Obesity Research & Clinical Practice (2014) 8, e238—e248

ORIGINAL ARTICLE
Acceleration training for improving
physical fitness and weight loss in
obese women
Rina So
a,b,∗
, Miki Eto
a
, Takehiko Tsujimoto
a
, Kiyoji Tanaka
a
a
Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai,
Tsukuba, Ibaraki 305-8574, Japan
b
Japan Society for the Promotion of Science, Tokyo, Japan
Received 24 September 2012; received in revised form 10 January 2013; accepted 12 March 2013
KEYWORDS
Acceleration training;
Physical fitness;
Visceral adipose tissue;
Obesity
Summary
Background: Reducing body weight and visceral adipose tissue (VAT) are the primary
goals for maintaining health in obese individuals as compared to those of normal
weight, but it is also important to maintain physical fitness for a healthy life after
weight-loss. Acceleration training (AT) has recently been indicated as an alterna-
tive to resistance training for elite athletes and also as a component of preventive
medicine. However, it is unclear whether combining AT with a weight-loss diet will
improve physical fitness in obese individuals. The present study aimed to deter-
mine the synergistic effects of AT on body composition and physical fitness with
weight-loss program in overweight and obese women.
Methods: Twenty-eight obese, middle-aged women were divided into two groups
as follows: diet and aerobic exercise group (DA; BMI: 29.3 ± 3.0 kg/m
2
); and diet,
aerobic exercise and acceleration training group (DAA; BMI: 31.2 ± 4.0 kg/m
2
). Both
groups included a 12-week weight-loss program. Body composition, visceral adipose
tissue (VAT) area and physical fitness (hand grip, side-to-side steps, single-leg bal-
ance with eyes closed, sit-and-reach and maximal oxygen uptake) were measured
before and after the program.
Result: Body weight, BMI, waist circumference and VAT area decreased significantly
in both groups. Hand grip (2.1 ± 3.0 kg), single-leg balance (11.0 ± 15.4 s) and sit-
and-reach (6.5 ± 4.8 cm) improved significantly only in the DAA group.

Corresponding author at: Graduate School of Comprehensive Human Science, University of Tsukuba, Address: 1-1-1 Tennodai,
Tsukuba, 305-8577, Japan. Tel.: +81 29 853 2655; fax: +81 29 838 5883.
E-mail address: rina@stat.taiiku.tsukuba.ac.jp (R. So).
1871-403X/$ — see front matter © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.orcp.2013.03.002
Effects of acceleration training on obesity e239
Conclusions: Our findings indicate that combining AT with classical lifestyle mod-
ifications is effective at reducing VAT, and it may enhance muscle strength and
performance in overweight and obese women.
© 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd.
All rights reserved.
Introduction
Obesity is closely associated with many major
metabolic diseases [1,2]. In particular, weight gain,
which sometimes progresses to obesity, is a major
health concern for women at midlife, and numer-
ous studies have pointed out that aging is associated
with an increased accumulation of visceral adipose
tissue (VAT) [3,4]. Dietary modification is generally
more effective for weight loss compared with exer-
cise alone because it is an easier means of inducing
a marked energy deficit [5—7]. However, losing
weight through severe dietary restriction alone can
dramatically reduce muscle mass strength [8,9] and
lead to a decline in physical fitness [10].
Some studies have shown that abdominally obese
and overweight people have lower maximal oxy-
gen uptake than people of normal weight, and that
VAT accumulation is closely related to diminished
physical fitness [11]. However, both cardiorespira-
tory fitness and muscle strength serve as indicators
of health status, especially for conditions such
as metabolic syndrome [12] and mortality [13].
Thus, it is important that obese individuals maintain
their physical fitness when losing weight. Resis-
tance training as part of an exercise program for
increasing muscle strength and preventing disease
has been endorsed by the American College of
Sports Medicine [14], the American Heart Asso-
ciation [15] and the Japanese physical activity
guideline [16]. However, obese individuals, with
their excessive body weight and their typically poor
posture, are more prone to injury [16] compared to
non-obese individuals [17]. To address this issue,
we formulated a novel resistance-training method
for obese individuals that preserves muscle strength
and reduces the chance of injury.
