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Barrow DR, Abbate LM, Paquette MR, Driban JB, Vincent HK, Newman C, Messier SP, Ambrose KR, Shultz SP. Exercise prescription for weight management in obese adults at risk for osteoarthritis: synthesis from a systematic review. BMC Musculoskelet Disord 2019; 20:610. [PMID: 31861990 PMCID: PMC6925458 DOI: 10.1186/s12891-019-3004-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/12/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The aim of this systematic review was to identify principles of exercise interventions associated with improved physical function, weight management or musculoskeletal pain relief among young and middle-aged adults with obesity and propose an evidence-based exercise prescription that could assist in secondary prevention of osteoarthritis. METHODS A structured electronic review was conducted using MEDLINE, PubMed, and SPORTDiscus. The search string included 1) "obes*" AND "exercise" AND "interven*" AND "musculoskeletal pain OR knee pain OR hip pain". Studies 1) were randomized controlled trials of humans, with a non-exercise control, 2) included participants aged 18-50 years, and 3) had outcomes that included physical function, musculoskeletal pain, and/or body composition. Studies were excluded if participants had peri-menopausal status, cancer, or obesity-related co-morbidities. A recommended exercise prescription was developed based on common principles used in the included exercise interventions with greatest change in function or pain. RESULTS Seven studies were included. Similarities in exercise intensity (40-80% VO2max), frequency (three times per week), duration (30-60 min), and exercise mode (treadmill, cross-trainer, stationary bike, aquatic exercise) were observed in exercise interventions that resulted in improved physical function and/or pain, compared to non-exercise control groups. CONCLUSION Common principles in exercise prescription for improvements in weight management, physical function and pain relief among otherwise healthy people with obesity. Exercise prescription including moderate intensity exercise for 30-60 min, three times per week can be considered an effective treatment for weight management and obesity-related musculoskeletal symptoms. Exercise should be recommended to at-risk individuals as part of secondary prevention of osteoarthritis.
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Affiliation(s)
- Dylan R Barrow
- School of Sport, Exercise and Nutrition, Massey University, Wellington, New Zealand
| | - Lauren M Abbate
- Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, USA.,Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Max R Paquette
- School of Health Studies, University of Memphis, Memphis, TN, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Heather K Vincent
- UF Health Sports Performance Center, Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Connie Newman
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, New York University School of Medicine, New York, NY, USA
| | - Stephen P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Kirsten R Ambrose
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
| | - Sarah P Shultz
- School of Sport, Exercise and Nutrition, Massey University, Wellington, New Zealand. .,Department of Kinesiology, Seattle University, 901 12th Avenue, Seattle, WA, 98122, USA.
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