title: The effects of exercise modality and intensity on energy expenditure and cardiorespiratory response in adults with obesity and treated obstructive sleep apnoea.
abstract: To inform recommendations for the exercise component of a healthy lifestyle intervention for adults with obesity and treated obstructive sleep apnoea (OSA), we investigated the total energy expenditure (EE) and cardiorespiratory response to weight-supported (cycling) and unsupported (walking) exercise. Individuals with treated OSA and a body mass index (BMI) > 30 kg/m2performed an incremental cardiopulmonary exercise test on a cycle ergometer and a treadmill to determine the peak oxygen uptake [Formula: see text]. Participants subsequently completed two endurance tests on each modality, matched at 80% and 60% of the highest [Formula: see text] determined by the incremental tests, to intolerance. The cardiorespiratory response was measured and total EE was estimated from the [Formula: see text]. Sixteen participants completed all six tests: mean [SD] age 57 [13] years and median [IQ range] BMI 33.3 [30.8-35.3] kg/m2. Total EE during treadmill walking was greater than cycling at both high (158 [101] vs. 29 [15] kcal; p < 0.001) and moderate (178 [100] vs. 85 [59] kcal; p = 0.002) intensities, respectively, with similar cardiorespiratory responses and pattern of EE during rest, exercise and recovery. Contrary to current guidelines, walking might be the preferred training modality to achieve the combination of weight loss and increased cardiorespiratory fitness in adults with obesity and treated OSA.
authors.affiliation: 1 Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.|2 Department of Infection, immunity and Inflammation, University of Leicester, Leicester, UK.|3 Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Rachael A
authors.initials: RA
authors.lastname: Evans
authors.affiliation: 1 Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.|4 Department of Respiratory Diagnostic and Evaluation Services, West Park Healthcare Centre, Toronto, Canada.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Dolmage
authors.affiliation: 1 Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.|5 Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Priscila G
authors.initials: PG
authors.lastname: Robles
authors.affiliation: 1 Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.|5 Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
authors.affiliation: 1 Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.|3 Department of Medicine, University of Toronto, Toronto, Ontario, Canada.|4 Department of Respiratory Diagnostic and Evaluation Services, West Park Healthcare Centre, Toronto, Canada.|5 Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D005080:Exercise Test / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D010101:Oxygen Consumption; D005082:Physical Exertion / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D016138:Walking / Q000502:physiology*
keywords: Energy expenditure; exercise; obesity; obstructive sleep apnoea; weight supported; weight unsupported