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Physical activity in women attending a dissonance-based intervention after Roux-en-Y Gastric Bypass: A 2-year follow-up of a randomized controlled trial. PLoS One 2021; 16:e0255556. [PMID: 34735452 PMCID: PMC8568166 DOI: 10.1371/journal.pone.0255556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/16/2021] [Indexed: 12/01/2022] Open
Abstract
Background The majority of Roux-en-Y gastric bypass (RYGB) patients are not sufficiently physically active post-surgery, yet little support from the Swedish healthcare system is offered. We investigated if a dissonance-based group intervention, aiming to increase health-related quality of life after surgery, had any effect on patients’ physical activity two years post-RYGB. Methods Women undergoing RYGB surgery were recruited from five Swedish hospitals and randomized to intervention or control group (standard post-surgery care). The dissonance-based intervention was conducted three months post-RYGB and consisted of four group sessions, each with a specific topic, of which one addressed physical activity. ActiGraph GT3X+ accelerometers were used to measure physical activity at pre-RYGB, one- and two-years post-surgery. Results At pre-RYGB, 259 women were recruited and randomized (intervention n = 156 and control n = 103). Participants had a mean age of 44.7 years (SD 10.3) and pre-RYGB body mass index of 40.8 (SD 4.5) kg/m2. At two-years follow-up, 99 participants (63.5%) in intervention group and 68 (66.0%) in control group had valid accelerometer-measurements. Pre- to post-surgery increases were seen in all physical activity outcomes, but no statistically significant differences between the groups were observed at the two-years follow-up, and intervention effects were poor (d = 0.02–0.35). Conclusion To our knowledge, this is the first dissonance-based intervention targeting women undergoing RYGB surgery. At two-years follow-up, we did not observe any differences in physical activity levels between the intervention group and control group. Trial registration number: ISRCTN16417174.
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de Aguiar JB, Gurgel LA, Santos ALB, Arruda SPM. Barriers to Physical Exercise and Associated Factors in the Pre- and Postoperative Periods of Bariatric Surgery. Obes Surg 2021; 31:1696-1704. [PMID: 33394252 DOI: 10.1007/s11695-020-05183-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/09/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND To compare the barriers to exercise and its associated factors among patients in the pre- and postoperative periods of bariatric surgery. METHODS Cross-sectional study with patients who were split into preoperative (n = 81) and postoperative (n = 209) groups. It was collected sociodemographic characteristics, and the Exercise Benefits Barriers Scale was adopted in order to identify the barriers related to exercise practice. Chi-square, Mann-Whitney, and Poisson regression were applied for comparisons and associations. RESULTS The postoperative group had a lower score on the barrier scale, except for the lack of time subdimension. In the preoperative, the subjects were considered physically active (p = 0.03), and those over 42 years old (p < 0.001) had the lowest score in lack of time subdimension. Those with a body mass index (BMI) higher than 36.89 kg/cm2 had a higher overall score on the scale (p < 0.001), also in the lack of time (p = 0.003) and physical effort subdimensions (p < 0.001). Those with higher education scored more in the lack of time (p = 0.014) and family discouragement subdimensions (p = 0.034). In the postoperative, the participants considered active had the lowest score on the general scale, as well as in all subdimensions (p < 0.001), and the ones with higher education presented better scores in physical effort subdimension (p = 0.041). CONCLUSIONS The preoperative group had a higher score of barriers to practice exercises related to physical effort, environment, and family discouragement, when compared to the postoperative. The factors associated were physical inactivity, BMI over 36.89 kg/cm2, age 42 years old or under, and higher education.
