Work Capacity and Cardiopulmonary Adaptation of the Obese Subject during Exercise Testing

Salvadori, Alberto; Fanari, Paolo; Mazza, P.; Agosti, R.; Longhini, E

doi:10.1378/chest.101.3.674

Cited by 74 publications

(59 citation statements)

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“…14,15,36,38 Age and pubertal stage, because of the muscle mass gained during puberty, are other factors that may contribute uniquely in adolescents. Depending on how the V o 2 max is scaled, studies have shown that overweight individuals attain lower, 14,36,37 higher, 15,16 or similar 39 oxygen uptake at maximal exercise, when compared with normal-weight control subjects. In this study, absolute values of oxygen uptake during maximal exercise were not different in nonoverweight and overweight adolescents.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Excess Adiposity on Exercise Fitness and Performance in Overweight Children and Adolescents

et al. 2005

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ABSTRACT. Objective. Relatively little is known about how excess body mass affects adolescents' capacity to perform sustained exercise. We hypothesized that most of the difficulty that severely overweight adolescents have with sustained exercise occurs because the metabolic costs of moving excess mass result in use of a high proportion of their total oxygen reserve.Methods. We compared results from a maximal cycle ergometry fitness test in 129 severely overweight adolescents who had BMIs of 41.5 ؎ 9.7 kg/m 2 and ages of 14.5 ؎ 1.8 years (range: 12.1-17.8 years) and 34 nonoverweight adolescents who had BMIs of 20.1 ؎ 2.9 kg/m 2 and ages of 14.5 ؎ 1.5 years (range: 12.0 -18.1 years). Oxygen uptake (V O 2 ) was compared at 3 times: during a 4-minute period of unloaded cycling (ULV O 2 ), at the lactate threshold estimated by gas exchange (LTV O 2 ), and at maximal exertion (V O 2 max). Heart rate was obtained at rest and at V O 2 max. Participants also completed a 12-minute walk/ run performance test to obtain distance traveled (D12) and heart rate. Results. Absolute LTV O 2 and V O 2 max and LTV O 2 as a percentage of V O 2 max were not different in overweight and nonoverweight adolescents during the cycle test.However, absolute ULV O 2 was significantly greater in overweight adolescents: ULV O 2 accounted for 35 ؎ 8% of V O 2 max (and 63 ؎ 15% of LTV O 2 ) in overweight adolescents but only 20 ؎ 5% of V O 2 max (and 39 ؎ 12% of LTV O 2 ) in nonoverweight adolescents. Resting heart rate before initiating the cycle test was significantly greater in overweight than nonoverweight adolescents (94 ؎ 14 vs 82 ؎ 15 beats per minute). However, maximal heart rate during the cycle test was significantly lower in overweight adolescents (186 ؎ 13 vs 196 ؎ 11 beats per minute). During the walk/run test, mean D12 was significantly shorter for overweight than for nonoverweight adolescents (1983 ؎ 323 vs 1159 ؎ 194 m). D12 was negatively related to BMI SDS (r ‫؍‬ ؊0.81) and to ULV O 2 (r ‫؍‬ ؊0.98).Discussion. Overweight and nonoverweight adolescents had similar absolute V O 2 at the lactate threshold and at maximal exertion, suggesting that overweight adolescents are more limited by the increased cardiorespiratory effort required to move their larger body mass through space than by cardiorespiratory deconditioning. ABBREVIATIONS. V o 2 max, maximum oxygen uptake; SDS, SD score; ULV o 2 , unloaded oxygen uptake; LTV o 2 , oxygen uptake at the lactate threshold; V o 2 max, oxygen uptake at maximal exertion; HRR, heart rate reserve; RPE, rating of perceived exertion; bpm, beats per minute; D12, distance achieved at 12 minutes during walk/run test; ANCOVA, analysis of covariance. O verweight during childhood has been identified as a major health problem in the United States. 1-4 Pediatric overweight commonly presages adult obesity 5 and is associated with the development of weight-related comorbid conditions and increased morbidity. [6][7][8] Decreased physical activity and a more sedentary lifestyle have been implicated as importan...

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Section: Discussionmentioning

confidence: 99%

“…Other reports have suggested that both deconditioning and obesity may reduce maximal heart rate. 21,27,39,40,41 Because of their higher resting heart rate and lower maximal …”

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Influence of Excess Adiposity on Exercise Fitness and Performance in Overweight Children and Adolescents

et al. 2005

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“…Variables used in the existent literature may not thoroughly capture the complexity of disability in obese people. In fact, obese individuals, in association with the increased BMI, show an energetic, cardiac and respiratory, limitation leading to a mobility impairment [45,46], together with the relative reduction of skeletal muscle strength and general deconditioning, also leading to disability [47,48]. Other potential contributors to the disabling status of obese subjects are the friction of the skin through fat depositions on the thighs, the increased plantar foot pressure (first and lesser metatarsal, mid-foot and heel region), as well as the pain and discomfort experienced when performing physical activities [30,[49][50][51].…”

Section: Original Articlementioning

confidence: 99%

Critical review of the equations predicting 6-minute walking distance in obese subjects

Donini

Poggiogalle

Mosca

et al. 2016

Monaldi Arch Chest Dis

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The correlation between the 6-minute walking distance and obesity has been only partially explored. Results obtained from the existing predictive equations are influenced by a variety of factors (health status, severity of obesity, reduced muscle strength and mobility, decreased aerobic capacity, presence of comorbidities).The aim of our study was to verify, compare and discuss the 6MWD predictive capacity of the equations currently available in the literature in a sample of obese subjects.Despite similar study design, the considered articles varied with regard to the number of individuals included and to age range. None of the equations available in the literature was able to accurately predict the six-minute walked distance performed by the obese subjects involved in our study. The six-minute walked distance performed by obese subjects seems to be influenced by other factors than the variables included in the equations from the literature, suggesting that they may not thoroughly capture the complexity of disability in obese people. Future research should be designed in order to validate population-specific equations, by including variables related to clinical, functional, and psychological areas, which are usually impaired in obese individuals.

