Progressive Resistance Training in Patients With Class III Obesity

Study Overview
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Brief Summary
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To test the strength and physical performance outcomes of a 12-week progressive resistance training (PRT) exercise program in a small cohort of patients with Class III obesity who are preparing for bariatric weight loss surgery at Beth Israel Deaconess. The study will also test patient compliance to the 12 week PRT program. Whereas PRT exercise is currently recommended as a part of preoperative clinical care for bariatric surgery patients, little research has been done to measure the acceptance and effectiveness of a standardized PRT exercise protocol for improving health and perioperative care. Preliminary data from this study could be used to justify larger studies and further investigation.

Official Title
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Pilot Study to Determine Feasibility, Acceptance, and Efficacy of a 12-week Progressive Resistance Training Exercise Protocol in Patients With Class III Obesity Preparing for Bariatric Surgery.

Conditions
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Obesity

Intervention / Treatment
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* Behavioral: Progressive Resistance Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and women 18-65 years old A BMI of ≥40 kg/m2 Considering Weight Loss Surgery at BIDMC Participating in multidisciplinary preoperative program: been determined by a mental health professional (i.e., psychologist or social worker) to be well-informed, motivated, and not symptomatic for psychopathology that would put the person at risk for injury or failure with WLS expressed strong desire for significant weight loss experienced documented failure of long-term weight loss using nonsurgical methods been informed of and accepts risks of surgery Cleared by their primary care physician to be in stable health and capable of moderate level exercise Willing to comply with expected attendance and participation at all intervention sessions and testing appointments Has reliable transportation to the intervention location Exclusion Criteria: Orthopedic limitations that would preclude exercise testing and training

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Resistance Training<br> | Behavioral: Progressive Resistance Training<br>* 12-week progressive resistance training (PRT) exercise program<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 6-Minute Walk Test | Subjects are instructed to walk from one end to the other of a 30- meter hallway at their own pace, while attempting to cover as much ground as possible in the allotted 6 minutes. Subjects are allowed to stop and rest during the test, but were instructed to resume walking as soon as they felt able to do so. Total distance walked was recorded at the end of the test. | Before training - Week 1 | 
| 6-Minute Walk Test | Subjects are instructed to walk from one end to the other of a 30- meter hallway at their own pace, while attempting to cover as much ground as possible in the allotted 6 minutes. Subjects are allowed to stop and rest during the test, but were instructed to resume walking as soon as they felt able to do so. Total distance walked was recorded at the end of the test. | After training - Week 12 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscle Fatigability Test | After appropriate warm-up, subjects performed as many repetitions as possible against a resistance set to 80% or 70% (leg and chest respectively) of their pre-intervention 1-repetition maximum resistance. Fatigability tests measures the ability to sustain a static muscle contraction or make repetitive submaximal dynamic contractions. The test was administered using the leg press and chest press machines (Nautilus Nitro). | Before training-Week 1 | 
| 1-repetition maximum muscle strength test | The subject performs repeated single repetitions of leg press and chest press, separated by 60-second rest periods. Resistance is increased systematically at each repetition until the person's maximum voluntary muscle force cannot move the resistance through the full range of motion. The greatest resistance (measured in lbs.) a person can move through a full range of motion is recorded as the one-repetition maximum. Tests were performed on leg and chest press machines (Nautilus Nitro). | Before training-Week 1 | 
| Muscle Fatigability Test | After appropriate warm-up, subjects performed as many repetitions as possible against a resistance set to 80% or 70% (leg and chest respectively) of their pre-intervention 1-repetition maximum resistance. Fatigability tests measures the ability to sustain a static muscle contraction or make repetitive submaximal dynamic contractions. The test was administered using the leg press and chest press machines (Nautilus Nitro). | After training-Week 12 | 
| 1-repetition maximum muscle strength test | The subject performs repeated single repetitions of leg press and chest press, separated by 60-second rest periods. Resistance is increased systematically at each repetition until the person's maximum voluntary muscle force cannot move the resistance through the full range of motion. The greatest resistance (measured in lbs.) a person can move through a full range of motion is recorded as the one-repetition maximum. Tests were performed on leg and chest press machines (Nautilus Nitro). | After training - Week 12 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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bariatric surgery, class III obesity, resistance training, strength, fitness