Concurrent and Aerobic Exercise on Maximal Oxygen Consumption in Adults with Obesity: Study Protocol for a Randomized Controlled Trial
Ejercicio Concurrente y Aeróbico sobre el Consumo Máximo de Oxígeno en Adultos con Obesidad: Protocolo de estudio para un ensayo controlado aleatorizado
Abstract
Background. Concurrent and aerobic physical exercise are strategies for treating overweight and obesity. Most interventions have utilized cardiovascular or guided execution machines, which often involve high-cost materials not easily accessible to the general population.
Objective. Identify the effect of 12 weeks of exercise (concurrent vs. aerobic training) based on the polarized training intensity distribution model on maximal oxygen consumption, muscle strength, and body composition.
Materials and methods. A randomized controlled trial with two groups, concurrent vs. aerobic training (n = 28), in overweight and obese individuals. Both groups will perform 36 sessions, 3 times a week, on alternate days.
Results. Current evidence has not demonstrated the superiority of concurrent over aerobic exercise on VO2max, muscle strength, and body composition. Additionally, the few randomized studies with concurrent exercise and the methodological limitations in their designs justify the importance of comparing both types of exercise to determine the best strategies for overweight and obese individuals regarding the mentioned outcomes.
Downloads
Authors
Keywords
References
Organizacion Mundial de la salud (OMS). Obesidad y sobrepeso [Internet]. 2021 [updated 2024 Mar 1; cited 2022 Oct 9]. Available from: https://www.who.int/es/news-room/fact-sheets/detail/obesity-and-overweight
Lobstein T, Brinsden H, Neveux M, compilers. World Obesity Atlas 2022 [Internet]. London: World Obesity Federation; 2022 March. 289 p. Available from: https://www.worldobesity.org/resources/resource-library/world-obesity-atlas-2022
FAO, WFP, PAHO, WHO, UNICEF, IFAD. Regional Overview of Food Security and Nutrition in Latin America and the Caribbean 2020. In Brief [Internet]. Santiago: FAO; 2021 [cited 2022 Oct 12]. 33 p. Available from: https://www.fao.org/policy-support/tools-and-publications/resources-details/es/c/1377737/
Batrakoulis A, Jamurtas AZ, Metsios GS, Perivoliotis K, Liguori G, Feito Y, et al. Comparative Efficacy of 5 Exercise Types on Cardiometabolic Health in Overweight and Obese Adults: A Systematic Review and Network Meta-Analysis of 81 Randomized Controlled Trials. Circ Cardiovasc Qual Outcomes [Internet]. 2022 Jun;15(6):E008243. doi: https://doi.org/10.1161/circoutcomes.121.008243 DOI: https://doi.org/10.1161/CIRCOUTCOMES.121.008243
Lamoureux NR, Fitzgerald JS, Norton KI, Sabato T, Tremblay MS, Tomkinson GR. Temporal Trends in the Cardiorespiratory Fitness of 2,525,827 Adults Between 1967 and 2016: A Systematic Review. Sports Med [Internet]. 2019;49(1):41-55. doi: https://doi.org/10.1007/s40279-018-1017-y DOI: https://doi.org/10.1007/s40279-018-1017-y
Slentz CA, Bateman LA, Willis LH, Tamlyn Shields A, Tanner CJ, Piner LW, et al. Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT. Am J Physiol Endocrinol Metabolic [Internet]. 2011;301(5):E1033-E1039. doi: https://doi.org/10.1152/ajpendo.00291.2011 DOI: https://doi.org/10.1152/ajpendo.00291.2011
Donges CE, Duffield R, Guelfi KJ, Smith GC, Adams DR, Edge JA. Comparative effects of single-mode vs. duration-matched concurrent exercise training on body composition, low-grade inflammation, and glucose regulation in sedentary, overweight, middle-aged men. Appl Physiol Nutr Metab [Internet]. 2013 Jul;38(7):779-88. doi: https://doi.org/10.1139/apnm-2012-0443 DOI: https://doi.org/10.1139/apnm-2012-0443
Schroeder EC, Franke WD, Sharp RL, Lee D chul. Comparative effectiveness of aerobic, resistance, and combined training on cardiovascular disease risk factors: A randomized controlled trial. PLoS One [Internet]. 2019 Jan;14(1): e0210292. doi: https://doi.org/10.1371/journal.pone.0210292 DOI: https://doi.org/10.1371/journal.pone.0210292
Gram AS, Petersen MB, Quist JS, Rosenkilde M, Stallknecht B, Bladbjerg EM. Effects of 6 Months of Active Commuting and Leisure-Time Exercise on Fibrin Turnover in Sedentary Individuals with Overweight and Obesity: A Randomised Controlled Trial. J Obes [Internet]. 2018;2018:7140754. doi: https://doi.org/10.1155/2018/7140754 DOI: https://doi.org/10.1155/2018/7140754
