercise capacity in obesity, which expression of oxygen uptake is the best? SPORTS MEDICINE AND HEALTH SCIENCE 2021; 3:138-147. [PMID: 35784518 PMCID: PMC9219259 DOI: 10.1016/j.smhs.2021.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 01/27/2021] [Accepted: 01/30/2021] [Indexed: 11/24/2022] Open
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The Role of Pain Catastrophizing and Pain Acceptance in Performance-Based and Self-Reported Physical Functioning in Individuals with Fibromyalgia and Obesity. J Pers Med 2021; 11:jpm11080810. [PMID: 34442454 PMCID: PMC8401554 DOI: 10.3390/jpm11080810] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 12/11/2022] Open
Abstract
Impaired physical functioning is one of the most critical consequences associated with fibromyalgia, especially when there is comorbid obesity. Psychological factors are known to contribute to perceived (i.e., subjective) physical functioning. However, physical function is a multidimensional concept encompassing both subjective and objective functioning. The contribution of psychological factors to performance-based (i.e., objective) functioning is unclear. This study aims to investigate the contribution of pain catastrophizing and pain acceptance to both self-reported and performance-based physical functioning. In this cross-sectional study, 160 participants completed self-report measures of pain catastrophizing, pain acceptance, and pain severity. A self-report measure and a performance-based test were used to assess physical functioning. Higher pain catastrophizing and lower pain acceptance were associated with poorer physical functioning at both self-reported and performance-based levels. Our results are consistent with previous evidence on the association between pain catastrophizing and pain acceptance with self-reported physical functioning. This study contributes to the current literature by providing novel insights into the role of psychological factors in performance-based physical functioning. Multidisciplinary interventions that address pain catastrophizing and pain acceptance are recommended and might be effective to improve both perceived and performance-based functioning in women with FM and obesity.
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Affective Responses during High-Intensity Interval Exercise Compared with Moderate-Intensity Continuous Exercise in Inactive Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105393. [PMID: 34070131 PMCID: PMC8158330 DOI: 10.3390/ijerph18105393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/06/2021] [Accepted: 05/14/2021] [Indexed: 12/14/2022]
Abstract
This study aimed to investigate the effects of an acute bout of high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) on affective responses in inactive women. Thirty women with normal body mass index (BMI) and 30 women with BMI ≥ 24 kg/m2 participated in the study. All participants completed a graded exercise test and performed two exercise sessions (HIIE and MICE) in random order. Affective responses were assessed during and after each exercise session, using the rating of perceived exertion (RPE), Self-Assessment-Manikin (SAM), and Subjective Exercise Experience Scale (SEES). The results showed that the RPE scores were significantly higher in HIIE than in MICE. HIIE resulted in significantly lower pleasure scores using the SAM while arousal and dominance scores were significantly higher with HIIE compared to MICE. Positive well-being scores using the SEES were significantly lower with HIIE and both psychological distress and fatigue scores were significantly higher with HIIE. The results showed that affective responses with MICE were more positive than with HIIE, but no differences were found between normal and overweight/obese women. Based on these results, MICE may be a more acceptable exercise program for inactive women regardless of their weight status.
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Project Step: A Randomized Controlled Trial Investigating the Effects of Frequent Feedback and Contingent Incentives on Physical Activity. J Phys Act Health 2021; 18:247-253. [PMID: 33601334 DOI: 10.1123/jpah.2020-0198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 11/02/2020] [Accepted: 11/15/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Financial incentives and feedback on behavior offer promise for promoting physical activity. However, evidence for the effect of each of these techniques is inadequate. The present study evaluated the effects of daily versus weekly feedback and incentives contingent on reaching a daily walking goal versus noncontingent incentives in a 2 × 2 trial. METHODS Participants (N = 57) had a body mass index >25 kg/m2 and were insufficiently active. Participants received a daily walking goal that adapted weekly. RESULTS Participants receiving daily feedback increased daily steps (P = .03) more than those receiving weekly feedback. Participants receiving contingent incentives did not significantly increase steps (P = .12) more than those receiving noncontingent incentives. A trend-level effect (P = .09) suggested that there may be an interaction such that the combination of daily feedback and contingent incentives is most effective. CONCLUSIONS Results indicate that feedback is an important component of remotely delivered PA interventions and that evaluating each component of low-intensity interventions may help to improve efficacy. Moreover, results indicate that possible synergistic effects of feedback and rewards should be investigated further to help optimize interventions.
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Martinez-Harvell G, Goluboff F, Rodriguez P, Castro G, Barengo NC. Predictors of adherence to physical activity guidelines in patients with diabetes mellitus in the US in 2017: An exploratory analysis. Prim Care Diabetes 2020; 14:645-653. [PMID: 32561381 DOI: 10.1016/j.pcd.2020.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/26/2020] [Accepted: 05/01/2020] [Indexed: 11/28/2022]
Abstract
AIMS To identify if there is an association between socio-economic or demographic factors, lifestyle habits, or chronic conditions and meeting the current exercise recommendations for adult patients with Diabetes Mellitus 2 in the United States. METHODS This secondary analysis of a cross sectional study used data from participants who reported having diabetes and answered questions regarding physical activity in the 2017 Behavioral Risk Factor Surveillance System survey (n=37,204; 42% women; 30%<60 years-of-age). Respondents were dichotomized according to physical activity adherence. Predictors tested included socioeconomic and demographic characteristics, lifestyle habits, and chronic conditions. Unadjusted and adjusted logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI). RESULTS Our data showed that 46.5% of participants with diabetes adhered to the physical activity guidelines. Daily smokers were 25% less likely to adhere to the physical activity recommendations (95% CI 0.59-0.95), patients with obesity were 37% less likely (95% CI 0.53-0.74), and those with chronic kidney disease were 24% (95% CI 0.61-0.94) less likely to do so. The odds of adhering to exercise guidelines were reduced by 20% (95% CI 0.70-0.92), 42% (95% CI 0.49-0.68), and 47% (95% CI 0.32-0.57) in good, fair, and poor health respectively. CONCLUSION Patients with poor health, daily smoking, obesity, or kidney disease may benefit from targeted interventions to accomplish their physical activity recommendations.
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Affiliation(s)
- Greisy Martinez-Harvell
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Florencia Goluboff
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Pura Rodriguez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; Faculty of Medicine, Riga Stradins University, Riga, Latvia; Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
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Fernández Menéndez A, Saubade M, Hans D, Millet GP, Malatesta D. The Determinants of the Preferred Walking Speed in Individuals with Obesity. Obes Facts 2019; 12:543-553. [PMID: 31505515 PMCID: PMC6876590 DOI: 10.1159/000501968] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 07/08/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The preferred walking speed (PWS), also known as the "spontaneous" or "self-selected" walking speed, is the speed normally used during daily living activities and may represent an appropriate exercise intensity for weight reduction programs aiming to enhance a more negative energy balance. OBJECTIVES The aim of this study was to examine, simultaneously, the energetics, mechanics, and perceived exertion determinants of PWS in individuals with obesity. METHODS Twenty-three adults with obesity (age 32.7 ± 6.8 years, body mass index 33.6 ± 2.6 kg/m2) were recruited. The participants performed 10 min of treadmill familiarization, and PWS was determined. Each subject performed six 5-min walking trials (PWS 0.56, 0.83, 1.11, 1.39, and 1.67 m/s). Gas exchanges were collected and analyzed to obtain the gross energy cost of walking (GCw), rated perceived exertion (RPE) was measured using a 6-20 Borg scale, and the external mechanical work (Wext) and the fraction of mechanical energy recovered by the pendular mechanism (Recovery) were computed using an instrumented treadmill. Second-order least-squares regression was used to calculate the optimal walking speed (OWS) of each variable. RESULTS No significant difference was found between PWS (1.28 ± 0.13 m/s) and OWS for GCw (1.28 ± 0.10 m/s), RPE cost of walking (1.38 ± 0.14 m/s), and Recovery (1.48 ± 0.27 m/s; p > 0.06 for all), but the PWS was significantly faster than the OWS for Wext (0.98 ± 0.56 m/s; p < 0.02). Multiple regression (r = 0.72; p = 0.003) showed that ∼52% of the variance in PWS was explained by Recovery, Wext, and height. CONCLUSION The main finding of this study was that obese adults may select their PWS in function of several competing demands, since this speed simultaneously minimizes pendular energy transduction, energy cost, and perceived exertion during walking. Moreover, recovery of mechanical work, external work, and height seem to be the major determinants of PWS in these individuals.