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Affiliation(s)
- Jaina Bezerra de Aguiar
- Health Sciences Center, Ceará State University, Avenue Dr Silas Munguba, 1700, Fortaleza, Ceará, 84030-900, Brazil.
| | - Luilma Albuquerque Gurgel
- Health Sciences Center, Ceará State University, Avenue Dr Silas Munguba, 1700, Fortaleza, Ceará, 84030-900, Brazil
| | - Ana Luisa Batista Santos
- Health Sciences Center, Ceará State University, Avenue Dr Silas Munguba, 1700, Fortaleza, Ceará, 84030-900, Brazil
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Reinmann A, Gafner SC, Hilfiker R, Bruyneel AV, Pataky Z, Allet L. Bariatric Surgery: Consequences on Functional Capacities in Patients With Obesity. Front Endocrinol (Lausanne) 2021; 12:646283. [PMID: 33868175 PMCID: PMC8049139 DOI: 10.3389/fendo.2021.646283] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 03/02/2021] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Bariatric surgery leads to loss of fat and fat-free mass (FFM). To preserve FFM it is recommended that weight loss interventions are accompanied by physical activity. However, it remains unknown if functional capacities spontaneously improve after a substantial weight loss. Study's aim was to assess the effect of bariatric surgery on strength, functional capacities and quality of life of participants with a body mass index (BMI) ≥ 35 kg/m2. METHOD Anthropometric parameters (weight, BMI, waist circumference), physical functions (quadriceps strength, walking capacity, spatio-temporal gait parameters, dynamic balance, lower limb power) and quality of life were assessed before and at three months after the bariatric surgery in 33 individuals who did not follow any physical activity program. RESULTS The anthropometric parameters, quality of life and three functional abilities (walking capacity, normal gait speed and lower limb power) improved significantly three months post-surgery. In contrast, fast gait speed, absolute strength, normalized strength, and dynamic balance did not improve. DISCUSSION A massive weight loss should be accompanied by an exercise program aiming to maintain FFM and to enhance muscle strength and balance. Such a program might also enhance functional capacities and help to sustain the weight loss over time.
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Affiliation(s)
- Aline Reinmann
- Geneva School of Health Sciences, Haute Ecole Spécialisée de Suisse Occidentale (HES-SO) University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
- *Correspondence: Aline Reinmann,
| | - Simone Chantal Gafner
- Geneva School of Health Sciences, Haute Ecole Spécialisée de Suisse Occidentale (HES-SO) University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Roger Hilfiker
- Valais-Wallis School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, Valais, Switzerland
| | - Anne-Violette Bruyneel
- Geneva School of Health Sciences, Haute Ecole Spécialisée de Suisse Occidentale (HES-SO) University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Zoltan Pataky
- Department of Medicine, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
| | - Lara Allet
- Valais-Wallis School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, Valais, Switzerland
- Department of Medicine, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
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Hussan H, Patel A, Akinyeye S, Porter K, Ahnen D, Lieberman D. Bariatric Surgery Is Associated with a Recent Temporal Increase in Colorectal Cancer Resections, Most Pronounced in Adults Below 50 Years of Age. Obes Surg 2020; 30:4867-4876. [PMID: 32789550 DOI: 10.1007/s11695-020-04902-9] [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: 04/20/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Colorectal cancer incidence is rising in adults < 50 years old, possibly due to obesity. Having bariatric surgery (BRS) should hypothetically reduce this trend, but data are limited. This study compared trends of colorectal cancer (CRC) versus other obesity-related gastrointestinal cancers (OGCs) between morbidly obese and post-BRS subjects. MATERIAL AND METHODS This retrospective cohort study investigated OGC resection trends using the 2006-2013 National Inpatient Sample. Patients with prior BRS and non-BRS controls with body mass index ≥ 40 kg/m2 were included (n = 30,279 total). We divided OGCs into CRC and non-CRC OGCs (esophageal, stomach, liver, gallbladder, and pancreas). We calculated OGC resection trends in patients < 50 and ≥ 50 years old using the average annual percent change (AAPC). RESULTS BRS patients with OGCs were younger (59.3 vs 62.3 years old), with more female gender (77.4% vs 57.1%) and White race (72.6% vs 67%) compared with controls (p < 0.05). The number of CRC resections increased across all ages in 2006-2013, especially rectal cancer for BRS patients (AAPC + 19.8%, p = 0.04). The steepest rise in early-onset CRC resections was after BRS versus a lesser increase in morbid obesity controls (AAPC + 18.7% and + 13.7%, respectively, p < 0.001). In contrast, non-CRC OGCs increased in our controls but not post-BRS. In a sensitivity analysis, estimated CRC incidence trends also increased post-BRS despite adjusting for increasing BRS prevalence. CONCLUSION Our findings suggest that bariatric surgery is associated with a persistent increase in early-onset CRC trends. Studies are warranted to validate our results and test the impact of bariatric surgery on early-onset CRC biological mechanisms.
