Hypoxic Training in Obese Patients

NCT02241473 | Unknown DMC

• 1 other identifier: 136/14
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

By analyzing energetic and biomechanical basis of walking, and the subsequent changes induced by hypoxic vs normoxic training in obese individuals, it may optimize the use of walking in hypoxia to gain perspective for exercise prescription to set up training programs that aim to induce negative energy balance and to deal with weight management. However to the investigators knowledge, the analysis of changes in mechanics, energetics and efficiency of walking after continuous hypoxic training (CHT) has not been performed yet. The aims of the present study were:

1. 1.Comparing the changes in body composition between continuous hypoxic training (CHT) and similar training in normoxia; e.g. continuous normoxic training (CNT) in obese subjects.
2. 2.Comparing the metabolic and energetics adaptations to CHT vs CNT.
3. 3.Finally, comparing the associated body-loss induced gait modification since walking intensity at spontaneous walking speed (Ss) is lower in CHT than in CNT.

Conditions

Obesity

Keywords

gait; physical activity; energy cost; efficiency

Outcome Measures

Primary Outcomes (4)

• Body composition and mass

  All subjects will undergo dual-energy X-ray absorptiometry (DEXA) and bio-impedance for measurements of body composition.

  Change from baseline at 5 weeks (e.g., baseline and 5th week after inclusion)

• Net energy cost of walking

  The subjects will be then asked to complete five 6 min level walking trials on the instrumented treadmill at five equally spaced speeds (0.55, 0.83, 1.11, 1.38 and 1.66 m/s), in randomized order. They will be allowed to establish their own preferred stride rate combination for each condition and will be given 5 min of rest between walking trials. During the walking trials, oxygen uptake (V˙O 2), carbon dioxide (CO2) output (V˙C O2) and ventilation (V˙ E) will be measured breath-by-breath (OxyconPro, Jaeger, Germany) and the volume and gases calibrations will be checked before each trial. Oxygen uptake values from the last 2 min will be averaged and normalized to body mass (V˙O 2, mlO2∙kg-1∙min-1). This value minus resting V'O2 was then divided by walking speed to obtain the net energy cost of walking (mlO2∙kg-1∙m-1).

  Change from baseline at 5 weeks (e.g., baseline and 5th week after inclusion)

• Mechanical external and internal work

  During steady metabolic state (i.e., the last 2 min of walking for each speed), the mechanical external (Wext) and internal (Wint) work changes of 20 consecutive walking steps will be determined with an instrumented treadmill (H-P-COSMOS Treadmill MCU2 EPROM 2.31), consisting of a treadmill mounted on four 3-D force sensors, following the methods described in detail by Cavagna (Cavagna 1975) and Willems et al. (1995).

  Change from baseline at 5 weeks (e.g., baseline and 5th week after inclusion)

• Efficiency

  Total mechanical work and efficiency. The total mass-specific muscular work per distance travelled (Wtot) will be calculated as the sum of Wext and Wint. The mechanical efficiency will be computed as the ratio between Wtot and net energy cost of walking.

  Change from baseline at 5 weeks (e.g., baseline and 5th week after inclusion)

Secondary Outcomes (1)

• Blood samples (this measure is a composite)

  Change from baseline at 5 weeks (e.g., baseline and 5th week after inclusion)

Study Arms (2)

CH training group

EXPERIMENTAL

During 3 weeks (9 sessions; three sessions/wk), subject will performed 60 min walking at spontaneous walking speed in hypoxic (continuous hypoxic training, CHT; simulated altitude of 3000 m) condition in a single-blind fashion.

Other: Training

CN training group

ACTIVE COMPARATOR

During 3 weeks (9 sessions; three sessions/wk), subject will performed 60 min walking at spontaneous walking speed in normoxic (continuous normoxic training; CNT) condition in a single-blind fashion.

Other: Training

Interventions

Training OTHER

During 3 weeks (9 sessions; three sessions/wk), subject will performed 60 min walking at spontaneous walking speed in normoxic (continuous normoxic training; CNT) or hypoxic (continuous hypoxic training, CHT; simulated altitude of 3000 m) condition in a single-blind fashion. Both CNT and CHT sessions will be performed in an hypoxic chamber (ATS Altitude, Sydney, Australia) built in our laboratory at an altitude of 380 m (Lausanne, Switzerland). In order to blind subjects to altitude, the system will also run for normoxic training groups with a normoxic airflow into the chamber.

CH training group; CN training group

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Healthy and free of clinically significant orthopaedic, neurological, cardiovascular or respiratory conditions.
• BMI \> 30 kg/m\^2.
• Age \> 18 yr.

You may not qualify if:

• Age \> 40 yr.
• BMI \< 35 kg/m\^2.
• Diabetes.
• Neurological disorders, orthopaedic injury, history of falls and medications that provoke dizziness.

Sponsors & Collaborators

• University of Lausanne: lead
• CHUV - Centre des Maladies Osseuses - Département de l'Appareil Locomoteur (DAL): collaborator
• Centre Hospitalier Universitaire Vaudois: collaborator

Study Sites (1)

Institute of Sport Sciences of the University of Lausanne

Lausanne, Canton of Vaud, 1015, Switzerland

RECRUITING

Related Publications (17)

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  PMID: 16210434 BACKGROUND

• Faiss R, Leger B, Vesin JM, Fournier PE, Eggel Y, Deriaz O, Millet GP. Significant molecular and systemic adaptations after repeated sprint training in hypoxia. PLoS One. 2013;8(2):e56522. doi: 10.1371/journal.pone.0056522. Epub 2013 Feb 20.