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Affiliation(s)
- Aitor Fernández Menéndez
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,
| | - Mathieu Saubade
- Sports Medicine Unit, Swiss Olympic Medical Center, Lausanne University Hospital, Lausanne, Switzerland
| | - Didier Hans
- Center for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Grégoire P Millet
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Davide Malatesta
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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14
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Adil MT, Jain V, Rashid F, Al-Taan O, Whitelaw D, Jambulingam P. Meta-analysis of the effect of bariatric surgery on physical function. Br J Surg 2018; 105:1107-1118. [PMID: 29893414 DOI: 10.1002/bjs.10880] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 03/11/2018] [Accepted: 03/23/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND Obesity leads to an impairment of physical function that limits the ability to perform basic physical activities affecting quality of life. Literature on the effect of bariatric surgery on physical function is confounding and generally of low quality. METHODS A comprehensive search was undertaken using MEDLINE, Scopus (including Embase), CENTRAL, PubMed, SPORTDiscus, Scirus and OpenGrey for published research and non-published studies to 31 March 2017. Studies employing objective measurement and self-reporting of physical function before and after bariatric surgery were included. The magnitude of experimental effect was calculated in terms of the standardized mean difference (MD), and confidence intervals were set at 95 per cent to reflect a significance level of 0·05. RESULTS Thirty studies including 1779 patients met the inclusion criteria. Physical function improved after bariatric surgery at 0-6 months (MD 0·90, 95 per cent c.i. 0·60 to 1·21; P < 0·001), more than 6 to 12 months (MD 1·06, 0·76 to 1·35; P < 0·001) and more than 12 to 36 months (MD 1·30, 1·07 to 1·52; P < 0·001). Objective assessment of physical function after bariatric surgery showed improvement at 0-6 months (MD 0·94, 0·57 to 1·32; P < 0·001), more than 6 to 12 months (MD 0·77, 0·15 to 1·40; P = 0·02) and more than 12 to 36 months (MD 1·04, 0·40 to 1·68; P = 0·001). Self-reported assessment of physical function showed similar improvements at 0-6 months (MD 0·80, 0·12 to 1·47; P = 0·02), more than 6 to 12 months (MD 1·42, 1·23 to 1·60; P < 0·001) and more than 12 to 36 months (MD 1·41, 1·20 to 1·61; P < 0·001) after a bariatric procedure. CONCLUSION Bariatric surgery improves physical function significantly within 6 months of the procedure and this effect persists over time to 36 months after surgery, whether measured objectively or by self-reporting.
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Affiliation(s)
- M T Adil
- Department of Upper Gastrointestinal and Bariatric Surgery, Luton and Dunstable University Hospital, Lewsey Road, Luton LU4 0DZ, UK
| | - V Jain
- Department of Upper Gastrointestinal and Bariatric Surgery, Luton and Dunstable University Hospital, Lewsey Road, Luton LU4 0DZ, UK
| | - F Rashid
- Department of Upper Gastrointestinal and Bariatric Surgery, Luton and Dunstable University Hospital, Lewsey Road, Luton LU4 0DZ, UK
| | - O Al-Taan
- Department of Upper Gastrointestinal and Bariatric Surgery, Luton and Dunstable University Hospital, Lewsey Road, Luton LU4 0DZ, UK
| | - D Whitelaw
- Department of Upper Gastrointestinal and Bariatric Surgery, Luton and Dunstable University Hospital, Lewsey Road, Luton LU4 0DZ, UK
| | - P Jambulingam
- Department of Upper Gastrointestinal and Bariatric Surgery, Luton and Dunstable University Hospital, Lewsey Road, Luton LU4 0DZ, UK
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15
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Elsangedy HM, Nascimento PHD, Machado DGS, Krinski K, Hardcastle SJ, DaSilva SG. Poorer positive affect in response to self-paced exercise among the obese. Physiol Behav 2018; 189:32-39. [PMID: 29458113 DOI: 10.1016/j.physbeh.2018.02.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 02/06/2018] [Accepted: 02/15/2018] [Indexed: 10/18/2022]
Abstract
We aimed to investigate the association between body mass index (BMI) and affective response, ratings of perceived exertion (RPE), and physiological responses during self-paced exercise. Sixty-six women were divided into three groups accordingly with the BMI: obese (n = 22: 33.5 ± 8.5 yr; 34.9 ± 4.1 kg∙m-2), overweight (n = 22: 34.8 ± 8.6 yr; 26.4 ± 1.3 kg∙m-2), and normal-weight (n = 22: 30.8 ± 9.3 yr; 22.0 ± 1.6 kg∙m-2). They underwent a graded exercise test and a 20-min self-paced walking session on a treadmill. Affective responses, RPE, heart rate (HR), and oxygen uptake (VO2) were recorded every 5 min. The women with obesity experienced the lowest affective rates (p < .001), despite similar RPE, HR, and VO2 to the other normal weight and overweight groups. In addition, a multiple regression model indicated that BMI was a significant predictor of affective responses (p < .001). In conclusion, the results of the present study suggest that obesity is associated with poorer affective responses to exercise even at self-paced intensity, with the same physiological responses and perceived exertion. Therefore, techniques that aim directly to increase pleasure and/or reduce attentional focus and perception of effort in this population are required, such as affect-regulated prescription, shorter bouts of self-paced exercise throughout the day, distraction away from internal cues (e.g. music, group exercise), etc.
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Affiliation(s)
- Hassan M Elsangedy
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
| | - Paulo H D Nascimento
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Daniel G S Machado
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Center of Physical Education and Sport, Londrina State University, Londrina, PR, Brazil
| | - Kleverton Krinski
- Department of Physical Education, Federal University of Vale do São Francisco, Petrolina, PE, Brazil; Center for Health Sciences, Northern Paraná State University, Alameda Padre Magno, 841, Jacarezinho, Paraná 86.400-000, Brazil
| | - Sarah J Hardcastle
- Health Psychology and Behavioral Medicine Research Group, School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Sérgio G DaSilva
- Department of Physical Education, Federal University of Paraná, Curitiba, PR, Brazil
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16
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Johnson RJ, Sánchez-Lozada LG, Andrews P, Lanaspa MA. Perspective: A Historical and Scientific Perspective of Sugar and Its Relation with Obesity and Diabetes. Adv Nutr 2017; 8:412-422. [PMID: 28507007 PMCID: PMC5421126 DOI: 10.3945/an.116.014654] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Fructose-containing added sugars, such as sucrose and high-fructose corn syrup, have been experimentally, epidemiologically, and clinically shown to be involved in the current epidemics of obesity and diabetes. Here we track this history of intake of sugar as it relates to these epidemics. Key experimental studies that have identified mechanisms by which fructose causes obesity and diabetes are reviewed, as well as the evidence that the uricase mutation that occurred in the mid-Miocene in ancestral humans acted as a "thrifty gene" that increases our susceptibility for fructose-associated obesity today. We briefly review recent evidence that obesity can also be induced by nondietary sources of fructose, such as from the metabolism of glucose (from high-glycemic carbohydrates) through the polyol pathway. These studies suggest that fructose-induced obesity is driven by engagement of a "fat switch" and provide novel insights into new approaches for the prevention and treatment of these important diseases.