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Affiliation(s)
- Hisham Hussan
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Ohio State University, 395 W 12th Ave, Suite 250, Columbus, OH, 43210, USA. .,The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
| | - Arsheya Patel
- Department of Internal Medicine, Ohio State University, Columbus, OH, USA
| | - Samuel Akinyeye
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Ohio State University, 395 W 12th Ave, Suite 250, Columbus, OH, 43210, USA
| | - Kyle Porter
- Center for Biostatistics, Department of Biomedical Informatics, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Dennis Ahnen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Colorado Hospital, Aurora, CO, USA
| | - David Lieberman
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Oregon Health and Science University, Portland, OR, USA
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Possmark S, Sellberg F, Willmer M, Tynelius P, Persson M, Berglind D. Accelerometer-measured versus self-reported physical activity levels in women before and up to 48 months after Roux-en-Y Gastric Bypass. BMC Surg 2020; 20:39. [PMID: 32103734 PMCID: PMC7045736 DOI: 10.1186/s12893-020-00699-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/14/2020] [Indexed: 01/07/2023] Open
Abstract
Background Roux-en-Y Gastric Bypass (RYGB) patients overestimate their time spent in moderate-to-vigorous physical activity (MVPA) to a greater extent post-surgery than pre-surgery. However, there is no data on discrepancy between self-reported and accelerometer-measured MVPA beyond nine months post-RYGB. The aim was to investigate how the duration of MVPA (main outcome) differs when comparing a self-administered questionnaire to accelerometer-data from pre-surgery and up to 48 months post-RYGB. Methods Twenty-six (38%) RYGB-treated women with complete data from the original cohort (N = 69) were included. Participants were recruited from five Swedish hospitals. Mean pre-surgery BMI was 38.9 (standard deviation (SD) = 3.4) kg/m2 and mean age 39.9 (SD = 6.5) years. MVPA was subjectively measured by a self-administered questionnaire and objectively measured by the ActiGraph GT3X+ accelerometer at 3 months pre-RYGB and 9- and 48 months post-RYGB. Means and SD were calculated at 3 months pre- and 9- and 48 months post-RYGB. We calculated the P-values of the differences with Wilcoxon Signed-Rank test. For correlations between the self-administered questionnaire and the accelerometers, Spearman’s rank correlation was used. Results Participants significantly overestimated (i.e. self-reported more time spent in MVPA compared to accelerometry) their MVPA in a higher degree post- compared to pre-RYGB surgery. Compared to pre-surgery, self-reported MVPA increased with 46.9 and 36.5% from pre- to 9- and 48 months, respectively, whereas changes were a 6.1% increase and 3.5% decrease with accelerometers. Correlations between self-reported and accelerometer-measured MVPA-assessments were poor at all measurement points (r = 0.21–0.42) and only significant at 48 months post-RYGB (P = 0.032). Conclusions The discrepancy between self-reported and objectively assessed MVPA within the same individual is greater up to 48 months post-RYGB compared to before surgery. To help bariatric patients understand and hopefully increase their physical activity behaviors post-surgery, objective measures of physical activity should be used.
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Affiliation(s)
- Sofie Possmark
- Department of Global Public Health, Karolinska Institutet, K9, Social Medicine, 171 77, Stockholm, Sweden.
