Sartorio A, Narici M V, Fumagalli E, Faglia G, Lafortuna C L
Laboratorio Sperimentale di Ricerche Endocrinologiche, Istituto Auxologico Italiano, IRCCS, Milano.
Diabetes Nutr Metab. 2001 Feb;14(1):51-7.
The cardiovascular response to an aerobic cycloergometer exercise test (ACET, 15 min at 60 W, 60 rpm) and the maximally attainable muscle power output, assessed by a stair climbing test (SCT), were evaluated in 60 obese patients (41 females and 19 males; age: 18-68 yr; body mass index, BMI: 40.8+/-4.8 kg/m2) before and after a 3-week body mass reduction (BMR) program, entailing integrated energy-restricted diet (1200-1500 kcal/day), low-grade aerobic exercise conditioning and individual and/or group psychological therapy. The daily conditioning protocol (5 days/week) consisted of: 1) 30 min of indoor jogging and dynamic aerobic standing and floor exercises performed with arms and legs, under the guidance of a therapist; 2) 30 min of cycloergometer exercise at 60 W; and/or 3) 4-km outdoor leisure walking on flat terrain. Three weeks of BMR program induced a significant weight loss (-4.5 %; p<0.001), a reduction of systolic (-11+/-14 mmHg, -7.3%,p<0.001) and diastolic (-7+/-9 mmHg, -7.3%,p<0.001) resting arterial blood pressure, as well as a reduction of heart rate at rest (-18.6%,p<0.001), during ACET (-11.3%,p<0.001) and 5 min thereafter (-14.8%,p<0.001). The subjective rating of perceived exertion in terms of breathlessness and general fatigue during ACET, scored on a 0-100 visual analogic scale, was significantly reduced (p<0.001) after BMR program. A 11.2% decrease in SCT time (p<0.001) was also observed, corresponding to a 9.6% increase (p<0.001) in average muscle power (W) and 14.6% increase (p<0.001) in specific muscle power (W.kg(-1)). In conclusion, a combination of energy restricted diet, low intensity aerobic exercise and psychological counselling appears to significantly improve both aerobic and anaerobic performance in morbidly obese subjects. Different factors (ie, reduction of body mass, shift in the balance between parasympathetic and sympathetic activity, a weight-loss dependent shift toward a more favourable region of the muscle power-velocity curve, acquisition of a certain degree of motor skillfulness during the conditioning program, improvement of self-esteem and motivation) might be responsible, alone or in combination, for these short-term positive effects of BMR program.
在60名肥胖患者（41名女性和19名男性；年龄：18 - 68岁；体重指数，BMI：40.8±4.8kg/m²）中，评估了为期3周的体重减轻（BMR）计划前后，对有氧测力计运动测试（ACET，60W，60转/分钟，持续15分钟）的心血管反应以及通过爬楼梯测试（SCT）评估的最大可达到的肌肉功率输出。该BMR计划包括综合能量限制饮食（1200 - 1500千卡/天）、低强度有氧运动训练以及个体和/或团体心理治疗。每日训练方案（每周5天）包括：1）在治疗师指导下进行30分钟的室内慢跑以及手臂和腿部的动态有氧站立和地面运动；2）在60W下进行30分钟的测力计运动；和/或3）在平坦地形上进行4公里的户外休闲步行。3周的BMR计划导致体重显著减轻（-4.5%；p<0.001），静息动脉收缩压（-11±14mmHg，-7.3%，p<0.001）和舒张压（-7±9mmHg，-7.3%，p<0.001）降低，以及静息心率（-18.6%，p<0.001）、ACET期间（-11.3%，p<0.001）及其后5分钟（-14.8%，p<0.001）降低。在ACET期间，根据呼吸困难和全身疲劳程度在0 - 100视觉模拟量表上评分的主观用力感觉，在BMR计划后显著降低（p<0.001）。还观察到SCT时间减少了11.2%（p<0.001），这对应于平均肌肉功率（W）增加了9.6%（p<0.001），特定肌肉功率（W.kg⁻¹）增加了14.6%（p<0.001）。总之，能量限制饮食、低强度有氧运动和心理咨询的组合似乎能显著改善病态肥胖受试者的有氧和无氧运动表现。不同因素（即体重减轻、副交感神经和交感神经活动平衡的改变、体重减轻导致向肌肉功率 - 速度曲线更有利区域的转变、在训练计划中获得一定程度的运动技能、自尊和动力的提高）可能单独或共同导致BMR计划的这些短期积极效果。
