Cardiopulmonary Adaptation to Exercise Training among Obese Subjects-Juniper Publishers
JUNIPER PUBLISHERS-OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY
Background: Cardiopulmonary fitness
among obese subjects is severely impaired with a multitude of
complications; however exercise training was proved to improve the
physical fitness and overall quality of life.
Objective: The aim was to measure cardiopulmonary adaptation to exercise training among obese subjects.
Material and Methods: Sixty adult
obese male subjects, the range of their age was 32 to 45 years and was
enrolled in two groups: group (A) performed treadmill aerobic exercise
training, where group (B) performed anaerobic exercise training three
sessions/week for three months. Cardiopulmonary functions were measured
for all participants before and after three months at the end of the
study.
Results: Both aerobic and anaerobic
exercise training produced different responses in the cardiopulmonary
functions, where aerobic exercise group indicated a significant
improvement in the cardiopulmonary functions but the anaerobic exercise
program indicated no significant changes in the cardiopulmonary
functions. Moreover, investigated parameters means values were
significantly different between both groups at the end of the study
(P<0.05).
Conclusion: Aerobic exercise is better than anaerobic exercise training in improving cardiopulmonary fitness among obese subjects.
Abbreviations: CPX: Cardio-Pulmonary Exercise stress test; VC: Vital Capacity; MVV: Maximum Voluntary Ventilation; SaO2: Arterial Oxygen Saturation; SBP: Systolic Blood Pressure; DBP: Diastolic Blood Pressure; MHR: Maximum Heart Rate; BMI: Body Mass Index; HDL-C: High-Density Lipoprotein- Cholesterol; TC: Total Cholesterol
Introduction
Obesity is an epidemic worldwide medical problem that
is characterized with excess energy intake than energy output, however,
obesity usually associated with many co-morbidities [1,2]. There are
many risk factors for obesity as hormonal disturbance, environmental
factors, genetic predisposition and behavioral factors [3-6].
Obesity may be named as the mother of diseases as it
is usually associated with number of many medical complications as
cardiovascular disorders as hypertension, stroke and thrombosis as well
as pulmonary disorders as obstructive sleep apnea in addition to
musculoskeletal disorders as osteoarthritis in weight bearing joints,
however poor psychological wellbeing is common among obese subjects
[7-10]. Moreover, diabetes
and metabolic syndrome are common among obese individuals [11,12].
Aerobic exercise was proved to induce functional
adaptation in both pulmonary and cardiovascular systems during rest as
well as during training [13,14]. In the other hand, anaerobic exercise
training was proved to improve cardiopulmonary fitness than low
intensity exercise training although intensive exercise training
couldn’t be tolerated for long time [15]. Therefore, the aim was to
measure cardiopulmonary adaptation to exercise training among obese
subjects.
Sixty healthy obese untrained non-smoking males were
randomly selected from King Abdul-Aziz University, Jeddah, Saudi Arabia
and did their training in fitness time health club, Jeddah, Saudi
Arabia, were included in the study between theperiod of October 2014 and
April 2015. Their age ranged from
32 to 45 (38.54 ± 5.32) years and their BMI ranged from 30-35
kg/m2. Initially, all participants were medically examined at King
Abdulaziz University Out-patient Clinics. Subsequently, their
medical history was taken to collect information about general
condition, physical activity and current medications if any. All
subjects with any cardiovascular conditions (those with a known
history of uncontrolled hypertension, congenital and rheumatic
heart diseases), any pulmonary disease (obstructive or restrictive
lung diseases), orthopedic or neurological abnormality were
excluded from the study. Research Ethical Committee of Faculty
of Applied Medical Sciences, King Abdulaziz University approve
the procedures of our study, in addition all participants signed a
consent form prior to their participation in training. Participants
were enrolled in two groups: group (A) performed treadmill
aerobic exercise training program, where group (B) performed
anaerobic exercise training program. However, both programs
continued for three successive months, three times per week.
- Measured parameters: Cardiopulmonary exercise stress test (CPX) was conducted using CPX unit (Zan 800; made in Germany) in order to measure the maximal oxygen consumption (VO2max) that followed the Bruce standard protocol. In addition, Spirometer (Schiller-Spirovit Sp-10, Swizerland) was used to measure vital capacity (VC) and maximum voluntary ventilation (MVV) with a special sensor to measure the arterial oxygen saturation (SaO2). However, pulse rate was measured with pulsometer (Tunturt TPM- 400, Japan). Moreover, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured with mercury sphygmomanometer (Diplomat Presameter, Germany) and stethoscope (Riester duplex, Germany) before the study and after 3 months at the end of the study.
- Aerobic treadmill exercise training program: Participants of group (A) started exercise training with warming up before the exercise program, included walking on the treadmill for 5 minutes at speed 1.5 km/h, with zero inclination. Mode of walk/run on the treadmill for 30 minutes with zero degree inclination, the frequency was three times weekly; for three successive months. The intensity was increased gradually from 60 to 80% of maximum heart rate (MHR) [16].