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Affiliation(s)
- Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO;
| | | | - Peter Andrews
- Natural History Museum, London, England; and
- Department of Anthropology, University College, London, England
| | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO
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17
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Krinski K, Machado DGS, Lirani LS, DaSilva SG, Costa EC, Hardcastle SJ, Elsangedy HM. Let's Walk Outdoors! Self-Paced Walking Outdoors Improves Future Intention to Exercise in Women With Obesity. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2017; 39:145-157. [PMID: 28787251 DOI: 10.1123/jsep.2016-0220] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In order to examine whether environmental settings influence psychological and physiological responses of women with obesity during self-paced walking, 38 women performed two exercise sessions (treadmill and outdoors) for 30 min, where oxygen uptake, heart rate, ratings of perceived exertion, affect, attentional focus, enjoyment, and future intentions to walk were analyzed. Physiological responses were similar during both sessions. However, during outdoor exercise, participants displayed higher externally focused attention, positive affect, and lower ratings of perceived exertion, followed by greater enjoyment and future intention to participate in outdoor walking. The more externally focused attention predicted greater future intentions to participate in walking. Therefore, women with obesity self-selected an appropriate exercise intensity to improve fitness and health in both environmental settings. Also, self-paced outdoor walking presented improved psychological responses. Health care professionals should consider promoting outdoor forms of exercise to maximize psychological benefits and promote long-term adherence to a physically active lifestyle.
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18
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Hornbuckle LM, Kingsley JD, Kushnick MR, Moffatt RJ, Haymes EM, Miles R, Toole T, Panton LB. Effects of a 12-Month Pedometer-Based Walking Intervention in Women of Low Socioeconomic Status. CLINICAL MEDICINE INSIGHTS. WOMEN'S HEALTH 2016; 9:75-84. [PMID: 27746679 PMCID: PMC5054940 DOI: 10.4137/cmwh.s39636] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/08/2016] [Accepted: 08/10/2016] [Indexed: 11/05/2022]
Abstract
This study examined the effects of a 12-month walking intervention in overweight/obese, low socioeconomic women. Forty-six women (48.2 ± 8.0 years) entered the study. Outcomes included weight, waist and hip circumferences, body mass index (BMI), blood pressure, glycosylated hemoglobin, blood lipids, fibrinogen, and high-sensitivity C-reactive protein (hsCRP). Both intention-to-treat analyses in all participants and group analyses in study completers only (3K group = increased steps/day by ≥3,000; No Δ group = did not increase steps/day by ≥3,000) were conducted. Group × time ANOVA was used. In study completers, 3K significantly increased steps/day (6,903 ± 3,328 to 12,323 ± 5,736) compared to No Δ (4,926 ± 3,374 to 5,174 ± 3,095) from baseline to 12 months. There was a significant time effect for weight (P = 0.030), BMI (P = 0.029), and hsCRP (P = 0.044). Low socioeconomic women who adhere to a long-term, pedometer-based walking intervention significantly increased steps/day and may improve body weight, BMI, and hsCRP. This could help reduce health disparities in this population over time.
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Affiliation(s)
- Lyndsey M Hornbuckle
- Assistant Professor, Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN, USA
| | - J Derek Kingsley
- Assistant Professor, School of Health Sciences, Kent State University, Kent, OH, USA
| | - Michael R Kushnick
- Associate Professor, School of Applied Health Sciences and Wellness, Ohio University, Athens, OH, USA
| | - Robert J Moffatt
- Professor, Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
| | - Emily M Haymes
- Professor Emerita, Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
| | - Rebecca Miles
- Professor, Department of Urban and Regional Planning, Florida State University, Tallahassee, FL, USA
| | - Tonya Toole
- Professor Emerita, Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
| | - Lynn B Panton
- Professor, Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA.; Florida State University Institute for Longevity, Tallahassee, FL, USA
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19
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Marcora S. Can Doping be a Good Thing? Using Psychoactive Drugs to Facilitate Physical Activity Behaviour. Sports Med 2016; 46:1-5. [PMID: 26497149 DOI: 10.1007/s40279-015-0412-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Samuele Marcora
- School of Sport and Exercise Sciences, University of Kent, Chatham, UK.
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20
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Brown BB, Werner CM, Smith KR, Tribby CP, Miller HJ, Jensen WA, Tharp D. Environmental, behavioral, and psychological predictors of transit ridership: Evidence from a community intervention. JOURNAL OF ENVIRONMENTAL PSYCHOLOGY 2016; 46:188-196. [PMID: 27672237 PMCID: PMC5034941 DOI: 10.1016/j.jenvp.2016.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Understanding who takes advantage of new transit (public transportation) interventions is important for personal and environmental health. We examine transit ridership for residents living near a new light rail construction as part of "complete street," pedestrian-friendly improvements. Adult residents (n=536) completed surveys and wore accelerometer and GPS units that tracked ridership before and after new transit service started. Transit riders were more physically active. Those from environments rated as more walkable were likely to be continuing transit riders. Place attachment, but not perceived physical incivilities on the path to transit, was associated with those who continued to ride or became new riders of transit. This effect was mediated through pro-city attitudes, which emphasize how the new service makes residents eager to explore areas around transit. Thus, place attachment, along with physical and health conditions, may be important predictors and promoters of transit use.
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Affiliation(s)
- Barbara B. Brown
- Department of Family and Consumer Studies; Cancer Control and Population Sciences, Huntsman Cancer Institute, 225 S 1400 E RM 228, University of Utah, Salt Lake City, UT
| | - Carol M. Werner
- Department of Psychology, 380 S. 1530 E., RM 502 BSB, University of Utah, Salt Lake City, UT
| | - Ken R. Smith
- Department of Family and Consumer Studies; Cancer Control and Population Sciences, Huntsman Cancer Institute, 225 S 1400 E RM 228, University of Utah, Salt Lake City, UT
| | - Calvin P. Tribby
- Department of Geography; Ohio State University, 1036 Derby Hall, 154 N. Oval Mall, The Ohio State University, Columbus, OH, USA
| | - Harvey J. Miller
- Department of Geography; Ohio State University, 1036 Derby Hall, 154 N. Oval Mall, The Ohio State University, Columbus, OH, USA
| | - Wyatt A. Jensen
- Department of Family and Consumer Studies; 225 S 1400 E RM 228, University of Utah, Salt Lake City, UT
| | - Doug Tharp
- Department of Family and Consumer Studies; 225 S 1400 E RM 228, University of Utah, Salt Lake City, UT
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21
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Evans RA, Dolmage TE, Robles PG, Brooks D, Goldstein RS. The effects of exercise modality and intensity on energy expenditure and cardiorespiratory response in adults with obesity and treated obstructive sleep apnoea. Chron Respir Dis 2016; 14:342-351. [PMID: 27075360 DOI: 10.1177/1479972316643699] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
To inform recommendations for the exercise component of a healthy lifestyle intervention for adults with obesity and treated obstructive sleep apnoea (OSA), we investigated the total energy expenditure (EE) and cardiorespiratory response to weight-supported (cycling) and unsupported (walking) exercise. Individuals with treated OSA and a body mass index (BMI) > 30 kg/m2 performed an incremental cardiopulmonary exercise test on a cycle ergometer and a treadmill to determine the peak oxygen uptake [Formula: see text]. Participants subsequently completed two endurance tests on each modality, matched at 80% and 60% of the highest [Formula: see text] determined by the incremental tests, to intolerance. The cardiorespiratory response was measured and total EE was estimated from the [Formula: see text]. Sixteen participants completed all six tests: mean [SD] age 57 [13] years and median [IQ range] BMI 33.3 [30.8-35.3] kg/m2. Total EE during treadmill walking was greater than cycling at both high (158 [101] vs. 29 [15] kcal; p < 0.001) and moderate (178 [100] vs. 85 [59] kcal; p = 0.002) intensities, respectively, with similar cardiorespiratory responses and pattern of EE during rest, exercise and recovery. Contrary to current guidelines, walking might be the preferred training modality to achieve the combination of weight loss and increased cardiorespiratory fitness in adults with obesity and treated OSA.