Increasing attention has been paid to acceler-
ation training (AT) and its use as an alternative
for traditional strength training. Several stud-
ies have shown that AT does not require heavy
dumbbells or a pulley system [17], it saves time
and it is a safe and effective intervention for
increasing muscle strength and functional capac-
ity [18—20]. As a result, although AT was initially
used by elite athletes to improve their physical
fitness and performance, it is now seen as a ben-
eficial training method for general exercise and
sports, and as a tool in rehabilitation and pre-
ventive medicine. In sports, AT seems to improve
flexibility, increase jumping height and increase
muscle strength. In preventive medicine, there is
already good evidence suggesting AT can improve
balance and muscle strength in the frail and
elderly.
Our group also investigated the effects of incor-
porating AT into a daily lifestyle as a means
of decreasing arterial stiffness and consequently
reducing the risk of cardiovascular disease and
muscle weakness in obese individuals [21]. Fur-
thermore, Vissers et al. recently reported that
combining AT with a weight-loss diet can help
achieve sustained long-term body weight loss of
5—10% over 6 months [22]. They concluded that
AT has a greater potential than aerobic exercise
to reduce VAT in obese adults. Vissers’ study was
the first clinical study to report the effect of AT
on VAT, but it is unclear whether combining AT
with a weight-loss diet provides sufficient physical
stimulation for improving physical fitness, includ-
ing muscle strength, agility, balance, flexibility and
maximal oxygen uptake in obese individuals.
Although the primary goal of a weight loss
program is to reduce weight and VAT, it is also
important to maintain physical fitness for a healthy
life after weight-loss. Therefore, the present study
was undertaken to examine whether adding AT
training to a conventional weight-loss program can
promote additional weight-loss while improving or
maintaining components of physical fitness in over-
weight and obese women.
Methods
Participants
We recruited 40 premenopausal, sedentary, over-
weight and obese women in Japan through local
newspaper advertisements and study flyers, and
32 met the following eligibility criteria: (1) aged
30—60 years, (2) BMI > 25 kg/m
2
according to the
domestic obesity guideline [23], and (3) no his-
tory of musculoskeletal disorders. In present study,
we did not include a control group, because of
our subjects participated as volunteer intent on
e240 R. So et al.
improving their health. Therefore, maintaining a
‘‘control group’’ of obese subjects who would not
be able to participate in the program was not
necessary and likely not possible with these volun-
teers. Instead, we maintained two groups with the
same lifestyle modifications but with or without AT.
This would be a more realistic study design in the
field or when providing general health guidance.
To increase adherence to the weight-loss program,
personal lifestyle (e.g., occupation and daily sched-
ule) was taken into account, and participants were
assigned to a diet with aerobic exercise (DA) group
(n = 12) or a diet with aerobic exercise and AT (DAA)
group (n = 20). One participant in the DAA group was
unable to start the study due to a health problem,
and two other participants in the DAA group failed
to complete the program successfully for personal
reasons. In addition, one participant withdrew due
to lack of motivation. Consequently, 12 participants
in the DA group and 16 in the DAA group were
included in the final analysis. All potential risks and
procedures of the study were fully explained to the
participants before they provided written informed
consent to participate in the study. The study con-
formed to the principles outlined in the Declaration
of Helsinki. The ethical committee of the University
of Tsukuba also reviewed and approved the study
protocol.
Dietary modification
Both groups received the same dietary program,
which consisted of 90-min, group-based instruc-
tional sessions performed weekly for 3 months
and individual counseling by trained staff. Dietary
habits were modified according to the Four-
Food-Group Point Method [24]. We instructed
participants to consume a well-balanced 1200-kcal
diet daily. Details of the program and methodology
have been published previously [25].
Aerobic exercise training
Exercise training sessions were conducted near
our facility and supervised by exercise physiolo-
gists. The exercise program consisted of a 60-min
(DA group) or 30-min (DAA group) aerobic exer-
cise session three times per week for 3 months.
Aerobic exercise included brisk walking, mild jog-
ging, and/or aerobic dancing. Each session was
preceded by 15—20 min of warm-up activities, such
as stretching and calisthenics and was concluded
with 15—20 min of cool-down activities. Exercise
intensity was based on maximum heart rate (HR)
percentage measured by short-range telemetry
(RS400, Polar, Kempele, Finland). Briefly, walking
intensity commenced at 45% maximum HR, and tar-
get exercise intensity was 65—80% of age-predicted
HR (220 minus age).
Acceleration training
The DAA group performed the AT session on
the same day as the aerobic exercise session.
