Amaç: Bu çalışmanın amacı, obezitesi olan kadınlarda evde uzman olmadan uygulanan tıbbi beslenme tedavisi ile desteklenen kombine egzersiz modelinin (aerobik ve direnç); vücut kompozisyonuna, el kavrama kuvvetine, esnekliğe, 6 dk yürüme mesafesine (6DYM) ve yaşam kalitesine olan etkisinin incelenmesidir. Gereç ve Yöntemler: Bir üniversitenin obezite merkezinde tıbbi takipleri yapılan 9 obez kadının (yaş ortalaması 45,00±7,31 yıl; beden kitle indeksi ortalaması: 40,96±8,30 kg/m2 ), araştırmanın başında ve sonunda vücut kompozisyonları (TANITA-SC-330) analiz edilmiş, ayrıca otur-uzan esneklik, el kavrama kuvveti ve 6DYM değerleri belirlenmiştir. Bu testlerinin yanı sıra katılımcılara yaşam kalitesi ölçeği (SF-36) uygulanmıştır. Katılımcıların, 24 saatlik geriye dönük besin tüketim kaydı ile yeme alışkanlıkları belirlenmiş, besin tüketimleri Beslenme Bilgi Sistemi (BeBiS 6.1) ile değerlendirilmiş ve bireye özgü tıbbi beslenme tedavisi düzenlenmiştir. Sekiz hafta süresince katılımcılara video görseli gönderilerek, toplamda 39 seans aerobik (4-6 gün/hafta, 15-25 dk/gün) ve 19 seans direnç (3-4 gün/hafta, 12-20 dk/gün) kombine egzersiz programını evlerinde yapmaları sağlanmıştır. İstatistiksel analizlerde Shapiro-Wilks normallik analizi ve Wilcoxon işaretli sıralar testi kullanılmıştır. Bulgular: Katılımcıların 6DYM (%37,1), el kavrama kuvveti (%19), otur-uzan esneklik (%12,3) ve yağsız vücut kütlesi (%1,7) değerlerinde anlamlı düzeyde artış sağlanmıştır (p0,05). Sonuç: Obezitesi olan kadınlarda, 8 hafta süresince evde uygulanan, tıbbi beslenme tedavisi ile desteklenmiş kombine egzersizler, vücut kompozisyonunu olumlu yönde değiştirmiş; esnekliği, kas kuvvetini, fiziksel performansı ve yaşam kalitesini arttırmıştır. Ev temelli egzersizler, obezitesi olan kadınlarda davranış değişikliği sağlamak amacıyla tedavinin bir parçası olarak kullanılabilir.
Anahtar Kelimeler: Ev temelli egzersiz; fiziksel performans; obezite; vücut kompozisyonu; yaşam kalitesi
Objective: To investigate the impact of a home based combined (aerobic and resistance) exercise model with medical nutritional therapy on body composition, hand grip strength, body flexibility, 6 minute walking distance (6MWD) and quality of life (QoL) in women living with obesity. Material and Methods: Nine women living with obesity, followed in a university obesity center, were included in the study (mean age: 45.00±7.31 years, Body Mass Index (BMI): 40.96±8.30 kg/m2 ). Body composition was evaluated at the beginning and the end (TANITA-SC-330). Body flexibility, grip strength, 6MWD tests and QoL survey (SF-36) were administered. Dietary adjustments were processed through Nutrition Informational Systems (BeBİS 6.1). Participants performed 39 sessions of aerobic (4-6 days/week, 15-25 min/day) and 19 sessions of resistance (3-4 days/week, 12-20 min/day) exercise at home with the aid of audio-visual instructions for eight weeks. Shapiro-Wilks normality analysis and Wilcoxon signed rank test were used for statistical analyses. Results: A significant increase in 6MWD (%37.1), hand grip strength (%19), body flexibility (%12.3) and fat free mass (%1.7) was encountered (p0.05). Conclusion: An eight-week home based combined exercise model in women living with obesity had a beneficial effect on body composition, hand grip strength, body flexibility, 6-minute walking distance and quality of life.