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Affiliation(s)
- Rachael A Evans
- 1 Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.,2 Department of Infection, immunity and Inflammation, University of Leicester, Leicester, UK.,3 Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Thomas E Dolmage
- 1 Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.,4 Department of Respiratory Diagnostic and Evaluation Services, West Park Healthcare Centre, Toronto, Canada
| | - Priscila G Robles
- 1 Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.,5 Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Dina Brooks
- 1 Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.,5 Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Roger S Goldstein
- 1 Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.,3 Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,4 Department of Respiratory Diagnostic and Evaluation Services, West Park Healthcare Centre, Toronto, Canada.,5 Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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22
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Marinac CR, Godbole S, Kerr J, Natarajan L, Patterson RE, Hartman SJ. Objectively measured physical activity and cognitive functioning in breast cancer survivors. J Cancer Surviv 2015; 9:230-8. [PMID: 25304986 PMCID: PMC4393781 DOI: 10.1007/s11764-014-0404-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 09/19/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to explore the relationship between objectively measured physical activity and cognitive functioning in breast cancer survivors. METHODS Participants were 136 postmenopausal breast cancer survivors. Cognitive functioning was assessed using a comprehensive computerized neuropsychological test. Seven-day physical activity was assessed using hip-worn accelerometers. Linear regression models examined associations of minutes per day of physical activity at various intensities on individual cognitive functioning domains. The partially adjusted model controlled for primary confounders (model 1), and subsequent adjustments were made for chemotherapy history (model 2) and body mass index (BMI) (model 3). Interaction and stratified models examined BMI as an effect modifier. RESULTS Moderate-to-vigorous physical activity (MVPA) was associated with information processing speed. Specifically, 10 min of MVPA was associated with a 1.35-point higher score (out of 100) on the information processing speed domain in the partially adjusted model and a 1.29-point higher score when chemotherapy was added to the model (both p < 0.05). There was a significant BMI × MVPA interaction (p = 0.051). In models stratified by BMI (<25 vs. ≥25 kg/m(2)), the favorable association between MVPA and information processing speed was stronger in the subsample of overweight and obese women (p < 0.05) but not statistically significant in the leaner subsample. Light-intensity physical activity was not significantly associated with any of the measured domains of cognitive function. CONCLUSIONS MVPA may have favorable effects on information processing speed in breast cancer survivors, particularly among overweight or obese women. IMPLICATIONS FOR CANCER SURVIVORS Interventions targeting increased physical activity may enhance aspects of cognitive function among breast cancer survivors.
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Affiliation(s)
- Catherine R. Marinac
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Suneeta Godbole
- Department of Family & Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Jacqueline Kerr
- Department of Family & Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Loki Natarajan
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
- Department of Family & Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Ruth E. Patterson
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
- Department of Family & Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Sheri J. Hartman
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
- Department of Family & Preventive Medicine, University of California, San Diego, La Jolla, CA
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23
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Williams DM, Dunsiger S, Miranda R, Gwaltney CJ, Emerson JA, Monti PM, Parisi AF. Recommending self-paced exercise among overweight and obese adults: a randomized pilot study. Ann Behav Med 2015; 49:280-5. [PMID: 25223963 PMCID: PMC4355095 DOI: 10.1007/s12160-014-9642-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND National guidelines call for exercise of at least moderate intensity; however, recommending self-paced exercise may lead to better adherence, particularly among overweight and obese adults. PURPOSE The purpose of this study was to test proof-of-concept for recommending self-paced exercise among overweight adults. METHODS Fifty-nine healthy, low-active (exercise <60 min/week), overweight (body mass index 25.0-39.9) adults (18-65) received a 6-month print-based exercise promotion program with the goal of walking 30-60 min/day. Participants were surreptitiously randomly assigned to receive a recommendation for either self-paced (n = 30) or moderate (64-76 % maximum heart rate; n = 29) intensity exercise. All participants used electronic diaries and heart rate monitors to track exercise frequency, duration, and intensity. RESULTS The self-paced condition reported more minutes/week of walking (f (2) = 0.17, p = 0.045) and a trend toward greater exercise-related energy expenditure/week (f (2) = 0.12, p = 0.243), corresponding to approximately 26 additional minutes/week and 83 additional kilocalories/week over 6 months. CONCLUSIONS Explicit recommendation for self-paced exercise may improve adherence to exercise programs among overweight and obese adults.
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Affiliation(s)
- David M Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA,
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Steele T, Cuthbertson DJ, Wilding JPH. Impact of bariatric surgery on physical functioning in obese adults. Obes Rev 2015; 16:248-58. [PMID: 25580667 DOI: 10.1111/obr.12247] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 11/14/2014] [Accepted: 12/01/2014] [Indexed: 01/17/2023]
Abstract
Obesity is associated with a profound impairment in the ability to perform the basic physical activities required for everyday function. This impacts on quality of life and contributes to disability. Bariatric surgery leads to weight loss and metabolic improvements in severe obesity; however, less is known about its effect on physical functioning. This narrative review summarizes current evidence on the effect of bariatric surgery on this outcome with a consideration of the mechanisms involved. Nine longitudinal observational studies reporting objective measures of physical functioning were identified. Inclusion criteria, follow-up time and outcomes reported varied considerably between studies and sample sizes were small. They all showed a significant improvement in performance following surgery despite variations in baseline patient characteristics. Additionally, six studies were found in which subjects were subjected to exercise testing protocols. Performance of the test protocol improved in all. Where reported, peak oxygen uptake related to body weight improved; however, absolute values were either unchanged or decreased. In conclusion, observational evidence suggests that patients' physical functioning improves following bariatric surgery. More evidence is required regarding mechanisms involved; however, it may be due to improved efficiency in performing activities as opposed to absolute improvements in cardiorespiratory or muscle function.
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Affiliation(s)
- T Steele
- Department of Obesity and Endocrinology, Clinical Sciences Centre, Aintree University Hospital NHS Foundation Trust, University of Liverpool, Liverpool, UK
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Pouwels S, Wit M, Teijink JA, Nienhuijs SW. Aspects of Exercise before or after Bariatric Surgery: A Systematic Review. Obes Facts 2015; 8:132-46. [PMID: 25895670 PMCID: PMC5644796 DOI: 10.1159/000381201] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 12/05/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Bariatric surgery has a considerable effect on weight loss. A positive relation of exercise and weight loss has been described before. However, the mode of exercise and its timing pre- or postoperatively or a combination remains unclear. METHODS A multi-database search was conducted. Identified articles were reviewed on description of exercise, timing around a bariatric intervention, and outcome. Methodological quality of the included studies was rated using the Physiotherapy Evidence Database scale. A Cohen’s kappa score assessed the level of agreement. Outcome measurements were improvement of anthropometric and physical fitness variables, operation related complications, weight regain, and quality of life. RESULTS A total of 8 prospective studies were included. Four focused on training before and 4 on training after a bariatric procedure. Details of exercises varied from 45 min treadmill up to full descriptive programs. Supervision was frequently included. Significant improvement was encountered for biometric results physical fitness variables. CONCLUSION In the majority of reports on exercising in a (future) bariatric population, positive effects on anthropometrics, cardiovascular risk factors and physical fitness were described. However, the results were not unanimous, with a wide range of exercise programs and perioperative timing, therefore hampering adequate practical guidance.
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Affiliation(s)
- Sjaak Pouwels
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
- Department of Epidemiology, CAPHRI Research School, Maastricht University, Maastricht, the Netherlands
| | - Marjon Wit
- Department of Physiotherapy, Catharina Hospital, Eindhoven, the Netherlands
| | - Joep A.W. Teijink
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
- Department of Epidemiology, CAPHRI Research School, Maastricht University, Maastricht, the Netherlands
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Physical activity monitoring in extremely obese adolescents from the Teen-LABORATORIES study. J Phys Act Health 2014; 12:132-8. [PMID: 25205688 DOI: 10.1123/jpah.2013-0006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The accuracy of physical activity (PA) monitors to discriminate between PA, sedentary behavior, and nonwear in extremely obese (EO) adolescents is unknown. METHODS Twenty-five subjects (9 male/16 female; age = 16.5 ± 2.0 y; BMI = 51 ± 8 kg/m2) wore 3 activity monitors (StepWatch [SAM], Actical [AC], Actiheart [AH]) during a 400-m walk test (400MWT), 2 standardized PA bouts of varying duration, and 1 sedentary bout. RESULTS For the 400MWT, percent error between observed and monitor-recorded steps was 5.5 ± 7.1% and 82.1 ± 38.6% for the SAM and AC steps, respectively (observed vs. SAM steps: -17.2 ± 22.2 steps; observed vs. AC steps: -264.5 ± 124.8 steps). All activity monitors were able to differentiate between PA and sedentary bouts, but only SAM steps and AH heart rate were significantly different between sedentary behavior and nonwear (P < .001). For all monitors, sedentary behavior was characterized by bouts of zero steps/counts punctuated by intermittent activity steps/counts; nonwear was represented almost exclusively by zero steps/counts. CONCLUSION Of all monitors tested, the SAM was most accurate in terms of counting steps and differentiating levels of PA and thus, most appropriate for EO adolescents. The ability to accurately characterize PA intensity in EO adolescents critically depends on activity monitor selection.
