virtuelle Fachbibliothek Sportwissenschaft
Dissertation: Simone Becker
Dissertation / Doktorarbeit / Thesis
The considerable negative impact of an unhealthy lifestyle – physical inactivity combined with qualitative and/or quantitative malnutrition – on cardiovascular morbidity and lethality has been demonstrated in several studies. The current therapeutic concept for both, obesity and metabolic diseases predominantly aims at physical activity. Since patients often show little compliance in therapeutic means to modify their lifestyle, an improvement of the health-related quality of life (HRQOL) – beyond reductions of risk factors and enhanced longevity – should increasingly receive attention in order to achieve a long lasting management of lifestyle.
The objective of the present studies was, to evaluate the influence of a combined therapy consisting of regular exercise as well as a dietary intervention in postmenopausal women with dyslipidaemia. In a second study, the influence of a training therapy without dietary modification was analysed in overweight men over 50 years. In both cases the HRQOL has been evaluated using PLC and SF-36. The specific aspects of these studies were based on the independent gender-specific PEPP-study (Postmenopausal Exercise Prevention Program) and the Ü50-study (Activity-based lifestyle modification for overweight inactive men over 50 years).
During the PEPP-study, 46 inactive postmenopausal women with dyslipidaemia (age: 55.74 ± 5.39 yrs, weight: 77.89 ± 14.51 kg, BMI: 28.38 ± 4.84 kg/m²) were randomly divided into a walking-, a power-walking-, and a nordic-walking-group. The women performed four training units of 90 minutes per week at an individually determined training intensity of 2 mmol/l lactate for 12 weeks. After 12 weeks the effects of the monotherapeutic activity program on HRQOL as well as various objective parameter were documented. During the last four weeks of the study an additional dietary modification had been introduced and the results have been analysed.
The main results of the PEPP-study are:
On the basis of the exercise programme, significant reductions of weight (p<0,01) and BMI (p<0,01) as well as mostly significant increases of HRQOL have been observed. The dietary modification lead to a further significant reduction of weight (p<0,01) and of BMI (p<0,01), and most parameters of HRQOL did improve. Only for single items of the HRQOL significant differences were found based on the type of activity (walking, power-walking, nordic-walking).
Within the Ü50-study, 44 overweight men which had not been engaged in any type of sport (age: 54.05 ± 4.83 yrs, weight: 97.96 8.52 kg, BMI: 30.65 ± 2.06 kg/m²) were randomly assigned to a walking-/jogging-, a cycling-, and a control group. The program of the 28-week exercise-intervention consisted of three 60 to 90 minute endurance exercise units per week with an individually determined training intensity of 2 mmol/l lactate. Additionally, the participants absolved a standardized muscular strengthening program with the Thera-Band®. Interventional effects on HRQOL and different objective parameters were measured at the beginning and at the end of the intervention.
The main results of the Ü50-study are:
Reductions in body weight (p<0,01) and in BMI (p<0,01) were found after the intervention period. Moreover HRQOL could mostly be improved. Differences between the intervention groups walking-/jogging and cycling were predominantly not significant.
The synopsis of these two studies showed clear evidence of the substantially positive influence of a therapeutic lifestyle modification for all objective as well as for subjective (HRQOL) parameters. Accordingly, physical activity contributes as an additional motivational factor to a therapeutic lifestyle modification.