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“…The fatigue during rehabilitation of those patients is difficult to evaluate. It is often unclear whether it arises from abnormalities of the circulatory system, respiratory system or the above-mentioned increased energy expenditure that favours discovery of so far unknown cardiac insufficiency in Unauthenticated Download Date | 5/12/18 10:30 AM oczywiście również sprzyja ujawnieniu w okresie okołoopera-cyjnym dotąd niemej klinicznie niewydolności serca [43]. Niestety często rehabilitacja pooperacyjna jest dla tej grupy chorych pierwszym od lat wysiłkiem fizycznym, co uniemożliwia odniesienie się do jego tolerancji z okresu przed zabiegiem.…”

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“…Pacjenci z HbA 1c > 9% nie powinni być poddawani zabiegom planowym. Niestety oznaczenie tego parametru często jest pomijane podczas oceny przedzathe perioperative period [43]. Sadly, for those patients post-operative rehabilitation is often the first physical exercise after years of inactivity, and thus, exercise tolerance cannot be compared to that prior to the procedure.…”

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The significance of post-operative rehabilitation in obese and overweight patients

Sutkowska¹,

Konieczny²,

Wrzosek³

et al. 2014

Physiotherapy

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StreszczenieOtyłość jest samodzielnym czynnikiem ryzyka wielu chorób. Nieprawidłowa masa ciała utrudnia rehabilitację pacjentów po zabiegach. W okresie pooperacyjnym często dochodzi do ujawnienia wielu nieprawidłowości, wcześniej ignorowanych przez chorego. Z tego powodu okres rekonwalescencji przedłuża się i nie zawsze w pełni satysfakcjonuje pacjenta i lekarza. Odpowiednie przygotowanie pacjentów otyłych do zabiegu oraz świadomość wystąpienia trudności w czasie ich rehabilitacji po operacji jest warunkiem dobrej współpracy z chorym i bezpiecznego przebiegu rekonwalescencji. W artykule omówiono najczęstsze problemy, które mogą pojawić się po rozpoczęciu rehabilitacji u pacjentów otyłych.Słowa kluczowe: rehabilitacja, otyłość, powikłania AbstractObesity is an independent risk factor for a number of diseases. Inadequate weight makes post-operative rehabilitation more difficult. It is not uncommon that at the post-operative stage many abnormalities, often ignored by the patient, are discovered. For this reason, the recovery takes longer and its results are not always satisfactory for patients and physicians. Adequate preparation of obese patients for the procedure and awareness of potential difficulties that may arise during post-operative rehabilitation are essential requisites for effective cooperation with the patient and safe recovery. The paper describes the most frequent problems experienced by obese patients during rehabilitation. Keywords: rehabilitation, obesity, complicationsOd wielu lat obserwowana jest epidemia otyłości w krajach cywilizowanych, także w Polsce [1]. Staje się to dużym wyzwaniem dla medycyny nie tylko ze względu na powikłania internistyczne otyłości, ale również dlatego, że osoby otyłe poddawane są zabiegom operacyjnym co najmniej tak samo czę-sto jak normostenicy. Przewiduje się, że ogólna liczba operacji do 2020 roku wzrośnie o ok. 25% [2]. Skoro zwiększa się liczba otyłych pacjentów, należy się zastanowić, czy ta grupa chorych może powodować dodatkowe problemy podczas opieki okołooperacyjnej i rehabilitacji po zabiegach. Z europejskich i amerykańskich badań wynika, że otyłość wiąże się z dużo większą śmiertelnością całkowitą [3][4][5][6][7][8][9]. Ogólna częstość hospitalizacji osób otyłych jest także więk-sza niż w przypadku pozostałej populacji [10][11][12]. Znany jest negatywny wpływ otyłości na śmiertelność i powikłania okołooperacyjne w chirurgii ogólnej [13][14][15][16][17][18] For many years, the obesity epidemic has been observed in advanced countries, Poland included [1]. It is becoming a great challenge for medicine, not only on account of internal complications of obesity, but also in view of the fact the obese people undergo surgery as often as normostenics. It is anticipated that by 2020 the general number of surgeries will grow by around 25% [2]. Since the group of obese patients is growing, one should consider whether this group of patients may pose additional problems in perioperative care and post-operative rehabilitation.European and American research studies suggest...

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Work Capacity and Cardiopulmonary Adaptation of the Obese Subject during Exercise Testing

Cited by 74 publications

References 20 publications

Influence of Excess Adiposity on Exercise Fitness and Performance in Overweight Children and Adolescents

Influence of Excess Adiposity on Exercise Fitness and Performance in Overweight Children and Adolescents

Critical review of the equations predicting 6-minute walking distance in obese subjects

The significance of post-operative rehabilitation in obese and overweight patients

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