Transcript Exercise Physiology and Fitness

Effect of exercise in treatment
of obesity
T.Ahadi MD
Gr.Raissi MD
Assistant professor of physical medicine
and rehabilitation
Prevalence of obesity
Prevalence of obesity
Why Exercise prescription is
important in obesity?
 Obesity
is associated with numerous health
problems and earlier mortality. Exercise is
effective for these co morbidities.
 Attempted weight loss is a common
behavior, approximately 40% of women
and 25% of men try to lose weight
Benefits of Exercise in obesity
 Cardiovascular
-Improved cardiovascular performance
-Slowing at atherosclerosis
-Blood pressure reduction
-Increased peripheral blood flow
- Lower pulse rate
- Larger stroke volume
Benefits of Exercise in obesity
 Metabolic
-Improve Lipid profile
-Decrease type2 DM
-Reduction of truncal obesity
-Increase of basic metabolic rate
 Reduction the rate of cancer (reproductive, Colon)
 Reduction the risk OA and OP
Benefits of Exercise in obesity
 Psychological
-Improve self image
-Decrease anxiety
-Improve the symptoms of depression
Cochrane Review
Exercise for overweight or obesity
(Cochrane Review)
Main results
The 43 studies included 3476 participants.
1-When compared with no treatment, exercise
resulted in small weight losses across studies.
Exercise combined with diet resulted in a greater
weight reduction than diet alone .
Increasing exercise intensity increased the
magnitude of weight loss
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Exercise for overweight or obesity
(Cochrane Review)
2 -Exercise as a sole weight loss intervention resulted in significant
reductions in diastolic blood pressure, triglycerides and fasting glucose.
No significant LDL reduction was detected, but HDL increase significantly.
Higher intensity exercise resulted in greater reduction in
fasting serum glucose than lower intensity exercise
Exercise for overweight or obesity (Review) 1
Copyright © 2009 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd
Pre exercise evaluation
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Current and previous exercise patterns.
Preferred types of exercise activity.
Review of heart disease risk factors:
(family history of heart disease before age 50; diabetes,
hypertension, smoking, hyperlipidemia; and sedentary
lifestyle and obesity).
Current medical problems (cardiac, pulmonary, and
musculoskeletal) .
History of exercise-induced symptoms (chest
pain,shortness of breath,).
Time and scheduling considerations.
Social support for exercise.
Current medications
Goal Writing
“Ink it, don’t think it.”
SMART
 Specific
 Measurable
 Achievable
 Realistic
 Timed
Goal writing
 Defining
the expected goals
 specifying the target weight
 Quantifying the performance
 Specifying the time period
”10%weight loss in 6month0/2-0/4 kg/wk.”
Goal Writing (continued)
 Goals
should be specified as:
 Short-term - STG – within 6 month
 Long-term – LTG – After 6 month
Exercise prescription
(FITT formula)
 Frequency
 Number of sessions each week
 Intensity
 Degree of effort put forth by the individual
during exercise.
 Time
 Duration of activity
 Type
 Mode of exercise being performed
Planning an exercise Program
 Threshold
of training
 Minimal level of exercise needed to achieve desired benefits.
 Target
zone
 Defines the upper limits of training and the optimal level of
exercise.
 FITT formula
 Frequency, Intensity, Time, and Type
 Manipulate these factors to produce an individualized
exercise program.
 Needs
and goals of individual
 Program should meet the goals of the individual
Goal
Initial goal of weight-loss therapy is to reduce BW by
approximately 10% from baseline within 6 months of
therapy.
 For patients with BMIs in the 25 to 35 range, a decrease
of 300 to 500 kcal/d results in weight losses of about 0.23 to
0.45 kg/wk and a 10% loss in 6 months (Table 1).
 For more severely obese patients with BMIs greater than
35 kg/m2, deficits of up to 500 to 1,000 kcal/d lead to
weight losses of about 0.45to 0.90 kg/wk and a 10%
weight loss in 6 months
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Goal
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The minimal amount of
accumulated physical
activity generally
recommended to achieve a
degree of protection from
chronic diseases (30
min/d) is insufficient for
most persons to maintain
BW in the desirable BMI
range (18.5–24.9 kg/m2).
Exercise
Nutrition
Cognitivebehavior
therapy
FITT Formula
 Frequency:
Start from 3d/wk
Goal is 5d/wk or near all d/wk
Prim Care Clin Office Pract 36 (2009) 379–393
FITT Formula
 Intensity:
between 45% to 85% of the maximal
heart rate
- maximal heart rate : By subtracting a patient’s age
from 220 (for men) or 226 (for women), a
maximal heart rate can be calculated.
- Adjustments in intensity should be made based on
a person’s baseline level of fitness, with lowerintensity exercise recommended for less fit
individuals.
Prim Care Clin Office Pract 36 (2009) 379–393
FITT Formula
 Time:
-Start from 30 min/d
Goal is 45 min/d and
more
-For weight
maintenance 6080min/d
FITT Formula
Type:
Aerobicactivities (Jogging,Running,Walking,Dancing,Biking,Swimming)
 Aerobic EX is the choice because of cardio respiratory effects
- large muscle groups are used in continuous rhythmic activity for
prolonged periods.
- Aerobic activities provide isotonic exercise, whereby skeletal
muscle fibers shorten in length with little change in tension.
-During isotonic exercise, heart rate and cardiac output increase, but
peripheral vascular resistance falls.
-During isometric exercise muscle tension increases with little change in
fiber length, producing a marked increase in peripheral vascular
resistance and blood pressure with little increase in cardiac output
 Patient should enjoy the activity
 an exercise prescription should contain recommendations for
resistance training and
flexibility training at least twice a week
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Flexibility
 Maximum
range of
motion possible at a
joint
 Can prevent muscle
injuries; improve lowback pain
Strengthening exercise
 Maintenance
of proper posture; protect
joints.
 Production of power to enhance
performance
Prevention
of osteoporosis
Exercise for geriatric
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2 main problem in Ex prescription in elderly
Differences in aerobic and functional capacity
Reduced strength and endurance of muscles
associated with aging and chronic Dis.
Flexibility training
Resistance training
Aerobic exercise.
Exercise for obes children
 An
exercise prescription similar to that for adults
appears appropriate for childrenolder than 6 years.
 Children should enjoy the EX.
 6omin/d,moderate intencity,near all day/weak,
Aerobic EX
 Limit resistant training
Summery
 45
min/d or more of aerobic Ex in 5 or
preferably all days of the week with
intencity of 45% to 85% of MaxHR
 Strength-developing
and flexibility
activities at least twice a week.
Thank you