Keywords: Home based exercise; physical performance; obesity; body composition; quality of life
- Bloom OJ, Fields KB, McGrath TM, Draper TR. Exercise prescription and physiology. In: Madden C, Putukian M, McCarty E, Young CC. Netter's Sports Medicine. 2nd ed. Phidelphia: Elsevier; 2018. p.117-23.
- McInnis KJ. Exercise for obese clients: benefits, limitations, guidelenes. ACSM'S Health & Fitness Journal. 2000;4(1):25-31.
- Schwartz MB, Brownell KD. Obesity and body image. Body Image. 2004;1(1):43-56.[Crossref] [PubMed]
- Puhl RM, Moss-Racusin CA, Schwartz MB. Internalization of weight bias: implications for binge eating and emotional well-being. Obesity (Silver Spring). 2007;15(1):19-23.[Crossref] [PubMed]
- Paluska SA, Schwenk TL. Physical activity and mental health: current concepts. Sports Med. 2000;29(3):167-80.[Crossref] [PubMed]
- Johnston L, Matteson CL, Finegood D. Systems science and obesity policy: a novel framework for analyzing and rethinking population-level planning. Am J Public Health. 2014;104(7):1270-8.[Crossref] [PubMed] [PMC]
- Dikareva A, Andersen RE. Physical activity programming for clients with obesity: considerations for exercise professionals. ACSM's Health & Fitness Journal. 2016;20(4):21-7.[Crossref]
- Oksel E, Kolcu Z, Yorulmaz S, Paşaoğlu Ş. [Quality of life in obese persons]. Ege Üniversitesi Hemşirelik Yüksek Okulu Dergisi. 2008;24(3):115-23.
- Rand K, Vallis M, Aston M, Price S, Piccinini-Vallis H, Rehman L, et al. It is not the diet; it is the mental part we need help with. A multilevel analysis of psychological, emotional, and social well-being in obesity. Int J Qual Stud Health Well-being. 2017;12(1):1306421.[Crossref] [PubMed] [PMC]
- Santangelo KS, Radakovich LB, Fouts J, Foster MT. Pathophysiology of obesity on knee joint homeostasis: contributions of the infrapatellar fat pad. Horm Mol Biol Clin Investig. 2016;26(2):97-108.[Crossref] [PubMed]
- McDermott MM, Guralnik JM, Ferrucci L, Tian L, Kibbe MR, Greenland P, et al. Community walking speed, sedentary or lying down time, and mortality in peripheral artery disease. Vasc Med. 2016;21(2):120-9.[Crossref] [PubMed] [PMC]
- American College of Sports Medicine. Exercise prescription for individuals with metabolic disease and cardiovascular disease risk factors. In: Riebe D, Ehrman JK, Liguori G, Magal M, eds. ACSM's Guidelines for Exercise Testing and Prescription. 10th ed. Philadelphia, PA: Wolters Kluwer; 2018. p.377-417.
- Bartelink ML, Stoffers HEJH, Biesheuvel CJ, Hoes AW. Walking exercise in patients with intermittent claudication. Experience in routine clinical practice. Br J Gen Pract. 2004;54(500):196-200.[PubMed]
- Dias MRC, Simão R, Machado GH, Furtado H, Sousa NF, Fernandes HM, et al. Relationship of different perceived exertion scales in walking or running with self-selected and imposed intensity. J Hum Kinet. 2014;43:149-57.[Crossref] [PubMed] [PMC]
- Emerenziani GP, Gallotta MC, Migliaccio S, Ferrari D, Greco EA, Saavedra FJ, et al. Effects of an individualized home-based unsupervised aerobic training on body composition and physiological parameters in obese adults are independent of gender. J Endocrinol Invest. 2018;41(4):465-73.[Crossref] [PubMed] [PMC]
- Shephard RJ. PAR-Q, Canadian Home Fitness Test and exercise screening alternatives. Sports Med. 1988;5(3):185-95.[Crossref] [PubMed]
- Marfell-Jones M, Olds T, Stewart A, Stewart-Oaten A, Jones M, Ridder WH. International Society for the Advancement of Kinanthropometry. International standards for anthropometric assessment. Potchefstroom, South Africa, 2001. https://www.scienceopen.com/document?vid=ccde4859-d1c7-4ea6-92b8-37d48744f862
- World Health Organization. Obesity Preventing and Managing the Global Epidemic: Report of a WHO Consultation on Obesity. Switzerland: WHO; 1997.