  PMID: 23437154 BACKGROUND

• Haufe S, Wiesner S, Engeli S, Luft FC, Jordan J. Influences of normobaric hypoxia training on metabolic risk markers in human subjects. Med Sci Sports Exerc. 2008 Nov;40(11):1939-44. doi: 10.1249/MSS.0b013e31817f1988.

  PMID: 18845972 BACKGROUND

• Hill JO, Peters JC. Environmental contributions to the obesity epidemic. Science. 1998 May 29;280(5368):1371-4. doi: 10.1126/science.280.5368.1371.

  PMID: 9603719 BACKGROUND

• Kayser B, Verges S. Hypoxia, energy balance and obesity: from pathophysiological mechanisms to new treatment strategies. Obes Rev. 2013 Jul;14(7):579-92. doi: 10.1111/obr.12034. Epub 2013 Mar 28.

  PMID: 23551535 BACKGROUND

• Messier SP, Gutekunst DJ, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 2005 Jul;52(7):2026-32. doi: 10.1002/art.21139.

  PMID: 15986358 BACKGROUND

• Messier SP, Legault C, Loeser RF, Van Arsdale SJ, Davis C, Ettinger WH, DeVita P. Does high weight loss in older adults with knee osteoarthritis affect bone-on-bone joint loads and muscle forces during walking? Osteoarthritis Cartilage. 2011 Mar;19(3):272-80. doi: 10.1016/j.joca.2010.11.010. Epub 2010 Dec 4.

  PMID: 21134477 BACKGROUND

• Millet GP, Faiss R, Brocherie F, Girard O. Hypoxic training and team sports: a challenge to traditional methods? Br J Sports Med. 2013 Dec;47 Suppl 1(Suppl 1):i6-7. doi: 10.1136/bjsports-2013-092793. No abstract available.

  PMID: 24282210 BACKGROUND

• Millet GP, Roels B, Schmitt L, Woorons X, Richalet JP. Combining hypoxic methods for peak performance. Sports Med. 2010 Jan 1;40(1):1-25. doi: 10.2165/11317920-000000000-00000.

  PMID: 20020784 BACKGROUND

• Netzer NC, Chytra R, Kupper T. Low intense physical exercise in normobaric hypoxia leads to more weight loss in obese people than low intense physical exercise in normobaric sham hypoxia. Sleep Breath. 2008 May;12(2):129-34. doi: 10.1007/s11325-007-0149-3.

  PMID: 18057976 BACKGROUND

• Peyrot N, Morin JB, Thivel D, Isacco L, Taillardat M, Belli A, Duche P. Mechanical work and metabolic cost of walking after weight loss in obese adolescents. Med Sci Sports Exerc. 2010 Oct;42(10):1914-22. doi: 10.1249/MSS.0b013e3181da8d1e.

  PMID: 20216466 BACKGROUND

• Peyrot N, Thivel D, Isacco L, Morin JB, Duche P, Belli A. Do mechanical gait parameters explain the higher metabolic cost of walking in obese adolescents? J Appl Physiol (1985). 2009 Jun;106(6):1763-70. doi: 10.1152/japplphysiol.91240.2008. Epub 2009 Feb 26.

  PMID: 19246657 BACKGROUND

• Plewa M, Cieślińska-Świder J, and Bacik B. Effects of the Weight loss Treatment on Selected Kinematic Gait Parameters in Obese Women. Journal of Human Kinetics 18: 3-14, 2007.

  BACKGROUND

• Pollock ML, Miller HS Jr, Janeway R, Linnerud AC, Robertson B, Valentino R. Effects of walking on body composition and cardiovascular function of middle-aged man. J Appl Physiol. 1971 Jan;30(1):126-30. doi: 10.1152/jappl.1971.30.1.126. No abstract available.

  PMID: 5538779 BACKGROUND

• Rosenbaum M, Vandenborne K, Goldsmith R, Simoneau JA, Heymsfield S, Joanisse DR, Hirsch J, Murphy E, Matthews D, Segal KR, Leibel RL. Effects of experimental weight perturbation on skeletal muscle work efficiency in human subjects. Am J Physiol Regul Integr Comp Physiol. 2003 Jul;285(1):R183-92. doi: 10.1152/ajpregu.00474.2002. Epub 2003 Feb 27.

  PMID: 12609816 BACKGROUND

• Wiesner S, Haufe S, Engeli S, Mutschler H, Haas U, Luft FC, Jordan J. Influences of normobaric hypoxia training on physical fitness and metabolic risk markers in overweight to obese subjects. Obesity (Silver Spring). 2010 Jan;18(1):116-20. doi: 10.1038/oby.2009.193. Epub 2009 Jun 18.

  PMID: 19543214 BACKGROUND

• Fernandez Menendez A, Saudan G, Sperisen L, Hans D, Saubade M, Millet GP, Malatesta D. Effects of Short-Term Normobaric Hypoxic Walking Training on Energetics and Mechanics of Gait in Adults with Obesity. Obesity (Silver Spring). 2018 May;26(5):819-827. doi: 10.1002/oby.22131. Epub 2018 Mar 25.

  PMID: 29575698 DERIVED

MeSH Terms

Conditions

Obesity; Motor Activity

Condition Hierarchy (Ancestors)

Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Behavior

Study Officials

• Davide Malatesta, Dr

  Institute of Sport Sciences of the University of Lausanne

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Davide Malatesta, Dr

CONTACT

+41 21 692 36 17; davide.malatesta@unil.ch

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr (Ph.D., Senior Lecturer)

Study Record Dates

• First Submitted: September 10, 2014
• First Posted: September 16, 2014
• Study Start: September 1, 2014
• Primary Completion: July 1, 2015
• Study Completion: July 1, 2015
• Last Updated: September 16, 2014

Record last verified: 2014-09

Locations

CH (1)