Faculty of Health Sciences, Methodist University of Piracicaba, Rodovia do Açucar, Km 156, Piracicaba, Sao Paulo 13.400-911, Brazil.
Faculty of Health Sciences, Methodist University of Piracicaba.
Phys Ther. 2020 Jun 23;100(6):963-978. doi: 10.1093/ptj/pzaa045.
Physical training, regardless of the presence of concurrent weight loss, provides numerous health benefits for individuals who are overweight and obese and have or are at risk for cardiovascular disease.
The purpose of this review was to identify different types of physical training programs (aerobic, resistance, or combined), with or without counseling/diet modifications, and their impact on physical fitness in individuals who have class II and III obesity.
Medline and Medline In-Process, EMBASE, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, Web of Science, LILACS, CINAHL, SPORTDiscus, PEDro, and PubMed were searched up to June 2017.
This review had the following inclusion criteria: body mass index of ≥35 kg/m2 and age 18 years or older; supervised physical training program; randomized controlled trial; physical fitness outcome (muscular strength, muscular endurance, cardiovascular endurance, and/or flexibility); in English or Portuguese; and available full-text article.
Three reviewers independently extracted data, assessed study risk of bias using the Cochrane tool, and discussed disagreements until consensus was reached.
Of the 9460 identified articles, 26 were included and 8 were used in a meta-analysis. The meta-analysis showed improvements in walking speed and maximal oxygen uptake but not knee extension strength in the intervention groups. The Cochrane risk-of-bias score indicated that the majority of the data were from randomized controlled trials with a low or unclear risk of bias.
The large variability of outcomes and interventions made comparisons difficult.
A combination of aerobic exercise and resistance exercise, in addition to diet modifications, may improve cardiovascular and muscular endurance in individuals with class II and III obesity. However, conclusions must be interpreted with caution because of the heterogeneity in interventions and outcome measures among the studies and an unclear risk of bias in several studies.
无论是否同时进行体重减轻，体育锻炼都为超重和肥胖且患有或有心血管疾病风险的个体提供了许多健康益处。
本综述的目的是确定不同类型的体育锻炼计划（有氧运动、抗阻运动或两者结合），有无咨询/饮食改变及其对 II 类和 III 类肥胖个体身体适应性的影响。
检索了 Medline 和 Medline In-Process、EMBASE、Cochrane 对照试验中心注册库、Cochrane 系统评价数据库、Web of Science、LILACS、CINAHL、SPORTDiscus、PEDro 和 PubMed，检索时间截至 2017 年 6 月。
本综述的纳入标准为：体重指数≥35 kg/m2 且年龄≥18 岁；有监督的体育锻炼计划；随机对照试验；身体适应性结局（肌肉力量、肌肉耐力、心血管耐力和/或柔韧性）；英文或葡萄牙文；提供全文文章。
3 位评审员独立提取数据，使用 Cochrane 工具评估研究偏倚风险，并讨论分歧，直至达成共识。
在 9460 篇鉴定文章中，有 26 篇被纳入，其中 8 篇用于荟萃分析。荟萃分析显示干预组的步行速度和最大摄氧量增加，但膝关节伸展力量没有改善。Cochrane 偏倚风险评分显示，大部分数据来自随机对照试验，偏倚风险低或不明确。
结局和干预措施的巨大变异性使得比较困难。
有氧运动和抗阻运动相结合，加上饮食改变，可能会改善 II 类和 III 类肥胖个体的心血管和肌肉耐力。然而，由于研究之间干预和结局测量的异质性以及部分研究偏倚风险不明确，必须谨慎解释结论。