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Coriolano K, Aiken A, Pukall C, Harrison M. Changes in self-reported disability after performance-based tests in obese and non-obese individuals diagnosed with osteoarthritis of the knee. Disabil Rehabil 2014; 37:1152-61. [PMID: 25176000 DOI: 10.3109/09638288.2014.956813] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The purposes of this study are three-fold: (1) To examine whether the WOMAC questionnaire should be obtained before or after performance-based tests. (2) To assess whether self-reported disability scores before and after performance-based tests differ between obese and non-obese individuals. (3) To observe whether physical activity and BMI predict self-reported disability before and after performance based tests. METHODS A longitudinal study included thirty one participants diagnosed with knee osteoarthritis (OA) using the Kellgren-Lawrence Scale by an orthopedic surgeon. RESULTS All WOMAC scores were significantly higher after as compared to before the completion of performance-based tests. This pattern of results suggested that the WOMAC questionnaire should be administered to individuals with OA after performance-based tests. The obese OA was significantly different compared to the non-obese OA group on all WOMAC scores. Physical activity and BMI explained a significant proportion of variance of self-reported disability. CONCLUSION Obese individuals with knee OA may over-estimate their ability to perform physical activities, and may under-estimate their level of disability compared to non-obese individuals with knee OA. In addition, self-reported physical activity seems to be a strong indicator of disability in individuals with knee OA, particularly for individuals with a sedentary life style. Implications for Rehabilitation Osteoarthritis is a progressive joint disabling condition that restricts physical function and participation in daily activities, particularity in elderly individuals. Obesity is a comorbidity commonly associated with osteoarthritis and it appears to increase self-reported disability in those diagnosed with osteoarthritis of the knee. In a relatively small sample, this study recommends that rehabilitation professionals obtain self-report questionnaires of disability after performance-based tests in obese individuals with osteoarthritis of the knee as they are more likely to give an accurate representation of their level of ability at this time.
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Affiliation(s)
- Kamary Coriolano
- School of Rehabilitation Therapy, Queen's University , Kingston ON , Canada
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Hemmingsson E. A new model of the role of psychological and emotional distress in promoting obesity: conceptual review with implications for treatment and prevention. Obes Rev 2014; 15:769-79. [PMID: 24931366 DOI: 10.1111/obr.12197] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/12/2014] [Accepted: 05/12/2014] [Indexed: 11/29/2022]
Abstract
The lack of significant treatment and prevention progress highlights the need for a more expanded strategy. Given the robust association between socioeconomic factors and obesity, combined with new insights into how socioeconomic disadvantage affects both behaviour and biology, a new causal model is proposed. The model posits that psychological and emotional distress is a fundamental link between socioeconomic disadvantage and weight gain. At particular risk are children growing up in a disharmonious family environment, mainly caused by parental socioeconomic disadvantage, where they are exposed to parental frustrations, relationship discord, a lack of support and cohesion, negative belief systems, unmet emotional needs and general insecurity. Without adequate resilience, such experiences increase the risk of psychological and emotional distress, including low self-esteem and self-worth, negative emotions, negative self-belief, powerlessness, depression, anxiety, insecurity and a heightened sensitivity to stress. These inner disturbances eventually cause a psycho-emotional overload, triggering a cascade of weight gain-inducing effects including maladaptive coping strategies such as eating to suppress negative emotions, chronic stress, appetite up-regulation, low-grade inflammation and possibly reduced basal metabolism. Over time, this causes obesity, circular causality and further weight gain. Tackling these proposed root causes of weight gain could potentially improve both treatment and prevention outcomes.
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Affiliation(s)
- E Hemmingsson
- Obesity Center, Karolinska University Hospital, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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Poirier P, Martin J, Marceau P, Biron S, Marceau S. Impact of bariatric surgery on cardiac structure, function and clinical manifestations in morbid obesity. Expert Rev Cardiovasc Ther 2014; 2:193-201. [PMID: 15151468 DOI: 10.1586/14779072.2.2.193] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Obesity results from the excessive accumulation of fat. Risk of premature death is doubled compared to nonobese individuals, and risk of death from cardiovascular disease is increased fivefold. In patients with morbid obesity, a variety of adaptations and alterations in cardiac structure and function occur in the individual, as an excess amount of adipose tissue accumulates. The high long-term failure rate of diet intervention is well acknowledged by the clinician. Surgery for severe obesity has evolved during the last 40 years. Many surgical techniques have been described and abandoned. Nevertheless, numerous different techniques are still in use today. Weight loss has beneficial impacts on functional and structural cardiac status and will be reviewed in this report.
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Affiliation(s)
- Paul Poirier
- Department of Cardiology, Institut Universitaire de Cardiologie et de Pneumologie, Laval Hospital, 2725 Chemin Sainte-Foy, Sainte-Foy, Québec, G1V 4G5, Canada.
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Lafortuna CL, Prinelli F, Adorni F, Agosti F, De Col A, Sartorio A. Effect of mechanical and metabolic factors on motor function and fatigue in obese men and women: a cross-sectional study. J Endocrinol Invest 2013; 36:1062-8. [PMID: 23888331 DOI: 10.3275/9064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Mechanical overload and poor quality of contractile elements related to metabolic abnormalities concur to motor disability of obesity. The independent contribution of these factors to motor dysfunction in obese individuals is scarcely defined. AIM Aim of the study is to test the hypothesis that metabolic factors may independently affect motor function in obesity. METHODS Leg maximum power output per unit body mass (W Mb), per unit fat-free mas (W FFM) and fatigue in daily functioning were assessed in 635 obese [body mass index (BMI)≥ 35 kg/m(2)] individuals (286 men, 349 women) aged 19-78 yr. The independent effects of age, BMI, insulin resistance and the five components of the metabolic syndrome on W Mb, W FFM and fatigue were evaluated by multivariate analysis. RESULTS A multiple regression analysis revealed that in both genders W Mb (denoting the individual's performance capability during anaerobic tasks) was independently reduced by age (p<0.001), BMI (p<0.05-0.001) and abnormalities of glucose metabolism (p<0.06-0.01), while W FFM (representing the muscle intrinsic anaerobic capability) was affected only by age (p<0.001) and glucose metabolism impairment (p<0.06-0.01). In both genders fatigue was increased by age (p<0.001) and BMI (p<0.05-0.01), but augmented by low levels of HDL-cholesterol in men only (p<0.05). CONCLUSIONS Besides depending on mechanical overload and age, low muscle power output in obese individuals was independently associated also with metabolic abnormalities related to impaired glucose homeostasis. Fatigue and performance, although similarly influenced by age and body mass excess, are affected by different metabolic factors.
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Affiliation(s)
- C L Lafortuna
- Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Via Cervi 93, I-20090 Segrate, Milano, Italy.