Emerenziani GP, Gallotta MC, Meucci M, Luigi Di L, Migliaccio S, Donini LM, et al. Effects of Aerobic Exercise Based upon Heart Rate at Aerobic Threshold in Obese Elderly Subjects with Type 2 Diabetes. Int J Endocrinol [Internet]. 2015;2015:695297. doi: https://doi.org/10.1155/2015/695297 DOI: https://doi.org/10.1155/2015/695297
Jin CH, Rhyu HS, Kim JY. The effects of combined aerobic and resistance training on inflammatory markers in obese men. J Exerc Rehabil [Internet]. 2018;14(4):660-5. doi: https://doi.org/10.12965/jer.1836294.147 DOI: https://doi.org/10.12965/jer.1836294.147
Atashak S, Stannard SR, Azizbeigi K. Cardiovascular risk factors adaptation to concurrent training in overweight sedentary middle-aged men. J Sports Med Phys Fitness [Internet]. 2016;56(5):624-30. Available from: https://www.researchgate.net/publication/272187511
Cruz-González JJ, Arboleda-Serna VH. Training intensity distribution on running time in amateur endurance runners: a scoping review. Rev Investig Innov Cienc Salud [Internet]. 2022;4(2):137-49. doi: https://doi.org/10.46634/riics.136 DOI: https://doi.org/10.46634/riics.136
Kenneally M, Casado A, Santos-Concejero J. The effect of periodization and training intensity distribution on middle-and long-distance running performance: A systematic review. Int J Sports Physiol Perform [Internet]. 2018;13(9):1114-21. doi: https://doi.org/10.1123/ijspp.2017-0327 DOI: https://doi.org/10.1123/ijspp.2017-0327
Treff G, Winkert K, Sareban M, Steinacker JM, Sperlich B. The polarization-index: A simple calculation to distinguish polarized from non-polarized training intensity distributions. Front Physiol [Internet]. 2019;10. doi: https://doi.org/10.3389/fphys.2019.00707 DOI: https://doi.org/10.3389/fphys.2019.00707
Hydren JR, Cohen BS. Current Scientific Evidence for a Polarized Cardiovascular Endurance Training Model. J Strength Cond Res [Internet]. 2015;29(12):3523-30. doi: https://doi.org/10.1519/JSC.0000000000001197 DOI: https://doi.org/10.1519/JSC.0000000000001197
Zapata-Lamana R, Henríquez-Olguín C, Burgos C, Meneses-Valdés R, Cigarroa I, Soto C, et al. Effects of polarized training on cardiometabolic risk factors in young overweight and obese women: A randomized-controlled trial. Front Physiol [Internet]. 2018;9. doi: https://doi.org/10.3389/fphys.2018.01287 DOI: https://doi.org/10.3389/fphys.2018.01287
Van Baak MA, Pramono A, Battista F, Beaulieu K, Blundell JE, Busetto L, et al. Effect of different types of regular exercise on physical fitness in adults with overweight or obesity: Systematic review and meta-analyses. Obes Rev [Internet]. 2021;22(Suppl 4). doi: https://doi.org/10.1111/obr.13239 DOI: https://doi.org/10.1111/obr.13239
Scapini KB, Bohlke M, Moraes OA, Rodrigues CG, Inácio JF, Sbruzzi G, et al. Combined training is the most effective training modality to improve aerobic capacity and blood pressure control in people requiring haemodialysis for end-stage renal disease: systematic review and network meta-analysis. J Physiother [Internet]. 2019;65(1):4-15. doi: https://doi.org/10.1016/J.JPHYS.2018.11.008 DOI: https://doi.org/10.1016/j.jphys.2018.11.008
Ratajczak M, Skrypnik D, Bogdański P, Madry E, Walkowiak J, Szulińska M, et al. Effects of Endurance and Endurance-Strength Training on Endothelial Function in Women with Obesity: A Randomized Trial. Int J Environ Res Public Health [Internet]. 2019;16(21):1-13. doi: https://doi.org/10.3390/IJERPH16214291 DOI: https://doi.org/10.3390/ijerph16214291
O’Donoghue G, Blake C, Cunningham C, Lennon O, Perrotta C. What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta-analysis. Obes Rev [Internet]. 2021;22(2):e13137. doi: https://doi.org/10.1111/OBR.13137 DOI: https://doi.org/10.1111/obr.13137
Morze J, Rücker G, Danielewicz A, Przybyłowicz K, Neuenschwander M, Schlesinger S, et al. Impact of different training modalities on anthropometric outcomes in patients with obesity: A systematic review and network meta-analysis. Obes Rev [Internet]. 2021;22(7):e13218. doi: https://doi.org/10.1111/obr.13218 DOI: https://doi.org/10.1111/obr.13218
