Effects of two resistance exercise programs on the health-related fitness of obese women with pain symptoms in the knees

Abstract

Introduction: Overweight negatively impacts the cardiovascular system and osteomyoarticular, promoting pain in the joints of the lower limbs. Therefore, strategies have been applied to reduce overweight through lifestyle changes. Objective: to investigate the effects of two multidisciplinary intervention programs on the health-related physical fitness of obese women with pain symptoms in the knees. Methods: Women between 40 and 59 years of age with obesity (n=59) were evaluated in the pre- and post-intervention time regarding anthropometry, body composition, physical fitness, level of disability in the knee and hip, and health-related quality of life. A randomized clinical trial of parallel groups was conducted, using two resistance exercise programs and food re-education, for eight weeks. All participants received the same nutritional intervention content and for physical exercises were randomized into two groups, G1 being the "strength group" using machines (n=30), and G2 being the "functional training" group (n=29). Twenty-eight women (G1=18 + G2=10) were included in the final analyses. The groups and time were evaluated by two-way analysis of variance, with repeated measures. A p < 0.05 was assumed for all analyses. Results: a time effect was identified, with higher values for maximum isometric lumbar-traction strength (MILTS), after the intervention period in both groups (p < 0.05). However, for the other variables investigated, no significant differences were identified (p > 0.05). Conclusion: The absence of significant results for all variables, except FIMTL, may be justified by the moderate adherence of the participants to interventions (~59% to 66%) since the study was conducted during the period of social isolation (COVID-19). However, it is believed that the intervention models were positive in maintaining the variables studied.

The usefulness of Integrative Neuromuscular Training to counteract obesity: a narrative review

“…Specifically, the upper and lower-body strength assessed with different procedures (e.g., one repetition maximum in vertical chest press, one repetition maximum in supinated lat pull-down, one repetition maximum in arm press, isometric handgrip strength test, one repetition maximum in horizontal leg press, one repetition maximum in seated leg extension, one repetition maximum in leg curl, sit to stand test, standing long jump test, isometric knee extensor test, isometric ankle plantar-flexors and dorsi-flexor test) showed positive changes in individuals with obesity in favor to an INT approach [ 33 , 37 , 38 , 40 , 42 ]. Two studies [ 34 , 48 ] found similar improvements overtime without differences between training interventions (INT protocol versus control) for both upper and lower-body segments. On one hand, it could be speculated that these controversial results might be due to a reduced adherence to the training program, or to the equipment used (e.g., elastic bands, dumbbells, suspension belts, kettlebells, medicine balls, battle ropes), but on the other hand the duration of each training program (e.g., from eight weeks to ten months) induced a better movement pattern learning and muscle recruitment leading to positive changes in muscular strength [ 50 , 51 ].…”

“…Cardiorespiratory fitness was investigated in six studies [ 33 , 34 , 37 , 41 , 45 , 48 ] reporting significant improvements following a specific neuromuscular training protocol. Batrakoulis and colleagues (2018) showed positive changes in VO2 max from baseline (26.1 ± 4.4 mL/kg/min) to post-training (33.1 ± 4.8 mL/kg/min; p < 0.001) following a INT protocol (e.g., high-intensity whole-body multi-joint movements in a circuit training modality respecting a heart rate maximum major of 65%) with a concomitant significant reduction in blood lactate concentration during the entire training phase (i.e., from week one to week forty) [ 37 ].…”

“…Notably, also La Scala Teixeira and colleagues observed a significant main effect of time on VO2 max ( F = 12.441, p = 0.001) in individuals who performed different functional training circuits composed by free weights, elastic bands and bodyweight movements (e.g., upright row with sumo squat, dumbbell fly with pelvic elevation, elastic trunk rotation, front raise with side lunge, suspended row, knee flexion with elbow flexion, trunk lateral flexion, single leg balance with eyes closed) ( p = 0.014) [ 45 ]. Conversely, three studies did not observe between-group changes in this specific outcome following a INT program [ 33 , 34 , 48 ].…”

“…In three studies, joint range of motion showed significant changes between groups [ 38 , 40 , 48 ]. In detail, Batrakoulis et al demonstrated remarkable variations ( p < 0.001) in sit and reach test and in glenohumeral internal rotation in favor to INT group respect to control group.…”

“…Finally, three days/week promoted a better flexibility ( p < 0.001) in ankle dorsiflexion, knee flexion, hip flexion and shoulder flexion [ 38 ]. Lastly, the study by Cambiriba and colleagues found that the flexibility detected through the Wells bench test reached similar changes in the experimental group who followed a training protocol focused on INT principles when compared to control group [ 48 ].…”