Physical training combined with dietary measures in the treatment  of adult obesity. A comparison of two protocols.
OBJECTIVE
Our objective was to study the effects of physical training combined with dietary measures in obese adults. In a second step, we sought to compare two training protocols and establish the additional contribution of strength training.


METHODS
We performed a randomized, prospective survey from July 2004 to November 2007. Included patients were randomized into three groups: a control group (G1), a group (G2) performing dietary measures and a programme of treadmill training at 60% of each individual's maximum heart rate (HRmax) and a group (G3) who followed the G2 programme supplemented with strength training. All patients underwent an initial and final assessment of anthropometric & cardiovascular parameters, muscle strength, dyspnoea during activities of daily living, metabolic disorders, psychological status and quality of life.


RESULTS
The greatest weight loss (7.24%) was observed in G3. Reduction in waistline measurement (WL) of 4.3% and 10.26% were noted in G2 and G3, respectively (p < 0.001). The percentage fat body mass fell by 10.4% in G3 (p < 0.001) and 8.6% in G2 (p = 0.03).We particularly noted an improvement in physical condition in groups 2 and 3, with lower HR and blood pressure values at rest and at maximum effort. The overall improvement in both arm and leg muscle strength was greater for G3 than for G2. Likewise, we noted an improvement in the metabolic parameters and depression & anxiety scores for the trained groups (G2, G3), relative to the control group (G1). We also noted improvements in the total impact of weight on quality of life (IWQOL) lite score of 15.2% in G2 and 18% in G3.


CONCLUSIONS
Our survey demonstrated the beneficial effect of combining dietary measures and physical training in obese patients. In addition to weight loss, the programme enabled a reduction in the patients' body fat mass and abdominal obesity, a correction of metabolic disorders and an improvement in aerobic capacity. The improvement in all these parameters also enhanced the patients' psychological status and quality of life. The addition of strength training produced notable improvements in weight loss, arm muscle strength and abdominal obesity.
Ghroubi
S
S
Service de medicine physique rééducation réadaptation fonctionnelle, hôpital Habib Bourguiba,CHU Habib Bourguiba S, unité de recherche 04/UR/08-07, université du Sud, Sfax, Tunisie.
Elleuch
H
H
Chikh
T
T
Kaffel
N
N
Abid
M
M
Elleuch
M H
MH
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000628:therapy; D001786:Blood Glucose / Q000032:analysis; D003131:Combined Modality Therapy; D003863:Depression / Q000209:etiology / Q000628:therapy; D004038:Diet, Reducing; D004417:Dyspnea / Q000209:etiology / Q000628:therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009765:Obesity / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000523:psychology / Q000628:therapy*; D010807:Physical Endurance; D011788:Quality of Life; D055105:Waist Circumference; D015431:Weight Loss; D055815:Young Adult
D001786:Blood Glucose; D008055:Lipids