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Sheehan K, Gormley J. Gait and increased body weight (potential implications for musculoskeletal disease). PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x11y.0000000057] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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da Silva-Hamu TCD, Formiga CKMR, Gervásio FM, Ribeiro DM, Christofoletti G, de França Barros J. The impact of obesity in the kinematic parameters of gait in young women. Int J Gen Med 2013; 6:507-13. [PMID: 23837005 PMCID: PMC3699163 DOI: 10.2147/ijgm.s44768] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background The prevalence of obesity is increasing in the population, particularly in women. Obesity has an impact on the musculoskeletal system, leading to knee and ankle overexertion, difficulty with balance, and functional disability. The aim of this study was to identify changes in kinematic parameters of gait in obese young women. Methods A case-control study with 24 obese women (mean age 35.20 ± 9.9 years and mean body mass index of 31.85 ± 2.94 kg/m2) and 24 eutrophic women (mean age of 36.33 ± 11.14 and mean body mass index of 21.82 ± 1.58 kg/m2). The gait of women was evaluated by the system Vicon Motus® 9.2. The linear parameters of speed, cadence, right and left step, and stride lengths were studied, as well as the angular parameters of knee and ankle. Results There was a decrease in linear gait parameters (P < 0.001), speed, cadence, right and left step, and stride lengths. In regard to the angular parameters of the knee and ankle, there were also differences between the analyses (P < 0.001). At the knee joint, obese women have delayed onset of the second wave of flexion, exacerbating such movement in order to compensate. In regard to the ankle, both groups showed curves of normal plantar flexion and dorsiflexion, but there was a delay in the path graph in the ankle of obese women indicating a reduced range of motion and possible over-exertion of the pretibial muscles and soleus muscles simultaneously. Conclusion The results of this study revealed that obesity is a factor that negatively influences the kinematic parameters of gait of young women.
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Sheehan KJ, Gormley J. The influence of excess body mass on adult gait. Clin Biomech (Bristol, Avon) 2013; 28:337-43. [PMID: 23380662 DOI: 10.1016/j.clinbiomech.2013.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 01/04/2013] [Accepted: 01/08/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aimed to assess the presentation of gait for adults who are overweight, independent of the confounding influence of velocity. METHODS Cross sectional study design. Twenty-five adults of a healthy weight were matched by age, gender, height and velocity to twenty-five adults who were overweight. Participants traversed a 10m walkway embedded with 2 AMTI force platforms (AMTI BP400600 Force Platforms: Advanced Mechanical Technologies, Inc., Watertown, MA, USA) and running between 2 CODA Dual CX1 sensors (CODA CX1: Charnwood Dynamics, Barrow on Soar, Leicestershire, England). Temporal-spatial parameters, maximum ground reaction forces, maximum joint powers, and three dimensional kinematic and kinetic parameters at the 7 events of the gait cycle were assessed. FINDINGS With velocity accounted for, relatively few changes in the presentation of gait were seen for adults who were overweight. Alterations included increased stance phase duration, hip flexion, knee flexion, hip abduction, and knee varus for overweight adults. A reduction in hip abductor moment normalised for body mass was noted for overweight adults. Absolute maximum ground reaction forces were increased while maximum hip power absorption was reduced for overweight adults. INTERPRETATION Changes were seen at the hip and knee during the swing phase of gait. During swing there is a stronger association with soft tissue injury as compared to joint injury. Overweight individuals were seen to adopt few alterations during the stance phase to accommodate for the increased absolute ground reaction forces. As a result the joint surfaces of overweight adults are exposed to increased loading.
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Affiliation(s)
- Katie Jane Sheehan
- Discipline of Physiotherapy, School of Medicine University of Dublin, Trinity College Dublin, Ireland.
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Browning RC, Reynolds MM, Board WJ, Walters KA, Reiser RF. Obesity does not impair walking economy across a range of speeds and grades. J Appl Physiol (1985) 2013; 114:1125-31. [PMID: 23412900 DOI: 10.1152/japplphysiol.00765.2012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Despite the popularity of walking as a form of physical activity for obese individuals, relatively little is known about how obesity affects the metabolic rate, economy, and underlying mechanical energetics of walking across a range of speeds and grades. The purpose of this study was to quantify metabolic rate, stride kinematics, and external mechanical work during level and gradient walking in obese and nonobese adults. Thirty-two obese [18 women, mass = 102.1 (15.6) kg, BMI = 33.9 (3.6) kg/m(2); mean (SD)] and 19 nonobese [10 women, mass = 64.4 (10.6) kg, BMI = 21.6 (2.0) kg/m(2)] volunteers participated in this study. We measured oxygen consumption, ground reaction forces, and lower extremity kinematics while subjects walked on a dual-belt force-measuring treadmill at 11 speeds/grades (0.50-1.75 m/s, -3° to +9°). We calculated metabolic rate, stride kinematics, and external work. Net metabolic rate (Ė net/kg, W/kg) increased with speed or grade across all individuals. Surprisingly and in contrast with previous studies, Ė net/kg was 0-6% less in obese compared with nonobese adults (P = 0.013). External work, although a primary determinant of Ė net/kg, was not affected by obesity across the range of speeds/grades used in this study. We also developed new prediction equations to estimate oxygen consumption and Ė net/kg and found that Ė net/kg was positively related to relative leg mass and step width and negatively related to double support duration. These results suggest that obesity does not impair walking economy across a range of walking speeds and grades.
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Affiliation(s)
- Raymond C Browning
- Department of Health and Exercise Science, Colorado State University, Ft. Collins, Colorado 80523-1582, USA.
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Browning RC, Kram R. Energetic Cost and Preferred Speed of Walking in Obese vs. Normal Weight Women. ACTA ACUST UNITED AC 2012; 13:891-9. [PMID: 15919843 DOI: 10.1038/oby.2005.103] [Citation(s) in RCA: 141] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We tested the hypotheses that walking is more expensive for obese women, and they prefer slower walking speeds that minimize the gross energy cost per distance despite a greater relative aerobic effort [percent of maximal oxygen uptake (Vo(2max))/kg]. RESEARCH METHODS AND PROCEDURES Twenty adult women, 10 obese (BMI = 34.1 +/- 3.2 kg/m(2)) and 10 normal weight (BMI = 20.4 +/- 2.1 kg/m(2)) volunteered. To determine the metabolic rate and energy cost per distance vs. speed relationships, we measured Vo(2) and V(CO(2)) while subjects walked on a treadmill at six speeds (0.50, 0.75, 1.0, 1.25, 1.5, and 1.75 m/s; 5-minute trials, with a 5-minute rest period between trials). We measured preferred walking speed on a 50-m section of level sidewalk and Vo(2max) using a modified Balke treadmill protocol. RESULTS Walking was 11% more expensive for the obese subjects, but they preferred to walk at similar speeds as normal weight subjects (1.40 vs. 1.47 m/s, p = 0.07). Both groups preferred walking speeds at which their gross energy cost per distance was almost minimized. Obese subjects had a smaller Vo(2max)/kg, so they required a greater relative aerobic effort at the preferred speed (51% vs. 36%, p = 0.001). DISCUSSION Obese women preferred a walking speed that minimized energy cost per distance, even though this strategy required a greater relative aerobic effort than walking more slowly. Our results suggest that walking slower for a set distance may be an appropriate exercise recommendation for a weight management prescription in obese adults.
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Affiliation(s)
- Raymond C Browning
- Department of Integrative Physiology, 354 UCB, University of Colorado, Boulder, CO 80309, USA.
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King WC, Hsu JY, Belle SH, Courcoulas AP, Eid GM, Flum DR, Mitchell JE, Pender JR, Smith MD, Steffen KJ, Wolfe BM. Pre- to postoperative changes in physical activity: report from the longitudinal assessment of bariatric surgery-2 (LABS-2). Surg Obes Relat Dis 2012; 8:522-32. [PMID: 21944951 PMCID: PMC3248952 DOI: 10.1016/j.soard.2011.07.018] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 06/30/2011] [Accepted: 07/28/2011] [Indexed: 11/22/2022]
Abstract
BACKGROUND Numerous studies have reported that bariatric surgery patients report more physical activity (PA) after surgery than before; however, the quality of the PA assessment has been questionable. METHODS The longitudinal assessment of bariatric surgery-2 is a 10-center longitudinal study of adults undergoing bariatric surgery. Of 2458 participants, 455 were given an activity monitor, which records the steps per minute, and an exercise diary before and 1 year after surgery. The mean number of steps/d, active min/d, and high-cadence min/wk were calculated for 310 participants who wore the monitor ≥10 hr/d for ≥3 days at both evaluations. Pre- and postoperative PA were compared for differences using the Wilcoxon signed-rank test. Generalized estimating equations were used to identify independent preoperative predictors of postoperative PA. RESULTS PA increased significantly (P < .0001) from before to after surgery for all PA measures. The median values before and after surgery were 7563 and 8788 steps/d, 309 and 340 active min/d, and 72 and 112 high-cadence min/wk, respectively. However, depending on the PA measure, 24-29% of participants were ≥5% less active postoperatively than preoperatively. Controlling for surgical procedure, gender, age, and body mass index, more PA preoperatively independently predicted for more PA postoperatively (P < .0001, for all PA measures). Less pain, not having asthma, and the self-report of increasing PA as a weight loss strategy preoperatively also independently predicted for more high-cadence min/wk postoperatively (P < .05). CONCLUSIONS The majority of adults increase their PA level after bariatric surgery. However, most remain insufficiently active, and some become less active. Increasing PA, addressing pain, and treating asthma before surgery might have a positive effect on postoperative PA.