- Anaerobic exercise training program: Participants of group (B) started exercise training with warming up before the exercise program, including walking on the treadmill for 5 minutes at speed 1.5 km/h with zero inclination. The duration was a short period of high-intensity anaerobic exercise, started with 2 minutes that was gradually increased to 3 minutes that was repeated five times every sessions with 2 minutes interval between each 2-3 minutes of training, the frequency was three times weekly; for three successive months. The frequency was three times per week; for three months. The intensity was increased gradually from 85 to 93% MHR [17]. Finally, cooling down procedure for all subjects following exercise training included treadmill walking for 5 minutes at speed of 1 km/h, with zero inclination and gradually decreasing speed until reaching zero.
The investigated parameters of both groups were compared
with student’s paired “t” test. However, the differences between
mean values of investigated parameters at the end of the study
of both groups were detected with independent “t” test (P<0.05).
Regarding the demographic variable, both groups were
homogeneous (Table 1). The mean age for group, (A) was 38.42±
5.63 years, and the mean age of the group (B) was 37.64 ± 6.23
years. There was no significant differences in body mass index
(BMI), fasting glucose, triglycerides, high-density lipoproteincholesterol
(HDL), total cholesterol (TC), systolic and diastolic
blood pressure between both groups. The mean values of heart
rate, SBP, and DBP were significantly decreased, where the mean
values of MVV, VO2max and SaO2 were significantly increased in
group (A) at the end of the study (Table 2). The mean values of
heart rate, SBP, DBP and VO2max were not significantly changed
and the mean values of MVV, VC and SaO2 were significantly increased in group (B) at the end of the study (Table 3). Moreover,
investigated parameters means values were significantly
different between both groups at the end of the study (P<0.05)
(Table 4).
BMI: Body mass index; HDL-C: High density lipoprotein
cholesterol; TC: Total cholesterol; SBP: Systolic Blood Pressure;
DBP: Diastolic Blood Pressure (Table 2).
SBP: Systolic Blood Pressure; DBP: Diastolic Blood Pressure;
MVV: Maximum Voluntary Ventilation; BMI: Body Mass Index;
VO2max. : Maximal Oxygen Consumption; SaO2: arterial oxygen
saturation; (*): indicates a significant difference, P < 0.05.
Previous studies confirmed that both aerobic and
anaerobic
exercise training effectively improved functional adaptation
of the cardiopulmonary system [13-15], however, for the best of our
knowledge there is no clear discrimination between
both exercise training programs, this study aimed to measure
differentiate between aerobic and anaerobic exercise training on
cardiopulmonary adaptation among obese subjects. Our results
proved that aerobic exercise is better than anaerobic exercise
training in improving cardiopulmonary fitness among obese
subjects. These findings agreed with many previous studies
[18,19]. While, Joyner and Tschakovsky stated that releasing
endothelium-derived relaxing factor as Nitric oxide induced by aerobic
exercise led to reduction of vascular resistance, arterial
blood pressure and heart rate [20]. In the other hand, our results
showed that anaerobic exercise resulted in non-significant
changes in arterial blood pressure and heart rate, these results
means that intensive exercise training resulted in more cardiac
work which couldn’t be sustained for long time [21].
Regarding ventilator function, aerobic and anaerobic
exercise training significantly improved MVV and VC. However,
aerobic exercise resulted in greater changes in MVV and VC than
anaerobic exercise; these results agreed with Juel et al . stated
that adult men who enrolled in aerobic exercise training induced
significant improvement in maximal oxygen consumption
and other variables of cardio-respiratory system adaptations
during dynamic exercise [22]. Also, O’Donovan et al. compared
the cardio-pulmonary system response to moderate exercise
training and severe exercise training and they reported that
there was significant improvement in VO2max and maximum
voluntary ventilation after both types of exercise [23].
Regarding results of arterial oxygen saturation, both aerobic
and anaerobic exercise training significantly increased value of
SaO2. However, aerobic exercise resulted in greater changes in
SaO2 than anaerobic exercise, our results agreed with a study of
Frisbee and Delp proved that adult men had significant cardio
respiratory system adaptation following aerobic exercise that
was evident by improvement in anaerobic threshold and VO2max
[24].
Our study has important strengths and limitations. The
major strength is the random selection of the participants; hence,
we can extrapolate adherence to the general population. In the
other hand, the major limitations are the relatively small sample
size in both groups may limit the possibility of generalization of
the findings in this study. Finally, within the limit of the present
study, aerobic exercise training is recommended for appropriate
cardiopulmonary adaptation to exercise training among obese
male subjects. Further researches are necessary to study the
influence of other exercise training programs on biochemical
and physiological parameters in obese subjects.
Aerobic exercise is better than anaerobic exercise training in
improving cardiopulmonary fitness among obese subjects.
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