Impacto de um programa mínimo de exercícios físicos supervisionados no risco cardiometabólico de pacientes com obesidade mórbida

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Abstract

OBJETIVO: Avaliar o impacto de um programa mínimo de exercícios físicos supervisionados na capacidade funcional e fatores de risco cardiometabólicos (FRCM) em obesos mórbidos. MATERIAL E MÉTODOS: Estudando uma série de casos com análise tipo pré e pós e amostragem por conveniência, avaliou-se o efeito de um programa semanal de 30 minutos de exercícios aeróbicos supervisionados, durante seis meses, no peso, na capacidade funcional e nos FRCM. RESULTADOS: Estudaram-se 61 indivíduos, dos quais 34 aderiram à intervenção. Nos aderentes, houve modificações em peso (-5,3 ± 5,3 kg, p < 0,0001), teste de caminhada de 6 minutos (69,8 ± 48,6 mts, p < 0,0001), pressão sistólica (-23,8 ± 27,7 mmHg, p < 0,0001), pressão diastólica (-14,4 ± 8,9 mmHg, p < 0 0001), escore de Framingham (-4,4 ± 5,1, p < 0,0001). CONCLUSÃO: Os resultados sugerem que exercícios físicos supervisionados em baixa intensidade e frequência podem interferir positivamente nos FRCM de indivíduos obesos mórbidos.

Translated abstract

OBJECTIVE: The objective aims at evaluating the impact of a minimum program of supervised physical exercise on functional capacity and cardiometabolic risk (CMR) in patients with morbid obesity. MATERIAL AND METHODS: By studying cases with pre and post analyses, we have assessed the variations in weight, functional capacity and in CMR, due to the program of supervised aerobic exercise on a weekly intensity of 30 minutes during a period of 6 months. RESULTS: We have studied 61 subjects, where 34 have only adhered to the intervention. There were significant changes in weight (-5.3 ± 5.3 kg, p < 0.0001), distance in the 6-minute walking test (69.8 ± 48.6 m, p < 0.0001), systolic pressure (-23.8 ± 27.7 mmHg, p < 0.0001), diastolic pressure (-14.4 ± 8.9 mmHg, p < 0.0001) and Framingham Score Risk (-4.4 ± 5.1, p < 0.0001) in the adherent patients. CONCLUSION: The results show that a supervised exercise program of low intensity and frequency might interfere positively on CMR in individuals with morbid obesity.

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The six minute walk test accurately estimates mean peak oxygen uptake

Robert M. Ross, Jayasimha Murthy, Istvan Wollak … (2010)

Background Both Peak Oxygen Uptake (peak VO2), from cardiopulmonary exercise testing (CPET) and the distance walked during a Six-Minute Walk Test (6 MWD) are used for following the natural history of various diseases, timing of procedures such as transplantation and for assessing the response to therapeutic interventions. However, their relationship has not been clearly defined. Methods We determined the ability of 6 MWD to predict peak VO2 using data points from 1,083 patients with diverse cardiopulmonary disorders. The patient data came from a study we performed and 10 separate studies where we were able to electronically convert published scattergrams to bivariate points. Using Linear Mixed Model analysis (LMM), we determined what effect factors such as disease entity and different inter-site testing protocols contributed to the magnitude of the standard error of estimate (SEE). Results The LMM analysis found that only 0.16 ml/kg/min or about 4% of the SEE was due to all of the inter-site testing differences. The major source of error is the inherent variability related to the two tests. Therefore, we were able to create a generalized equation that can be used to predict peak VO2 among patients with different diseases, who have undergone various exercise protocols, with minimal loss of accuracy. Although 6 MWD and peak VO2 are significantly correlated, the SEE is unacceptably large for clinical usefulness in an individual patient. For the data as a whole it is 3.82 ml/kg/min or 26.7% of mean peak VO2. Conversely, the SEE for predicting the mean peak VO2 from mean 6 MWD for the 11 study groups is only 1.1 ml/kg/min. Conclusions A generalized equation can be used to predict peak VO2 from 6 MWD. Unfortunately, like other prediction equations, it is of limited usefulness for individual patients. However, the generalized equation can be used to accurately estimate mean peak VO2 from mean 6 MWD, among groups of patients with diverse diseases without the need for cardiopulmonary exercise testing. The equation is:

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Predictors of 6-minute walk test results in lean, obese and morbidly obese women.