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Affiliation(s)
- Wendy C King
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
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Dynamic Relations Between Sedentary Behavior, Physical Activity, and Body Composition After Bariatric Surgery. Obes Surg 2012; 22:1251-6. [DOI: 10.1007/s11695-012-0619-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Ybarra J, Romeo JH, Férnandez S, Sanchez-Hernandez J. The influence of obesity duration on left ventricular mass, volume and function: A pilot study. Health (London) 2012. [DOI: 10.4236/health.2012.412a205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Deusinger SS. Exercise intervention for management of obesity. Pediatr Blood Cancer 2012; 58:135-9. [PMID: 22009641 DOI: 10.1002/pbc.23368] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 09/06/2011] [Indexed: 12/30/2022]
Abstract
Obesity touches the lives of most Americans regardless of age. In adults, accrual of co-morbidities, including frank disability, impacts health in ways that mandate aggressive public health action. In children, the rising prevalence of overweight and obesity raises serious prospective concerns for life as these children enter adulthood. Action is imperative to provide medical interventions and preventive strategies to reduce the threat this condition poses to future generations. Obesity primarily results from an energy regulation imbalance within the body; understanding its origin and effects requires considering both the intake (via eating) and output (via moving) of energy. This article focuses on how exercise and physical activity (i.e., energy output) can influence the primary condition of obesity and its health sequelae. Components, strategies, and expected outcomes of exercise and lifestyle activity are addressed. Successful long-term participation in daily movement requires matching exercise regimens and physical activity outlets to individual preferences and environmental conditions. Activity habits of Americans must change at home and in the workplace, schools and the community to positively influence health. Although the goals of Healthy People 2010 to reduce sedentary behavior have not been met, success of other public health interventions (e.g., immunizations, use of bicycle helmets) suggests that social change to alter activity habits can be achieved. Failure to reach our public health goals should serve as a catalyst for broad-based action to help children, adolescents, and adults attain and maintain behaviors that reduce the risk of obesity and its health insults.
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Affiliation(s)
- Susan S Deusinger
- Washington University School of Medicine, St. Louis, Missouri 63108, USA.
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Hall CW, Holmstrup ME, Koloseus J, Anderson D, Kanaley JA. Do overweight and obese individuals select a "moderate intensity" workload when asked to do so? J Obes 2012; 2012:919051. [PMID: 22655176 PMCID: PMC3359713 DOI: 10.1155/2012/919051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 12/15/2011] [Accepted: 02/27/2012] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was (1) to determine if overweight/obese individuals (age 26-50 y) would self-select moderate exercise intensity when asked to do so and (2) to determine how this self-selected workload compared to exercising at a workload (60% peak aerobic capacity) that is known to provide cardioprotective health benefits. Oxygen consumption (VO(2)) and energy expenditure were measured in 33 men/women (BMI ≥ 27 kg/m(2)) who completed two 30 min walking bouts: (1) self-selected walking pace on an indoor track and (2) prescribed exercise pace (60% VO(2) peak) on a treadmill. The data revealed that (1) the prescribed intensity was 6% higher than the self-selected pace and elicited a higher energy expenditure (P < 0.05) than the self-selected pace (+83 kJ); (2) overweight subjects walked at a slightly lower percentage of VO(2) peak than the obese subjects (P < 0.05); (3) men walked at a lower percentage of VO(2) peak than the women (P < 0.05). In conclusion when asked to walk at a moderate intensity, overweight/obese individuals tended to select a lower workload in the "moderate intensity" range which could be maintained for 30 min; however, a higher intensity which would be more cardioprotective could not be maintained for 30 min by most individuals.
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Affiliation(s)
- Cameron W. Hall
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | | | - Jay Koloseus
- Department of Exercise Science, Syracuse University, Syracuse, NY 13244, USA
| | - Daniel Anderson
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Jill A. Kanaley
- Department of Exercise Science, Syracuse University, Syracuse, NY 13244, USA
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
- *Jill A. Kanaley:
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da Silva SG, Elsangedy HM, Krinski K, de Campos W, Buzzachera CF, Krause MP, Goss FL, Robertson RJ. Effect of Body Mass Index on Affect at Intensities Spanning the Ventilatory Threshold. Percept Mot Skills 2011; 113:575-88. [DOI: 10.2466/06.09.15.pms.113.5.575-588] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to compare acute affective responses at exercise intensities based on the ventilatory threshold between normal weight, overweight, and obese women. 66 sedentary women (22 in each Body Mass Index group) performed a maximal graded treadmill test to measure their maximal oxygen uptake and ventilatory thresholds. Affective valence was compared at intensities spanning the ventilatory threshold (below, at, and above threshold). Affective valence below ventilatory threshold did not differ among the Body Mass Index groups. The obese group had a lower affective response at ventilatory threshold and above ventilatory threshold than the normal weight and overweight groups; the latter two groups did not differ. The obese group had a lower affective response than the normal and overweight groups, which corresponds to a less pleasant experience. Exercise prescriptions for obese subjects targeting intensities below ventilatory threshold can provide a more pleasant experience and may facilitate exercise adherence.
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Affiliation(s)
| | | | | | | | - Cosme F. Buzzachera
- Rome University Institute of Motor Sciences, Italian University of Sport and Movement
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Hortobágyi T, Herring C, Pories WJ, Rider P, Devita P. Massive weight loss-induced mechanical plasticity in obese gait. J Appl Physiol (1985) 2011; 111:1391-9. [PMID: 21852410 DOI: 10.1152/japplphysiol.00291.2011] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We examined the hypothesis that metabolic surgery-induced massive weight loss causes mass-driven and behavioral adaptations in the kinematics and kinetics of obese gait. Gait analyses were performed at three time points over ∼1 yr in initially morbidly obese (mass: 125.7 kg; body mass index: 43.2 kg/m(2)) but otherwise healthy adults. Ten obese adults lost 27.1% ± 5.1 (34.0 ± 9.4 kg) weight by the first follow-up at 7.0 mo (±0.7) and 6.5 ± 4.2% (8.2 ± 6.0 kg) more by the second follow-up at 12.8 mo (±0.9), with a total weight loss of 33.6 ± 8.1% (42.2 ± 14.1 kg; P = 0.001). Subjects walked at a self-selected and a standard 1.5 m/s speed at the three time points and were also compared with an age- and gender-matched comparison group at the second follow-up. Weight loss increased swing time, stride length, gait speed, hip range of motion, maximal knee flexion, and ankle plantarflexion. Weight loss of 27% led to 3.9% increase in gait speed. An additional 6.5% weight loss led to an additional 7.3% increase in gait speed. Sagittal plane normalized knee torque increased and absolute ankle and frontal plane knee torques decreased after weight loss. We conclude that large weight loss produced mechanical plasticity by modifying ankle and knee torques and gait behavior. There may be a weight loss threshold of 30 kg limiting changes in gait kinematics. Implications for exercise prescription are also discussed.
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Affiliation(s)
- Tibor Hortobágyi
- Department of Exercise and Sport Science, East CarolinaUniversity, Greenville, North Carolina, USA.
