Feasibility and effectiveness of a distance-adapted physical activity intervention in adolescents with obesity during the COVID-19 pandemic

Background: Pediatric obesity represents one of the most important public health challenges and its prevalence significantly increased during the COVID-19 pandemic. Our prospective study aimed to assess the feasibility of a remote adapted physical activity (PA) intervention and its effectiveness in improving anthropometric indices, metabolic health parameters, as well as cardiopulmonary function and fitness in adolescents with obesity. Methods: A PA intervention involving synchronous online lessons combined with asynchronous sessions and promotion of independent PA and "active breaks" to interrupt prolonged sedentary behaviors was proposed to 20 adolescents aged 11-17 years with obesity over a 4-month period. Clinical and anthropometric parameters (weight, height, waist, body composition, blood pressure), metabolic parameters (glycemia, insulinemia, glycated hemoglobin, oral glucose tolerance test [OGTT], lipid profile, presence of hepatic steatosis), cardiopulmonary function and fitness indices (VO2max, six-minute walking test [6MWT], upper and lower limb strength test) were evaluated before and after the intervention. Results: Twenty adolescents with obesity were enrolled (11 male [55%], aged 14.1±1.5 years, BMI SDS 3.1±0.5). Eighteen participants (90%) successfully completed the project, and no adverse events were reported. We observed an increase in cardiovascular and muscle fitness [higher VO2peak, maximal workload, better performance at limb strength and 6MWT (all P<0.05)], increased lean body mass (P=0.005), and an improvement of glucose metabolism response with a reduction of insulin concentrations during OGTT (P=0.043). Conclusions: Participation in the training program was feasible and effective in improving cardiovascular fitness, glucose metabolism, body composition, strength, and endurance in adolescents with obesity during the COVID-19 pandemic.