| | - Fanny Sellberg
- Department of Global Public Health, Karolinska Institutet, K9, Social Medicine, 171 77, Stockholm, Sweden
| | - Mikaela Willmer
- Department of Health and Caring Sciences, University of Gävle, 801 76, Gävle, Sweden
| | - Per Tynelius
- Department of Global Public Health, Karolinska Institutet, K9, Social Medicine, 171 77, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Box 45436, 104 31, Stockholm, Sweden
| | | | - Daniel Berglind
- Department of Global Public Health, Karolinska Institutet, K9, Social Medicine, 171 77, Stockholm, Sweden
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Possmark S, Berglind D, Sellberg F, Ghaderi A, Persson M. To be or not to be active - a matter of attitudes and social support? Women's perceptions of physical activity five years after Roux-en-Y Gastric Bypass surgery. Int J Qual Stud Health Well-being 2019; 14:1612704. [PMID: 31072238 PMCID: PMC6522969 DOI: 10.1080/17482631.2019.1612704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: Despite positive health advantages of post-surgery physical activity (PA) for bariatric surgery patients, the majority is not sufficiently physically active. The aim was to explore women’s perceptions and experiences concerning PA five years after Roux-en-Y Gastric Bypass (RYGB) surgery. Methods: Eleven women were interviewed five years post-surgery. Grounded Theory approach was applied. Results: The core-category “Attitudes and surrounding environment influence activity levels” includes three attitudes towards PA: “Positive attitudes”, “Shifting attitudes” and “Negative attitudes”. Participants with a positive attitude were regularly physically active, felt supported and proud of their achievements. Contrary, participants with a negative attitude didn’t prioritize PA, didn’t feel supported and saw no need or benefit of PA. Some participants revealed an on-off behaviour, hovering between the attitudes of vigorous PA and sedentary lifestyle, without sustainable balance. The majority mostly viewed PA as a mean to lose weight. Conclusion: The level of perceived post-surgery PA was related to the participants’ attitudes towards PA and whether or not they had a supportive environment. These findings might explain why bariatric surgery patients often fail to be sufficiently active post-surgery, and highlight the need for prolonged support and motivational interventions to promote sustainable PA post-bariatric surgery.
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Affiliation(s)
- Sofie Possmark
- a Department of Public Health Sciences , Karolinska Institutet, K9, Social Medicin , Stockholm , Sweden
| | - Daniel Berglind
- a Department of Public Health Sciences , Karolinska Institutet, K9, Social Medicin , Stockholm , Sweden
| | - Fanny Sellberg
- a Department of Public Health Sciences , Karolinska Institutet, K9, Social Medicin , Stockholm , Sweden
| | - Ata Ghaderi
- b Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
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Noack Segovia JP, Sánchez López A, García-García I, Rodríguez-Blanque R, León Ríos XA, Aguilar Cordero MJ. Physical Exercise and Grip Strength in Patients Intervened through Bariatric Surgery. AQUICHAN 2019. [DOI: 10.5294/aqui.2019.19.3.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: This work sought to evaluate a physical exercise program of moderate intensity in patients operated of bariatric surgery and its influence on muscle strength. Method: Randomized clinical trial, with an intervention group and a control group. Forty-three patients were operated of bariatric surgery. The intervention group was applied a program of moderate physical activity during six months. Grip strength and bioimpedance were measured at their baseline form, at one month, and six months after surgery. A bivariate study was conducted to observe variable changes. Results: Upon conducting Student´s t for independent samples in all the variables (weight, body mass index, grip strength, lean mass, fat mass, and metabolism), the result is that no significant differences exist between the intervention group and the control group with p > 0.05. Conclusion: A program of moderate physical activity lasting six months in patients intervened of bariatric surgery has no significant result in the development of muscle mass evaluated through manual dynamometry and bioimpedance.