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King WC, Engel SG, Elder KA, Chapman WH, Eid GM, Wolfe BM, Belle SH. Walking capacity of bariatric surgery candidates. Surg Obes Relat Dis 2011; 8:48-59. [PMID: 21937285 DOI: 10.1016/j.soard.2011.07.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 06/24/2011] [Accepted: 07/01/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study characterizes the walking limitations of bariatric surgery candidates by age and body mass index (BMI) and determines factors independently associated with walking capacity. The setting was multi-institutional at research university hospitals in the United States. METHODS Participants of the Longitudinal Assessment of Bariatric Surgery study (n=2458; age 18-78 yr, BMI 33-94 kg/m(2)) attended a preoperative research visit. Their walking capacity was measured by self-report and the 400 m Long Distance Corridor Walk (LDCW). RESULTS Almost two thirds (64%) of subjects reported limitations with walking several blocks, 48% had an objectively defined mobility deficit, and 16% reported at least some walking aid use. In multivariate analysis, BMI, older age, lower income, and greater bodily pain were independently associated (P < .05) with walking aid use, physical discomfort during the LDCW, an inability to complete the LDCW, and a slower time to complete the LDCW. Female gender, Hispanic ethnicity (but not race), greater heart rate at rest, a history of smoking, several co-morbidities (history of stroke, ischemic heart disease, diabetes, asthma, sleep apnea, venous edema with ulcerations), and depressive symptoms were also independently related (P < .05) to at least one measure of reduced walking capacity. CONCLUSIONS Walking limitations are common in bariatric surgery candidates, even among the least severely obese and youngest patients. Physical activity counseling must be tailored to individuals' abilities. Although several factors identified in the present study (eg, BMI, age, pain, co-morbidities) should be considered, directly assessing the patient's walking capacity will facilitate appropriate goal setting.
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Affiliation(s)
- Wendy C King
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
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Poirier P, Cornier MA, Mazzone T, Stiles S, Cummings S, Klein S, McCullough PA, Ren Fielding C, Franklin BA. Bariatric surgery and cardiovascular risk factors: a scientific statement from the American Heart Association. Circulation 2011; 123:1683-701. [PMID: 21403092 DOI: 10.1161/cir.0b013e3182149099] [Citation(s) in RCA: 281] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Elloumi M, Makni E, Ounis OB, Moalla W, Zbidi A, Zaoueli M, Lac G, Tabka Z. Six-minute walking test and the assessment of cardiorespiratory responses during weight-loss programmes in obese children. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2011; 16:32-42. [DOI: 10.1002/pri.470] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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46
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Ciolac EG, Greve JMD. Exercise-induced improvements in cardiorespiratory fitness and heart rate response to exercise are impaired in overweight/obese postmenopausal women. Clinics (Sao Paulo) 2011; 66:583-9. [PMID: 21655751 PMCID: PMC3093788 DOI: 10.1590/s1807-59322011000400011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 12/25/2010] [Accepted: 01/10/2011] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE The purpose of this study was to compare the heart rate response to exercise and the exercise-induced improvements in muscle strength, cardiorespiratory fitness and heart rate response between normal-weight and overweight/obese postmenopausal women. METHODS Sedentary women (n = 155) were divided into normal-weight (n = 79; BMI <25 kg/m(2); 58.3 ± 8.6 years) and overweight/obese (n = 76; BMI >25 kg/m(2); 58.3 ± 8.6 years) groups, and have their 1-repetition maximum strength (adjusted for body mass), cardiorespiratory fitness and heart rate response to a graded exercise test compared before and after 12 months of a three times-per-week exercise-training program. RESULTS Overweight/obese women displayed decreased upper and lower extremity muscle strengths, decreased cardiorespiratory fitness, and lower peak and reserve heart rates compared to normal-weight women. After follow-up, both groups improved their upper (32.9% and 41.5% in normal-weight and overweight/obese women, respectively) and lower extremity(49.5% and 47.8% in normal-weight and overweight/obese women, respectively) muscle strength. However, only normal-weight women improved their cardiorespiratory fitness (6.6%) and recovery heart rate (5 bpm). Resting, reserve and peak heart rates did not change in either group. CONCLUSIONS Overweight/obese women displayed impaired heart rate response to exercise. Both groups improved muscle strength, but only normal-weight women improved cardiorespiratory fitness and heart rate response to exercise. These results suggest that exercise-induced improvements in cardiorespiratory fitness and heart rate response to exercise may be impaired in overweight/obese postmenopausal women.
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Affiliation(s)
- Emmanuel Gomes Ciolac
- Laboratory of Kinesiology, Institute of Orthopedics and Traumatology, School of Medicine, University of São Paulo, Brazil.
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Josbeno DA, Jakicic JM, Hergenroeder A, Eid GM. Physical activity and physical function changes in obese individuals after gastric bypass surgery. Surg Obes Relat Dis 2010; 6:361-6. [DOI: 10.1016/j.soard.2008.08.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 07/17/2008] [Accepted: 08/05/2008] [Indexed: 10/21/2022]
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Brock DW, Chandler-Laney PC, Alvarez JA, Gower BA, Gaesser GA, Hunter GR. Perception of exercise difficulty predicts weight regain in formerly overweight women. Obesity (Silver Spring) 2010; 18:982-6. [PMID: 19816412 PMCID: PMC2924634 DOI: 10.1038/oby.2009.318] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
It has been previously reported that overweight and obese individuals perceive exercise as more difficult than their lean counterparts, and this difference may not be solely attributed to physiological differences. Therefore, we tested the hypothesis that individual differences in the perception of exercise difficulty during exercise, independent of concurrently measured physiological markers of exertion, are predictive of weight regain, after completion of a weight loss program. A total of 113 formerly overweight women who had previously completed a weight-loss program to achieve a normal body weight (BMI <25 kg/m(2)) underwent a submaximal aerobic exercise task while measures of physiological and perceived exertion (rating of perceived exertion (RPE)) were recorded. Weight gain was assessed following a subsequent 1-year free-living period. Average weight regain 1 year following the intervention was 5.46 +/- 3.95 kg. In regression modeling, RPE (beta = 0.21, P = 0.01), but not physiological exertion (beta = 0.02, P = 0.81), during the submaximal exercise task was positively associated with 1-year weight regain following weight loss in premenopausal women, independent of measured confounding variables. The association between RPE and weight regain suggests that perception of exercise difficulty is an important predictor of weight regain following a weight-loss intervention.
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Affiliation(s)
- David W Brock
- Department of Exercise and Movement Science, University of Vermont, Burlington, Vermont, USA.
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Aguer C, Gavarry O, Gole Y, Boussuges A, Doyard P, Falgairette G. A 5-month weight-reduction programme has a positive effect on body composition, aerobic fitness, and habitual physical activity of severely obese girls: A pilot evaluation study. J Sports Sci 2010; 28:281-9. [DOI: 10.1080/02640410903460734] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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50
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Ekkekakis P, Lind E, Vazou S. Affective responses to increasing levels of exercise intensity in normal-weight, overweight, and obese middle-aged women. Obesity (Silver Spring) 2010; 18:79-85. [PMID: 19556979 DOI: 10.1038/oby.2009.204] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
At least 60 min of daily physical activity (PA) are recommended for weight control, a target achieved by only 3% of obese (OB) women. The purposes of this study were to examine (i) the affective responses of normal-weight (NW), overweight (OW), and OB middle-aged sedentary women to exercise of increasing intensity and (ii) the relationship of affective responses to self-efficacy and social physique anxiety. The women participated in a graded treadmill protocol to volitional exhaustion while providing ratings of pleasure-displeasure and perceived activation each minute. The Activation Deactivation Adjective Check List (AD ACL) was also completed before and after exercise. The affective responses of NW and OW women did not differ. However OB women gave lower pleasure ratings during the incremental protocol and reported lower Energy scores immediately after the protocol. Social physique anxiety, but not self-efficacy, was inversely related to pleasure and energy. The lower levels of pleasure and energy experienced by OB than nonobese women could account in part for their dramatically low levels of PA participation. Modifying the cognitive antecedents of social physique anxiety might be a useful intervention strategy.
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