R Lysens, G Vansant, A L Claessens … (2003)

The aim of this study was first, to assess the presence of medical conditions that might interfere with walking; second, to assess the differences in walking capacity, perceived exertion and physical complaints between lean, obese and morbidly obese women; and third, to identify anthropometric, physical fitness and physical activity variables that contribute to the variability in the distance achieved during a 6-minute walk test in lean and obese women. A total of 85 overweight and obese females (18-65 years, body mass index (BMI) > or = 27.5 kg m(-2)), 133 morbidly obese females (BMI > or = 35 kg m-2) and 82 age-matched sedentary lean female volunteers (BMI 35 kg m(-2)N = 133) walked significantly slower (5.4 km h(-1)) than obese (5.9 km h(-1)) and lean women (7.2 km h(-1), P < 0.05), were more exerted (RPE 13.3, 12.8 and 12.4, respectively, P < 0.05) and complained more frequently of dyspnea (9.1%, 4.7% and 0% resp., P < 0.05) and musculoskeletal pain (34.9%, 17.7% and 11.4% resp., P < 0.05) at the end of the walk. In a multiple regression analysis, 75% of the variance in walking distance could be explained by BMI, peakVO2, quadriceps muscle strength age, and hours TV watching or sports participation. These data suggest that in contrast with lean women, walking ability of obese women is hampered not only by overweight, reduced aerobic capacity and a sedentary life style, but also by perceived discomfort and pain. Advice or programs aimed at increasing walking for exercise also need to address the conditions that interfere with walking, as well as perceived symptoms and walking difficulties in order to improve participation and compliance.

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Aerobic exercise and HDL2-C: a meta-analysis of randomized controlled trials.

K. D. Kelley, Diane Kelley (2005)

Use the meta-analytic approach to examine the effects of aerobic exercise on high-density lipoprotein two cholesterol (HDL2-C) in adults. STUDY SOURCES: (1) Computerized literature searches; (2) cross-referencing from retrieved articles; (3) hand-searching; and (4) expert review of our reference list. (1) Randomized controlled trials; (2) aerobic exercise > or = 8 weeks; (3) adults > or = 18 years of age; (4) studies published in journal, dissertation, or master's thesis format; (5) studies published in the English-language between January 1, 1955 and January 1, 2003; and (6) assessment of HDL2-C in the fasting state. All coding conducted by both authors, independent of each other. Discrepancies were resolved by consensus. Nineteen randomized controlled trials representing 20 HDL2-C outcomes from 984 males and females (516 exercise, 468 control) were pooled for analysis. Using random-effects modeling and bootstrap confidence intervals (BCI), a statistically significant increase of approximately 11% was observed for HDL2-C (X +/- S.E.M., 2.6 +/- 0.9 mg/dl, 95% BCI, 1.0-4.4 mg/dl). With each study deleted from the model once, results remained statistically significant. Increases in HDL2-C were independent of decreases in body weight, body mass index (kg/m2), and percent body fat. Aerobic exercise increases HDL2-C in adults.

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Author and article information

Contributors

Emilian Rejane Marcon: Role: ND

Iseu Gus: Role: ND

Cristina Rolim Neumann: Role: ND

Journal

Journal ID (publisher): abem

Title: Arquivos Brasileiros de Endocrinologia & Metabologia

Abbreviated Title: Arq Bras Endocrinol Metab

Publisher: Sociedade Brasileira de Endocrinologia e Metabologia (São Paulo )

ISSN: 1677-9487

Publication date (Print): June 2011

Volume: 55

Issue: 5

Pages: 331-338

Affiliations

[1 ] Instituto de Cardiologia do Rio Grande do Sul Brazil

[2 ] Universidade Federal do Rio Grande do Sul Brazil

[3 ] Universidade Federal do Rio Grande do Sul Brazil

Article

Publisher ID: S0004-27302011000500006

DOI: 10.1590/S0004-27302011000500006

SO-VID: 883ce625-eac7-4045-a364-ec8dda76e7f9

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http://creativecommons.org/licenses/by/4.0/

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SciELO Brazil

Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-2730&lng=en

Impacto de um programa mínimo de exercícios físicos supervisionados no risco cardiometabólico de pacientes com obesidade mórbida Translated title: Impact of a minimum program of supervised exercises in the cardiometabolic risk in patients with morbid obesity

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Most cited references 39

The six minute walk test accurately estimates mean peak oxygen uptake

Predictors of 6-minute walk test results in lean, obese and morbidly obese women.

Aerobic exercise and HDL2-C: a meta-analysis of randomized controlled trials.

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