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Effects of exercise on mobility in obese and nonobese older adults
Manini TM, Newman AB, Fielding R, Blair SN, Perri MG, Anton SD, Goodpaster BC, Katula JA, Rejeski WJ, Kritchevsky SB, Hsu F-C, Pahor M, Life Research Group
Obesity 2010 Jun;18(6):1168-1175
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Coupled with an aging society, the rising obesity prevalence is likely to increase the future burden of physical disability. We set out to determine whether obesity modified the effects of a physical activity (PA) intervention designed to prevent mobility disability in older adults. Older adults at risk for disability (N = 424, age range 70 to 88 years) were randomized to a 12 month PA intervention involving moderate intensity aerobic, strength, balance, and flexibility exercise (150 min per week) or a successful aging (SA) intervention involving weekly educational workshops. Individuals were stratified by obesity using a BMI >= 30 (n = 179). Mobility function was assessed as usual walking speed over 400 m and scores on a short physical performance battery (SPPB), which includes short distance walking, balance tests, and chair rises. Over 12 months of supervised training, the attendance and total amount of walking time was similar between obese and nonobese subjects and no weight change was observed. Nonobese participants in the PA group had significant increases in 400-m walking speed (+1.5%), whereas their counterparts in the SA group declined (-4.3%). In contrast, obese individuals declined regardless of their assigned intervention group (PA -3.1%; SA -4.9%). SPPB scores, however, increased following PA in both obese (PA +13.5%; SA +2.5%) and nonobese older adults (PA +18.6%; SA +6.1%). A moderate intensity PA intervention improves physical function in older adults, but the positive benefits are attenuated with obesity.

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