Impact of Physical Training Programs on Physical Fitness in People With Class II and III Obesity: A Systematic Review and Meta-Analysis

Abstract

Background Physical training, regardless of the presence of concurrent weight loss, provides numerous health benefits for individuals who are overweight and obese and have or are at risk for cardiovascular disease. Purpose The purpose of this review was to identify different types of physical training programs (aerobic, resistance, or combined), with or without counseling/diet modifications, and their impact on physical fitness in individuals who have class II and III obesity. Data Sources Medline and Medline In-Process, EMBASE, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, Web of Science, LILACS, CINAHL, SPORTDiscus, PEDro, and PubMed were searched up to June 2017. Study Selection This review had the following inclusion criteria: body mass index of ≥35 kg/m2 and age 18 years or older; supervised physical training program; randomized controlled trial; physical fitness outcome (muscular strength, muscular endurance, cardiovascular endurance, and/or flexibility); in English or Portuguese; and available full-text article. Data Extraction Three reviewers independently extracted data, assessed study risk of bias using the Cochrane tool, and discussed disagreements until consensus was reached. Data Synthesis Of the 9460 identified articles, 26 were included and 8 were used in a meta-analysis. The meta-analysis showed improvements in walking speed and maximal oxygen uptake but not knee extension strength in the intervention groups. The Cochrane risk-of-bias score indicated that the majority of the data were from randomized controlled trials with a low or unclear risk of bias. Limitations The large variability of outcomes and interventions made comparisons difficult. Conclusions A combination of aerobic exercise and resistance exercise, in addition to diet modifications, may improve cardiovascular and muscular endurance in individuals with class II and III obesity. However, conclusions must be interpreted with caution because of the heterogeneity in interventions and outcome measures among the studies and an unclear risk of bias in several studies.

Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

“…Second, previous systemic review studies have indicated that muscle strength training, especially RET, augments muscle mass gain in older people with sarcopenia [99,100], individuals with obesity and OA [101], and older adults with OA [24]. The muscle mass gain caused by exercise may be beneficial for older adults with obesity who are undergoing weight management [31,102]. The previous results support our findings that RET plus RMMR for dietary weight management exerts superior effects on muscle mass relative to RMMR or RET alone.…”

The Effects of Two Different Concurrent Training Configurations on Markers of Metabolic Syndrome and Fitness in Women With Severe/Morbid Obesity: A Randomised Controlled Trial

“…Morbid obesity, defined as a body mass index (BMI) of ≥40kg/m 2 (class III obesity), is a chronic disease with life-threatening cardiometabolic consequences such as elevated blood pressure [systolic (SBP) or diastolic BP (DBP)], fasting plasma glucose (FPG), triglycerides (Tg), and low high-density lipoprotein cholesterol (HDL-c), all summarised as metabolic syndrome (MetS; Baffi et al, 2016 ), substantially increasing the rates of total mortality, with most of the excess deaths due to heart disease, cancer, diabetes, and important life expectancy reductions compared with normal weight peers ( Kitahara et al, 2014 ). Moreover, morbid obesity has been associated with impairments of cardiorespiratory fitness and muscle strength, limiting the capacity to perform activities of daily living ( Pazzianotto-Forti et al, 2020 ). Additionally, this fact increases the economic costs associated with healthcare in this population ( Espallardo et al, 2017 ).…”

Patients at risk of the progression of chronic venous disease.

“…(49) Many studies have been performed on weight loss and exercise programs in obese patients, and two meta-analyses show that the combination of weight loss interventions with exercise is effective in fat reduction and preventing muscle decline. (50,51) The only addition for chronic venous disease patients would be physical therapy to improve the range of motion of the ankle in order to optimise calf muscle pump function. Simply treating venous reflux and obstruction might be of lesser importance in managing chronic venous disease when obesity and reduced mobility are left untreated.…”

“…A patient can be treated in all combinations of these settings; health care professionals each commit to their own guidelines and an overarching quality standard. (24,50,51) In conclusion, there are no fixed healthcare paths that ensure adequate diagnostics and treatment for patients with a venous leg ulcer.…”

“…46,49,50 A reduced ROAM correlates with a reduced function of the CMP. 51 The CMP is the main factor in venous outflow because it transposes the most blood volume specifically in the body weight transfer manoeuvre. 52 The body weight transfer manoeuvre is comparable to walking.…”