Daley Amanda J, Copeland Robert J, Wright Neil P, Roalfe Andrea, Wales Jerry K H
Department of Primary Care and General Practice, University of Birmingham, Clinical Sciences Building, Birmingham, B15 2TT, United Kingdom.
Pediatrics. 2006 Nov;118(5):2126-34. doi: 10.1542/peds.2006-1285.
We conducted a proof-of-concept, randomized, controlled trial to investigate the effects of a supervised exercise therapy intervention on psychopathologic outcomes in obese adolescents.
The participant sample consisted of 81 adolescents (age: 11-16 years) who had been referred to a children's hospital for evaluation of obesity or who responded to a community advertisement. Participants were assigned randomly to exercise therapy, an equal-contact exercise placebo intervention, or usual care. Intervention participants attended 3 one-on-one sessions per week for 8 weeks and then completed a home program for another 6 weeks. Outcomes included self-perceptions (self-esteem), depression, affect, physical activity, aerobic fitness, and BMI.
A total of 18 of 81 participants were categorized as morbidly obese (BMI SD score: > 3.5; adult equivalent BMI: > or = 40). At baseline, 30.3% of participants had a Children's Depression Inventory score of > or = 13, and 27% reported recent suicidal ideation. Repeated-measures mixed analysis of covariance (controlling for baseline scores) revealed significant changes in physical self-worth, associated measures of self-esteem, and physical activity over time, consistently favoring exercise therapy. There were no significant changes in BMI.
Findings confirmed psychopathologic conditions as a serious health concern in obese and morbidly obese adolescents. Our study is the first randomized, controlled trial to demonstrate that a brief supervised exercise therapy intervention has the potential to improve psychopathologic outcomes significantly and to increase physical activity in obese adolescents, relative to usual care.
我们进行了一项概念验证性随机对照试验，以研究监督式运动疗法干预对肥胖青少年心理病理结果的影响。
参与者样本包括81名青少年（年龄：11 - 16岁），他们因肥胖问题被转诊至儿童医院评估，或对社区广告做出回应。参与者被随机分配到运动疗法组、同等接触量的运动安慰剂干预组或常规护理组。干预组参与者每周参加3次一对一课程，为期8周，然后再完成为期6周的家庭计划。结果包括自我认知（自尊）、抑郁、情感、身体活动、有氧适能和体重指数。
81名参与者中共有18人被归类为病态肥胖（体重指数标准差评分：> 3.5；成人等效体重指数：>或 = 40）。在基线时，30.3%的参与者儿童抑郁量表得分>或 = 13，27%的人报告近期有自杀意念。重复测量协方差混合分析（控制基线分数）显示，随着时间推移，身体自我价值、自尊相关指标和身体活动有显著变化，始终有利于运动疗法。体重指数没有显著变化。
研究结果证实心理病理状况是肥胖和病态肥胖青少年严重的健康问题。我们的研究是第一项随机对照试验，证明相对于常规护理，简短的监督式运动疗法干预有可能显著改善肥胖青少年的心理病理结果并增加其身体活动。