- Gerodimos V, Karatrantou K, Psychou D, Vasilopoulou T, Zafeiridis A. Static and dynamic handgrip strength endurance: test-retest reproducibility. J Hand Surg Am. 2017;42(3):e175-e184.[Crossref] [PubMed]
- Kim CR, Jeon YJ, Kim MC, Jeong T, Koo WR. Reference values for hand grip strength in the South Korean population. PLoS One. 2018;13(4):e0195485.[Crossref] [PubMed] [PMC]
- Hui SS, Yuen PY. Validity of the modified back-saversit-and-reach test: a comparison with other protocols. Med Sci Sports Exerc. 2000;32(9):1655-9.[Crossref] [PubMed]
- ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-7.[Crossref] [PubMed]
- Larsson UE, Reynisdottir S. The six‐minute walk test in outpatients with obesity: reproducibility and known group validity. Physiother Res Int. 2008;13(2);84-93.[Crossref] [PubMed]
- Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.[Crossref] [PubMed]
- Enright PL & Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998;158(5):1384-7.[Crossref] [PubMed]
- Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş AK. [Reliability and validity of the Turkish version of form-36 (SF-36)]. İlaç ve Tedavi Dergisi. 1996;12(2):102-6.
- Ware JR, John E, Sherbourne CD. The MOS 36-item short form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-83.[Crossref] [PubMed]
- Obezite Cep Rehberi. Obezitesi olan bireylerin beslenme açısından değerlendirilmesi ve beslenme önerileri. İşeri C, Yazıcı D, editörler. İstanbul: Türkiye Obezite Araştırma Derneği Yayını; 2019. p.15-22.
- Frankenfield D, Roth-Yousey L, Compher C. Evidence Analysis Working Group. Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review. J Am Diet Assoc. 2005;105(5):775-89.[Crossref] [PubMed]
- Karaca, A. Fiziksel Aktivite Değerlendirme Yöntemleri. 1. Baskı. Ankara: Spor Yayınevi; 2017.
- Mattsson E, Larsson UE, Rössner S. Is walking for exercise too exhausting for obese women? Int J Obes Relat Metab Disord. 1997;21(5):380-6.[Crossref] [PubMed]
- Byrne NM, Hills AP. Relationships between HR and (.)VO(₂) in the obese. Med Sci Sports Exerc. 2002;34(9):1419-27.[Crossref] [PubMed]
- Tumiati R, Mazzoni G, Crisafulli E, Serri B, Beneventi C, Lorenzi C, et al. Home-centred physical fitness programme in morbidly obese individuals: a randomized controlled trial. Clin Rehabil. 2008;22(10-11):940-50.[Crossref] [PubMed]
- Aadland E, Robertson L. Physical activity is associated with weight loss and increased cardiorespiratory fitness in severely obese men and women undergoing lifestyle treatment. J Obes. 2012;2012:810594.[Crossref] [PubMed] [PMC]
- Baillot A, Romain AJ, Boisvert-Vigneault K, Audet M, Baillargeon JP, Dionne IJ, et al. Effects of lifestyle interventions that include a physical activity component in class II and III obese individuals: a systematic review and meta-analysis. PLoS One. 2015;10(4):e0119017.[Crossref] [PubMed] [PMC]
- Sartorio A, Lafortuna CL, Vangeli V, Tavani A, Bosetti C, La Vecchia C. Short-term changes of cardiovascular risk factors after a non-pharmacological body weight reduction program. Eur J Clin Nutr. 2001;55(10):865-9.[Crossref] [PubMed]
