Nonresponders by the Session Order Factor
Condition: Morbid Obesity; Sports Physical Therapy
MeSH terms: Obesity; Obesity, Morbid
Study type: Interventional

Summary: 
      Concurrent training (CT, characterised by the inclusion of two exercise modalities), is
      recognised to improve metabolic syndrome (MetS) markers, but little is known about order
      session effect on interindividual variability. The purpose of the present study was to
      describe the effects, and the interindividual variability, of 20 weeks of CT in different
      order at (i.e., high intensity interval training (HIIT) plus resistance training (RT),
      compared with another group doing RT plus HIIT) in women with severe/morbidly obesity at risk
      of MetS.
    

Detailed description: 
      Morbid obesity, defined as a body mass index (BMI) of 40 kg/m2 (class III obesity), is a
      chronic disease with life-threatening cardiometabolic consequences such as elevated blood
      pressure (systolic [SBP] or diastolic BP [DBP]), fasting plasma glucose (FPG), triglycerides
      (Tg), and low high-density lipoprotein cholesterol (HDL-c), all summarised as metabolic
      syndrome (MetS). In this sense, exercise training as resistance training (RT), defined as any
      exercise that causes voluntary skeletal muscle contraction by using external weights such as
      dumbbells and metal bars, is a known non-pharmacotherapy strategy for improving muscle
      strength and functional capacity in obese patients undergoing bariatric surgery. Similarly,
      high-intensity interval training (HIIT), defined as several and brief bouts of high-intensity
      effort usually by cycling/running, interspersed by recovery periods ), has produced strong
      evidence for the improvement of cardiometabolic risk factors for type 2 diabetes mellitus,
      arterial hypertension, central arterial stiffness and, vascular function, and
      cardiorespiratory fitness. Thus, in individuals with morbid obesity, for example, exercise
      training has proven to be effective for inducing clinically significant weight loss (5-10%),
      and for the reduction of cardiovascular risk, following the standard recommendations for
      these cohorts prior to bariatric surgical. However, some inconsistencies have been described
      after CT, which are directly concerned with the 'order' (i.e. starting the CT session with
      MICT followed by RT, or vice versa) of the CT session. However, little is known about the
      interindividual variability of exercise training (IVET) in relation to different order
      sessions of CT in morbidly obese populations and health-related outcomes, such as MetS
      markers. Briefly, IVET means that some subjects achieve benefits after training, and are
      termed responders (Rs), while others exhibit a worsened or unchanged response, and that is
      commonly known termed as nonresponders (NRs).
    

Intervention name(s): HIIT+RT experimental group; RT+HIIT experimental group
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Each experimental group will be compared with their another contrast order session group; Each experimental group will be compared with their another contrast order session group
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: We will compare a concurrent training group (HIIT+RT) with morbid obesity with another experimental group of concurrent training with morbid obesity, but with another exercise order (RT+HIIT).
Masking: Double (Participant, Investigator)
Primary purpose: Prevention
Keywords: Morbid obesity; Exercise training; Metabolic syndrome; Concurrent training; Exercise order