The DAA group performed upper and lower body
exercises on the AT platform (Power Plate, Bad-
hoevendorp, The Netherlands). Participants in the
DAA group performed the AT training protocol
for 30 min 3 times per week with a gradual
increase in frequency (30—35 Hz), execution ampli-
tude (static—dynamic) and number of exercises
(12—24). Each interval of acceleration lasted 30 s
and was followed by a 30-s rest. The mean
total exercise time per session increased steadily
(7.7 min—11.5 min—13 min) according to the pro-
gressive overload principle. A training session
typically included squats, wide-stance squats, deep
squats, lunges, push-ups, triceps dips, and front
plank. Trained staff supervised all training ses-
sions to ensure correct execution. Briefly, in the
first month the program consisted of static exer-
cises (30 Hz), and in the second month, the training
intensity increased by increasing the frequency of
the acceleration to 35 Hz. In the last month, train-
ing intensity increased by switching from static to
dynamic exercises.
Daily energy intake and expenditure
We assessed total energy intake (TEI; kcal) 2 weeks
before and at the end of the program (week
10) by reviewing 3-day weighed dietary records
and through dietary recall interviews performed
by a skilled interviewer. Participants were also
instructed to record their dietary information on
two days during the week and on one weekend
day or holiday. The food data gathered by these
methods were converted to energy consumed by
a registered dietician and analyzed using commer-
cially available software (Excel Eiyoukun version
4.0, Kenpakusya, Tokyo).
We also assessed total energy expenditure (TEE;
kcal) with a validated uniaxial accelerometer
(Lifecorder; Suzuken Co. Ltd., Nagoya, Japan). The
accelerometer was firmly attached to the partic-
ipant’s clothing (belt or waistband), and was to
be worn during all waking hours (except while
bathing). The recording started 2 weeks before the
12-week program, to assess expenditure at base-
line, and continued throughout the program. The
accelerometer can determine the level of move-
ment intensity every 4 s. It can assess two types
Effects of acceleration training on obesity e241
of activity-related energy expenditure. The TEE
can then be calculated from the sum of the basal
metabolic rate, the diet-induced thermogenesis
and the two types of activity-related energy expen-
diture. Detailed descriptions of the accelerometer
have been published elsewhere [26]. Also, the
physical activity variables used in this study were
calculated on a daily basis and then used to
estimate weekly activity by taking a weighted aver-
age of daily weekday and weekend activity. Data
from participants who had worn the accelerom-
eter for at least 10 h per day for at least 4
weekdays and 1 weekend day were considered
valid.
Anthropometric measurements
All measurements were conducted in the same
order at baseline and at week 12. Participants were
instructed not to engage in vigorous physical activ-
ity or alcohol consumption within 24 h prior to the
measurements. Body weight was measured to the
nearest 0.1 kg using a digital scale (TBF-551; Tanita,
Tokyo, Japan), and height was measured once to the
nearest 0.1 cm using a wall-mounted stadiometer
(YG-200; Yagami, Nagoya, Japan) with the partic-
ipants barefoot and in underwear in the morning
after fasting for at least 8 h. BMI was calculated
as weight (kilograms) divided by height (in meters)
squared. Waist circumference (WC) was measured
to the nearest 0.1 cm at the level of the umbilicus
using a flexible, retractable, fiberglass tape mea-
sure. WC measurements were taken in duplicate to
the nearest 0.1 cm, and the average value was used
for analysis.
Body composition
We measured body composition by dual energy X-
ray absorptiometry (DEXA, QDR 4500A, Hologic,
CO) with manufacturer-supplied software (version
1.35). Body composition was assumed to consist of
fat mass (FM) and fat free mass (FFM) as previously
described [25]. A standard soft tissue examina-
tion was performed and entailed total body and
regional measurements of the trunk, arms and
legs to analyze body composition according to a
three-compartment model including FM and FFM.
Participants lay in the supine position with their
legs closed and their arms at their sides during the
15-min scan.
Abdominal adipose tissue by MRI
We performed magnetic resonance imaging
(MRI) scans at baseline and repeated the same
measurements in the same order on completion
of the program. We instructed participants not to
wear metal objects during the MRI measurements
and to refrain from eating or drinking for 2 h
prior to the measurement. Abdominal multiple-
slice MRI scans were performed using a 1.5-T
system (SIEMENS MAGNETON Avanto syngo MR
B15, Siemens, Erlangen, Germany) at the Tsukuba
Medical Center Hospital and conducted according
to our previously described protocol [27]. We used
single-slice images at the L4-L5 level to assess
VAT and subcutaneous adipose tissue (SAT) areas.