- Christiansen T, Bruun JM, Madsen EL, Richelsen B. Weight loss maintenance in severely obese adults after an intensive lifestyle intervention: 2- to 4-year follow-up. Obesity (Silver Spring). 2007;15(2):413-20.[Crossref] [PubMed]
- Orange ST, Marshall P, Madden LA, Vince RV. Effect of home‐based resistance training performed with or without a high‐speed component in adults with severe obesity. Translational Sports Medicine. 2020;3(1):34-45.[Crossref]
- Bouchard DR, Soucy L, Sénéchal M, Dionne IJ, Brochu M. Impact of resistance training with or without caloric restriction on physical capacity in obese older women. Menopause. 2009;16(1):66-72.[Crossref] [PubMed]
- Wang J, Tan S, Cao L. Exercise training at the maximal fat oxidation intensity improved health-related physical fitness in overweight middle-aged women. J Exerc Sci Fit. 2015;13(2):111-6.[Crossref] [PubMed] [PMC]
- Hill KD, Hunter SW, Batchelor FA, Cavalheri V, Burton E. Individualized home-based exercise programs for older people to reduce falls and improve physical performance: a systematic review and meta-analysis. Maturitas. 2015;82(1):72-84.[Crossref] [PubMed]
- Juneau M, Rogers F, De Santos V, Yee M, Evans A, Bohn A, et al. Effectiveness of self-monitored, home-based, moderate-intensity exercise training in middle-aged men and women. Am J Cardiol. 1987;60(1):66-70.[Crossref] [PubMed]
- Morey MC, Snyder DC, Sloane R, Cohen HJ, Peterson B, Hartman TJ, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. JAMA. 2009;301(18):1883-91.[Crossref] [PubMed] [PMC]
- McDermott MM, Spring B, Berger JS, Treat-Jacobson D, Conte MS, Creager MA, et al. Effect of a home-based exercise intervention of wearable technology and telephone coaching on walking performance in peripheral artery disease: the HONOR randomized clinical trial. JAMA. 2018;319(16):1665-76.[Crossref] [PubMed] [PMC]
- Mediano MFF, de Oliveira Barbosa JS, Moura AS, Willett WC, Sichieri R. A randomized clinical trial of home-based exercise combined with a slight caloric restriction on obesity prevention among women. Prev Med. 2010;51(3-4):247-52.[Crossref] [PubMed] [PMC]
- Günther CM, Bürger A, Rickert M, Crispin A, Schulz CU. Grip strength in healthy caucasian adults: reference values. J Hand Surg Am. 2008;33(4):558-65.[Crossref] [PubMed]
- Liguori G, American College of Sports Medicine. ACSM's Resources for the Health Fitness Specialist. 1st ed. Philadelphia, PA: Wolters Kluwer Lippincott Williams & Wilkins; 2014. p.405.
- Ölçücü B, Vatansever Ş, Özcan G, Çelik A. [The relationship between physical activity level and life quality among middle aged individuals]. INES Journal. 2015;2(2):63-73.[Crossref]
- Modrzejewska A, Musial P, Baron N, Czepczor-Bernat K. Is quality of life associated with negative emotions, body satisfaction and depression symptoms in sample of obesit? Life and Well-Being. International Student Congress. Faculty of Humanities and Social Sciences. İstanbul: Ege Reklam Basım; 2019. p.31-2.
- El-Kader SMA, Al-Jiffri OH. Impact of aerobic versus resisted exercise training on systemic inflammation biomarkers and quality of Life among obese post-menopausal women. Afr Health Sci. 2019;19(4):2881-91.[Crossref] [PubMed] [PMC]
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