INTRODUCTION: Severe obesity is associated with sedentary behavior, low fitness, and metabolic dysmetabolism. Exercise can improve strength, fitness, and metabolic health independent of weight loss in obese patients. Progressive Resistance Training (PRT) is particularly beneficial in modifying body composition, developing musculoskeletal strength, and improving metabolic health. To date, there has been no investigation that measures strength, fitness, and physical performance following a PRT exercise protocol in Class III obese candidates undergoing surgical treatment.
METHODS AND PROCEDURES: The study objective is to evaluate the feasibility and efficacy of PRT as a preoperative exercise protocol in patients with Class III obesity. Patients have been recruited from the weight loss surgery clinics at two major academic centers. Participants are men and women aged 18-65 years with a BMI of greater than or equal to 40 kg/m2 who are considering weight loss surgery at BIDMC and Boston University. All 16 patients will be enrolled in a 12 week PRT protocol, which includes biweekly training sessions with an exercise physiotherapist. Exercise testing will be completed at three timepoints in the study: baseline – (within 90 days of surgery), mid-intervention – week 5 of training at target resistance, and post-intervention – within 1 week of last training session. Exercise testing measurements include the chest press and leg press (1 repetition maximum, 1-RM), chest and leg press fatigability (80% 1-RM) and the 6-minute walk test (6MWT, 30 meter course). Pilot data recorded (N= Newtons)
|1 RM Leg Press (sum)||3075.7N||3411.4N||10.9%|
|1 RM Chest Press (sum)||409N||534.2N||30.6%|
|Leg Press Fatigability (reps)||14||26||85.7%|
|Chest Press Fatigability (reps)||20||30||50.0%|
|6 Minute Walk (distance)||563.27m||579.73||2.9%|
CONCLUSIONS: Progressive Resistance Training represents a novel evidence-based approach to improve strength, fitness, and metabolic health in Class III obese, weight loss surgery patients. The PRT protocol was effective for improving strength and fitness in our trial run. Press and fatigability data may prove more sensitive than six minute walk to assess early impact of PRT. Future research will include blood serum analysis to determine PRT’s effect on markers of metabolic health.
Program Number: P054