Chen HT, Chung YC, Chen YJ, Ho SY, Wu HJ. Effects of Different Types of Exercise on Body Composition, Muscle Strength, and IGF-1 in the Elderly with Sarcopenic Obesity. J Am Geriatr Soc [Internet]. 2017;65(4):827-32. doi: https://doi.org/10.1111/jgs.14722 DOI: https://doi.org/10.1111/jgs.14722
Hsu KJ, Liao C De, Tsai MW, Chen CN. Effects of Exercise and Nutritional Intervention on Body Composition, Metabolic Health, and Physical Performance in Adults with Sarcopenic Obesity: A Meta-Analysis. Nutrients [Internet]. 2019;11(9):1-15. doi https://doi.org/10.3390/NU11092163 DOI: https://doi.org/10.3390/nu11092163
Wang S, Zhou H, Zhao C, He H. Effect of Exercise Training on Body Composition and Inflammatory Cytokine Levels in Overweight and Obese Individuals: A Systematic Review and Network Meta-Analysis. Front Immunol [Internet]. 2022;13:921085. doi: https://doi.org/10.3389/fimmu.2022.921085 DOI: https://doi.org/10.3389/fimmu.2022.921085
Soori R, Rezaeian N, Khosravi N, Ahmadizad S, Taleghani HM, Jourkesh M, et al. Effects of water-based endurance training, resistance training, and combined water and resistance training programs on visfatin and ICAM-1 levels in sedentary obese women. Sci Sports [Internet]. 2017;32(3):144-51. doi: https://doi.org/10.1016/J.SCISPO.2016.12.004 DOI: https://doi.org/10.1016/j.scispo.2016.12.004
Park SH, Kim CG. What Types of Exercise Are More Effective in Reducing Obesity and Blood Pressure for Middle-Aged Women? A Systematic Review with Meta-Analysis. Biol Res Nurs [Internet]. 2021;23(4):658-75. doi: https://doi.org/10.1177/10998004211015424 DOI: https://doi.org/10.1177/10998004211015424
Park SK, Park JH, Kwon YC, Kim HS, Yoon MS, Park HT. The Effect of Combined Aerobic and Resistance Exercise Training on Abdominal Fat in Obese Middle-aged Women. J Physiol Anthropol Appl Human Sci [Internet]. 2003;22(3):129-35. doi: https://doi.org/10.2114/JPA.22.129 DOI: https://doi.org/10.2114/jpa.22.129
Deligiannis A, Kouidi E, Tourkantonis A. Effects of physical training on heart rate variability in patients on hemodialysis. Am J Cardiol [Internet]. 1999;84(2):197-202. doi: https://doi.org/10.1016/S0002-9149(99)00234-9 DOI: https://doi.org/10.1016/S0002-9149(99)00234-9
Cuff DJ, Meneilly GS, Martin A, Ignaszewski A, Tildesley HD, Frohlich JJ. Effective Exercise Modality to Reduce Insulin Resistance in Women with Type 2 Diabetes. Diabetes Care [Internet]. 2003;26(11):2977-82. doi: https://doi.org/10.2337/DIACARE.26.11.2977 DOI: https://doi.org/10.2337/diacare.26.11.2977
Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA [Internet]. 2009;301(19):2024-35. doi: https://doi.org/10.1001/JAMA.2009.681 DOI: https://doi.org/10.1001/jama.2009.681
Slade SC, Dionne CE, Underwood M, Buchbinder R. Consensus on Exercise Reporting Template (CERT): Explanation and Elaboration Statement. Br J Sports Med [Internet]. 2016;50(23):1428-37. doi: https://doi.org/10.1136/bjsports-2016-096651 DOI: https://doi.org/10.1136/bjsports-2016-096651
Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ [Internet]. 2010;340:c869. doi: https://doi.org/10.1136/bmj.c869 DOI: https://doi.org/10.1136/bmj.c869
Sealed Envelope Ltd. Create a blocked randomisation list [Internet]. 2022 [cited 2023 Feb 5]. Available from: https://www.sealedenvelope.com/simple-randomiser/v1/lists
Ellegård L, Bertz F, Winkvist A, Bosaeus I, Brekke HK. Body composition in overweight and obese women postpartum: bioimpedance methods validated by dual energy X-ray absorptiometry and doubly labeled water. Eur J Clin Nutr [Internet]. 2016;70(10):1181-8. doi: https://doi.org/10.1038/EJCN.2016.50 DOI: https://doi.org/10.1038/ejcn.2016.50
ERGOTECH Consulting SL. Sistema Dinámico de Medida para la Evaluación y el Entrenamiento de la Fuerza. Manual del usuario. Versión 2.35. Ergotech; 2011. 85 p.
Hoppe MW, Sperlich B, Baumgart C, Janssen M, Freiwald J. Reliabilität ausgewählter Parameter der Fahrradergospirometrie anhand des PowerCube-Ergo-Atemgasanalysators. Sportverletz Sportschaden [Internet]. 2015;29(3):173-9. doi: https://doi.org/10.1055/S-0034-1399096/ID/BR764-53 DOI: https://doi.org/10.1055/s-0034-1399096
Vickers AJ, Altman DG. Analysing controlled trials with baseline and follow up measurements. BMJ [Internet]. 2001;323(7321):1123-4. doi: https://doi.org/10.1136/bmj.323.7321.1123 DOI: https://doi.org/10.1136/bmj.323.7321.1123