Background Obesity is a major public health issue. Combining exercise training, nutrition, and therapeutic education in metabolic rehabilitation (MR) is recommended for obesity management. However, evidence from randomized controlled studies is lacking. In addition, MR is associated with poor patient adherence. Mobile health devices improve access to MR components. Objective The aim of this study is to compare the changes in body composition, anthropometric parameters, exercise capacity, and quality of life (QOL) within 12 weeks of patients in the telerehabilitation (TR) program to those of usual care patients with obesity. Methods This was a parallel-design randomized controlled study. In total, 50 patients with obesity (BMI>30 kg/m²) were included in a TR group (TRG) or a usual care group (UCG) for 12 weeks. Patients underwent biometric impedance analyses, metabolic exercise tests, actimetry, and QOL and satisfaction questionnaires. The primary outcome was the change in fat mass at 12 weeks from baseline. Secondary outcomes were changes in body weight, metabolic parameters, exercise capacity, QOL, patients’ adhesion, and satisfaction. Results A total of 49 patients completed the study. No significant group × time interaction was found for fat mass (TRG: mean 1.7 kg, SD 2.6 kg; UCG: mean 1.2 kg, SD 2.4 kg; P=.48). Compared with the UCG, TRG patients tended to significantly improve their waist to hip ratios (TRG: −0.01 kg, SD 0.04; UCG: +0.01 kg, SD 0.06; P=.07) and improved QOL physical impact (TRG: +21.8, SD 43.6; UCG: −1.2, SD 15.4; P=.005). Significant time effects were observed for body composition, 6-minute walk test distance, exercise metabolism, sedentary time, and QOL. Adherence (95%) and satisfaction in the TRG were good. Conclusions In adults with obesity, the TR program was not superior to usual care for improving body composition. However, TR was able to deliver full multidisciplinary rehabilitation to patients with obesity and improve some health outcomes. Given the patients’ adherence and satisfaction, pragmatic programs should consider mobile health devices to improve access to MR. Further studies are warranted to further establish the benefits that TR has over usual care. Trial Registration ClinicalTrials.gov NCT03396666; http://clinicaltrials.gov/ct2/show/NCT03396666

Introduction: the main problem in obesity management is weight regain that occurs after all currently used slimming procedures. Regular physical activity remains the most effective measure to stop this weight regain. Among the varieties of training that can be offered, endurance exercise at low to moderate intensities targeted at the level of maximum lipid oxidation (LIPOX max) is one of the easiest to implement and has well-documented effects on glucose metabolism, blood lipids, eating behavior, and body composition. Our purpose in this study was to study the effect of this type of exercise on body composition over 2 years. Methods: Nonrandomized controlled longitudinal study. 45 obese subjects (14 men, 31 women, age = 20-85 years old) were re-trained with LIPOXmax (3x45 min / week at home with regular follow-up after induction in hospital) over 2 years. They were compared to a matched control group of 26 subjects. Exercise calorimetry and segmental bioelectric impedance were performed at the beginning and at the 24th month. Results: Trained group lost weight (-6 ± 1.44 kg) over 2 years. This is explained by a loss of fat mass (-5 ± 1.26 kg), affecting truncal fat mass (-2.66 ± 0.62 kg p <0.0001), and appendicular fat mass (1.38 ± 0.72 kg p <0.01). There is also a reduction in lean body mass (-2.41 ± 0.86 kg, p <0.01). Controls gain 3 ± 0.85 kg (p <0.001). In the trained group, the ability to oxidize lipids increased (p <0.001) and there was a positive correlation between weight changes and mean arterial blood pressure at 24 months (r = 0.37 p = 0.02). Conclusion:The weight loss effectiveness of endurance training targeted at the LIPOXmax is maintained for 24 months. This weight loss affects both trunk and appendicular fat mass but also lean mass. It associated with a decrease in blood pressure and an improvement in the ability to oxidize lipids during exercise.

Our study provides insights into the role of altered low and high density lipoprotein metabolism in the pathogenesis of carotid stenosis. The statistically significant association of serum lipoprotein metabolic rates with carotid stenosis, rather than their respective serum concentrations, implies that metabolic parameters may be more important in predicting stroke risk.

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The 6-minute walk-test in type 2 diabetics predicts to some extent maximal aerobic capacity but not its training-induced improvement. Ann Musculoskelet Med 4(1): 003-009.

BACKGROUND Obesity is a challenge for public health. Combining exercise training, nutrition and therapeutic education in a metabolic rehabilitation (MR) is recommended for obesity management. Yet, randomized controlled study-based evidences are lacking. In addition MR is associated with poor patient’s adherence. Mobile Health (mHealth) devices improve the access to the MR components. OBJECTIVE Thus, a telerehabilitation (TR) solution could deliver a feasible multidisciplinary MR in obese patients and improve fat mass (FM), metabolic parameters and quality of life versus usual care. METHODS This was a randomised, controlled, parallel-design study. Fifty obese (body mass index BMI > 30 kg/m²) patients were included in a telerehabilitation group (TRG) or a usual care group (UCG) for 12 weeks. Patients underwent biometric impedance analyses, metabolic exercise tests, actimetry, QOL and satisfaction questionnaires. The primary outcome was the changes in body composition. Secondary outcomes were BW, metabolic parameters, exercise capacity, QOL, patient’s adhesion and satisfaction. RESULTS Forty-nine patients completed the study. No significant group*time interaction was found for FM. Compared to UCG, TRG patients significantly improved waist to hip ratio and EQVOD’s physical impact. Significant time effects occurred for body composition, 6MWT distance, exercise metabolism, sedentary time and QOL (p<0,05). Adherence (95%) and satisfaction in the TRG were good. CONCLUSIONS In obese adults, TR was able to deliver a full multidisciplinary rehabilitation in obese patients and improved their health outcomes. Given the patient’s adherence and satisfaction, pragmatic programs should consider mHealth devices to improve the access to MR. Further studies are warranted to establish the additional TR benefits versus usual care. CLINICALTRIAL Mobile Tele-rehabilitation Solution for Obese Patients NCT03396666 https://clinicaltrials.gov/ct2/show/NCT03396666?term=03396666&draw=2&rank=1