Obesity and Prader-Willi Syndrome Affect Heart Rate Recovery from Dynamic Resistance Exercise in Youth

Abstract

Following exercise, heart rate decline is initially driven by parasympathetic reactivation and later by sympathetic withdrawal. Obesity delays endurance exercise heart rate recovery (HRR) in both children and adults. Young people with Prader-Willi Syndrome (PWS), a congenital cause for obesity, have shown a slower 60-s endurance exercise HRR compared to lean and obese children, suggesting compromised regulation. This study further evaluated effects of obesity and PWS on resistance exercise HRR at 30 and 60 s in children. PWS (8–18 years) and lean and obese controls (8–11 years) completed a weighted step-up protocol (six sets x 10 reps per leg, separated by one-minute rest), standardized using participant stature and lean body mass. HRR was evaluated by calculated HRR value (HRRV = difference between HR at test termination and 30 (HRRV30) and 60 (HRRV60) s post-exercise). PWS and obese had a smaller HRRV30 than lean (p < 0.01 for both). Additionally, PWS had a smaller HRRV60 than lean and obese (p = 0.01 for both). Obesity appears to delay early parasympathetic reactivation, which occurs within 30 s following resistance exercise. However, the continued HRR delay at 60 s in PWS may be explained by either blunted parasympathetic nervous system reactivation, delayed sympathetic withdrawal and/or poor cardiovascular fitness.

Physical exercise and Prader‐Willi syndrome: A systematic review

“…A total of 483 studies were identified, of which 447 did not meet the inclusion criteria. Twenty‐two studies, whose details are summarized in Tables and , were finally included and evaluated (Figure ). The retrieved articles included a total of 766 subjects (356 patients with PWS [242 children and/or adolescents and 114 adults]).…”

“…25 With regard to blood pressure (BP), similar levels of systolic BP were found in children with or without PWS. 16,22,33 However, one study observed a higher post-exercise diastolic BP in children with PWS compared to lean and obese children without this condition (24% and 11% lower, respectively). 22 Adults with PWS showed lower values of maximal oxygen uptake (~47%) and ventilatory threshold (~44%) than overweight and obese adults without PWS.…”

“…A total of 483 studies were identified, of which 447 did not meet the inclusion criteria. Twenty-two studies, 10,15,16,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] whose details are summarized in Tables 2 and 3 Mullins (1987)…”

“…Ten studies 10,15,16,[22][23][24][25] reported the acute effects (either physiological response or physical performance) of exercise in patients with PWS using the following types of exercise tests: cycle ergometer, 16,22,23 lower-body strength, 10,24,33 treadmill along with upper-body strength and flexibility, 15 only treadmill, 25,34 or the Bruininks-Oseretsky test to analyse motor proficiency. 35 Eight out of ten studies were carried out in children and/or adolescents, 16,[22][23][24][25] with the remainder of studies conducted in adults.…”

“…15,16,22,25,33 In three studies, a lower (12%-22%) peak value of exertional heart rate (HR) was observed in PWS patients compared to controls. 15,16,22 A slower HR recovery after submaximal exercise 16,33 but similar after maximal exercise 16 was observed in children with PWS compared to obese and normal-weight peers. A consistently higher HR during submaximal exercise (12%-14%) at the same absolute workload was also reported in children with PWS compared to normal-weight or obese children.…”