title: Improvements in Functional Exercise Capacity after a Residential Behavioural Change, Diet and Fitness Program for Obese Adults.
abstract: OBJECTIVE
  Obese adults are at an increased risk for mobility-related problems. National guidelines recommend calorie restrictions and exercise for obese adults as a means to improve functional fitness capacity and to increase mobility. Yet, lifestyle weight loss interventions often fail to measure fitness changes. The aim of this study was to assess whether a 1-month, intensive behavioural change, diet and fitness intervention for overweight and obese adults would result in statistically significant and clinically meaningful changes in functional exercise.
  
  
  METHODS
  A pre-post test design was used in this study. Seventy-two participants (40 women, 32 men; mean baseline body mass index (BMI) = 42.6 + 9.0; mean age = 45.8 + 16.8) completed a modified 6-minute walk test (6MWT), performed on a treadmill, at baseline and at end of treatment.
  
  
  RESULTS
  Significant improvements included decreased BMI (2.7 + 1.7 kg m(-2) , p < 0.001) and increased 6MWT distance (66.4 + 73.0 m, p < 0.001). The 6MWT improved by 66 m on average, a reported clinically meaningful difference. Greater improvements in the 6MWT were significantly correlated with greater weight loss and BMI reduction.
  
  
  CONCLUSIONS
  Our findings suggest that rehabilitation beyond weight loss may be derived from participation in a brief, intensive behavioural change, diet and fitness programme. Physiotherapists are in a prime position to address the physical and motivational challenges participants face while living with severe obesity: targeting functional exercise capacity is one key strategy for addressing immobility associated with obesity. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Duke University, School of Medicine, Doctor of Physical Therapy Program, Durham, NC, USA.
authors.forename: Sadye Paez
authors.initials: SP
authors.lastname: Errickson
authors.affiliation: Duke University Medical Center, Community and Family Medicine, Durham, NC, USA.|Quality of Life Consulting, PLLC, Durham, NC, USA.|Department of Health Studies, Sogn og Fjordane University College, Førde, Norway.
authors.forename: Ronette L
authors.initials: RL
authors.lastname: Kolotkin
authors.affiliation: Lincoln Community Health Center, Durham, NC, USA.
authors.forename: Megan Simmons
authors.initials: MS
authors.lastname: Skidmore
authors.affiliation: Lincoln Community Health Center, Durham, NC, USA.
authors.forename: Gerald
authors.initials: G
authors.lastname: Endress
authors.affiliation: Duke University Medical Center, Community and Family Medicine, Durham, NC, USA.|Duke University, NUS Graduate Medical School, Singapore, Singapore.
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
authors.affiliation: Neuropsychiatric Research Institute, Fargo, ND, USA.|University of North Dakota School of Medicine and Health Sciences, Clinical Neuroscience, Fargo, ND, USA.
authors.forename: Ross
authors.initials: R
authors.lastname: Crosby
authors.affiliation: Duke University Medical Center, Community and Family Medicine, Durham, NC, USA.|Lincoln Community Health Center, Durham, NC, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Eisenson
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D015331:Cohort Studies; D004038:Diet, Reducing; D015444:Exercise / Q000502:physiology*; D017079:Exercise Tolerance; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000534:rehabilitation*; D050177:Overweight / Q000175:diagnosis / Q000534:rehabilitation; D010809:Physical Fitness / Q000502:physiology*; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
keywords: diet; fitness programme; functional exercise capacity; obese adults