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The effect of a physical activity education programme on physical activity, fitness, quality of life and attitudes to exercise in obese females

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Summary

Obesity has reached epidemic proportions worldwide. Decline in physical activity has occurred simultaneously or before the increase in obesity. The aim of this pilot study was to investigate the effect of a physical activity group-based education programme delivered by a Physiotherapist on weight, physical activity, cardiovascular fitness, quality of life and attitudes to exercise in obese females. A sample of 18 obese Irish females (mean age 37.6 years, mean weight 117.9 kg), took part in this study. The participants attended four physical activity education sessions in groups of 6–8, 1 month apart. Outcome measures were Cardiorespiratory fitness (CRF) measured by the Incremental Shuttle Walk test (ISWT) International Physical Activity Questionnaire-Short Form (IPAQ-Short) Impact of Weight on Quality of Life Questionnaire-Short Form (IWQOL-Lite), and a questionnaire adapted from the EU survey on Consumer Attitudes to Physical Activity. There were no significant decreases in participants’ weight (p = 0.444) and there were no significant improvements in IPAQ (p = 0.496) and IWQOL-Lite scores (p = 0.337). There were significant improvements in CRF (p < 0.0002). Attitudes towards exercise improved as shown by decreased barriers to exercise, i.e. decreased shyness (17%) and increased energy (22%) and increased enjoyment (22%). A group education programme focusing on physical activity alone demonstrated a significant increase in CRF (ISWT) and had a positive influence on attitudes to exercise. Longer duration interventions may allow participants to make the necessary lifestyle changes to achieve weight loss.

Introduction

The prevalence of overweight and obesity worldwide is increasing at such a dramatic rate that it is now considered a global epidemic.1 Mortality rates rise with increasing levels of obesity, particularly when body mass index (BMI) is ≥35 kg/m2. Psychosocial problems associated with obesity include social stigma, low self-esteem, isolation and humiliation.1

A review of obesity interventions concluded that the most effective interventions produce modest weight loss (i.e. 3–5 kg), with the exception of surgery.2 Physical activity alone has been shown to produce weight loss, however the optimum structure in terms of the type and amount of exercise for long-term weight loss has not been defined.2 Increased physical activity attenuates many of the health risks associated with obesity and active obese individuals have lower morbidity and mortality than normal weight individuals who are sedentary.3 A recent Cochrane review concluded that it is still unclear as to what are the most suitable settings, outcomes measures, type and frequency of interventions and follow up needed in the management of obesity.4 A meta-analysis of the efficacy of interventions for increasing physical activity in general showed that short interventions which included behaviour modification strategies delivered to healthy, targeted and unsupervised groups reported larger effects. Few studies were found to measure increases in fitness. The review concluded that the optimal ways to select physical activity components require experimental confirmation.5

The aim of this pilot study was to investigate the effect of a physical activity group-based education programme delivered by a Chartered Physiotherapist on weight reduction, physical activity, cardiovascular fitness, quality of life and attitudes to exercise in obese Irish females.

Section snippets

Participants

A sample of 21 obese females (mean age 37.6 years, S.D. = 10.7; mean weight 117.9 kg, S.D. = 17.5; mean BMI 43.5 kg/m2 S.D. = 4.8) were recruited from the waiting list of the Weight Management Service at St. Columcille's Hospital, Loughlinstown, Co. Dublin, Ireland. Participants were excluded if they had significant psychiatric illness, musculoskeletal problems that would limit their ability to exercise, ischemic heart disease and previous bariatric surgery. Thirty-nine participants out of a total of

Methods

Ethical approval was obtained from St. Vincent's University Hospital Research Ethics Committee. The participants attended four 1 h education sessions in groups of 6–8, 1 month apart. The first session included factors that effect weight gain, energy balance, components of energy output, exercise frequency intensity and type, warm up, rating of perceived exertion and contraindications to exercise. The second session included set point theory, exercise progression, resistance, cardiovascular

Results

There were no significant decreases in participants’ weight. There were no significant improvements in IPAQ and IWQOL-Lite scores (Table 1). The IPAQ scores increased by 19 MET min week−1 from 1113 (S.D. = 974) at baseline to 1131 (S.D. = 1176) at 18 weeks (p = 0.946). Cardiovascular fitness (CRF) as measured by the ISWT improved significantly (p < 0.001).

The results of the questionnaire adapted from the EU survey on Consumer Attitudes to Physical Activity, Body-weight and Health showed the importance

Discussion

A group education programme focusing on physical activity alone demonstrated a significant increase in CRF (ISWT), which has been previously shown to have considerable positive effects on morbidity and mortality even in the absence of weight loss.3 CRF improved in the majority of participants 83.3% (n = 15) regardless of whether they lost or gained weight. The improvement in CRF was equivalent to a 10.4% increase in fitness. Using the McArdle et al. (2001)10 classification of CRF a value of ≤19.9 

Acknowledgments

We would like to thank the weight management team and participants at St. Columcille's Hospital, Loughlinstown, Co. Dublin, Ireland. Catherine Blake, UCD, for statistical advice. No financial assistance was received for this project.

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