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Meeting physical activity recommendations is associated with health-related quality of life in women before and after Roux-en-Y gastric bypass surgery. Qual Life Res 2019; 28:1497-1507. [PMID: 30721385 PMCID: PMC6522440 DOI: 10.1007/s11136-019-02120-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2019] [Indexed: 02/08/2023]
Abstract
PURPOSE Meeting physical activity (PA) recommendations is positively associated with health-related quality of life (HRQoL), but it is still unclear whether PA (specifically objectively measured) is associated with HRQoL in bariatric surgery candidates, both before and after surgery. Thus, the aim of this study was to examine the cross-sectional association between meeting objectively measured PA recommendations and HRQoL before and after Roux-en-Y gastric bypass (RYGB) surgery. METHODS Sixty-six women undergoing RYGB with pre-surgery and 62 women with post-surgery valid PA and HRQoL data were included from the control group of a RCT study aiming at improving HRQoL and PA post-RYGB surgery. Measures before and 12 months after RYGB included the Short Form Health Survey (SF-36) and objectively measured PA, sedentary time (ST), and step counts with GT3X+ accelerometers. Multiple linear regression models were used to analyze the associations between PA and HRQoL. RESULTS Participants who engaged in more than 150 min of moderate to vigorous PA (MVPA)/week (PA recommendations) had considerably higher SF-36 scores (HRQoL) than those who did not, both pre and 12-month post-surgery, with greatest difference in the subscale bodily pain, 15.5 (p = 0.021) higher score (higher scores means less pain) pre-surgery and a 19.7 (p = 0.004) higher score post-surgery. Higher LPA and step counts and lower ST also showed positive associations in some of the subscales of SF-36. CONCLUSIONS Meeting the PA recommendations and overall engaging in more PA was associated with higher HRQoL, pre-, and post-RYGB surgery, highlighting the importance of PA both pre- and post-surgery.
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Coen PM, Carnero EA, Goodpaster BH. Exercise and Bariatric Surgery: An Effective Therapeutic Strategy. Exerc Sport Sci Rev 2018; 46:262-270. [PMID: 30052546 PMCID: PMC6147093 DOI: 10.1249/jes.0000000000000168] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exercise is a clinically effective adjunct therapy with the potential to promote long-term weight loss maintenance for bariatric surgery patients. The long-term efficacy of bariatric surgery is not entirely clear, and weight regain and diabetes relapse are problems for some patients. Exercise is a feasible and clinically effective adjunct therapy for bariatric surgery patients. We hypothesize that exercise is also a critical factor for long-term weight loss maintenance and lasting remission of type 2 diabetes.
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Affiliation(s)
- Paul M Coen
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital.,Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, FL
| | - Elvis A Carnero
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital
| | - Bret H Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital.,Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, FL
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Gill DL, Fasczewski KS, Reifsteck EJ, Rothberger SM, Davis PG. Evaluation of an exercise programme for post-bariatric surgery patients: views of participants. Obes Sci Pract 2018; 4:259-267. [PMID: 29951216 PMCID: PMC6010004 DOI: 10.1002/osp4.165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 02/01/2018] [Accepted: 02/05/2018] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Exercise programmes typically are evaluated with fitness assessments and psychological survey measures but seldom include participants' insights. The purpose of this study was to evaluate the benefits, facilitators and barriers of a 12-week exercise programme for post-bariatric surgery patients from the participants' perspective. METHOD Over a 2-year period, 20 patients recently having undergone bariatric surgery completed a 12-week programme that included participation in structured exercise and in focus groups designed to supplement standard evaluation data and provide insight into participants' views. RESULTS Participants were highly adherent to the programme, and focus group results reflected a clear positive evaluations. Benefits included helpful information, developing commitment, physical fitness and social support; notably, weight was seldom mentioned. Participants cited structure, accountability and group support as facilitators of exercise. Participants cited few barriers, although very few had set plans for continuing exercise after programme completion. CONCLUSION Participants saw many benefits to the exercise programme, and those benefits reflected lifestyle changes rather than a focus on weight. Programme structure, accountability and the support of the group were facilitators to exercise. Participants cited few barriers. However, the lack of plans for continued exercise suggested the need for a transition phase to help participants continue an active lifestyle after the 12-week structured programme.
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Affiliation(s)
- D. L. Gill
- Department of KinesiologyUniversity of North Carolina at GreensboroGreensboroNCUSA
| | - K. S. Fasczewski
- Department of Health and Exercise ScienceAppalachian State UniversityBooneNCUSA
| | - E. J. Reifsteck
- Department of KinesiologyUniversity of North Carolina at GreensboroGreensboroNCUSA
| | - S. M. Rothberger
- Technology Center to Promote Healthy LifestyleUniversity of South CarolinaColumbiaSCUSA
| | - P. G. Davis
- Department of KinesiologyUniversity of North Carolina at GreensboroGreensboroNCUSA
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