The images were retrieved from the scanner
according to a Digital Imaging and Communications
in Medicine protocol. After image acquisition,
the same experienced technician performed the
segmentation and quantification of SAT and VAT
using image analysis software (SLICEOMATIC,
Tomovision Inc., Montreal, Canada). The model
and method employed to segment the various
tissues is comprehensively presented elsewhere
[28,29].
Physical fitness tests
Participants performed the following physical fit-
ness tests as a measure of the respective health
components: hand-grip (muscle strength), side-to-
side step (agility), single-leg balance (balance),
sit-and-reach test (flexibility) and maximal oxygen
uptake (VO
2
max) (cardiorespiratory fitness). Hand-
grip strength was assessed in both hands with a
hand-dynamometer (TKK, Tokyo, Japan), and the
mean value of both hands was used for analy-
sis. The side-to-side steps test was performed on
the floor and expressed as the number of steps
completed in 20 s. In the single-leg balance test,
participants closed their eyes and balanced on
one leg with the opposite knee bent back and
held behind their buttocks with the hand on that
same side. The sit-and-reach test assessed reach-
ing distance (cm) while sitting on the floor with
legs stretched out straight ahead. The participant
reached forward along the measuring line as far
as possible. VO
2
max was determined by a graded
exercise test using a cycling ergometer (828E,
Monark, Stockholm, Sweden). Following a 2-min
warm-up at 15 watts (W), the workload increased by
15 W min
−1
until volitional exhaustion. During the
test, ventilation and expiratory gases were mea-
sured using an indirect calorimeter (Oxycon Alpha,
Mijnhardt, Breda, The Netherlands). The highest
oxygen uptake achieved over 30 s was taken as the
VO
2
max and then analyzed in accordance with pub-
lished criteria [30].
e242 R. So et al.
Biochemical analysis
Trained observers measured systolic and diastolic
blood pressure using a standard mercury sphygmo-
manometer on the right arm of seated participants
(cuff size: 14 cm × 47 cm) who had rested for
at least 10 min. A blood sample of ∼10 mL was
drawn from each participant after an overnight
fast of at least 8 h. Serum concentrations of
total cholesterol and triglycerides were determined
enzymatically, and high-density lipoprotein choles-
terol was measured by the heparin-manganese
precipitation method. Serum concentration of low-
density lipoprotein (LDL) was estimated according
to the method of Friedewald et al. [31]. Blood
plasma glucose and insulin concentrations were
assayed by a glucose oxidase method and radioim-
munoassay, respectively. The glucose and insulin
concentrations were used to determine the homeo-
stasis model assessment as an index of insulin
resistance (HOMA-IR) according to the equations of
Matthews et al. [32].
Statistical analyses
We used the statistical package SPSS version 13.0
for Windows (SPSS, Chicago, IL) to perform statisti-
cal calculations. Data are expressed as mean ± SD.
We used a paired-sample t-test to analyze changes
within groups and a two-way repeated measures
ANOVA with time by intervention interaction to
analyze differences in daily energy intake and
expenditure, weight, BMI, body composition, phys-
ical fitness and biochemical parameters between
groups. We also calculated effect sizes with the
G*Power 3 analysis program [33]. A scale for effect
sizes has been suggested by Cohen [34], with >0.8
reflecting a large effect, >0.5 a moderate effect
and >0.2 a small effect. Results were considered
significant if p< 0.05.
Results
The average attendance rate was 70.8% (DA group)
and 73.7% (DAA group). Values for energy intake
and expenditure at baseline and their changes
are shown in Table 1. There were no differ-
ences in TEI or macronutrient balance between the
groups at baseline, and the TEI and macronutri-
ent balance changed significantly by the end of
the program in both groups. Furthermore, TEE and
physical activity energy expenditure increased sig-
nificantly during the study period in both groups.
However, we detected no significant interactions
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Figure 1 Comparisons (% change) in physical fitness
components between the DA group andthe DAA group.
Data are expressed as mean ± SE values. Gray bars indi-
cate the DA group, black bars indicate the DAA group.
*p < 0.05: significant differences from baseline values.
(p= 0.540—0.915) between the groups in the abso-
lute change of any variable.
Participant characteristics at baseline and after
the program are shown in Table 2. At baseline,
no significant differences were noted between the
groups in age, height, weight, BMI or body composi-
tion. Anthropometry measures, abdominal adipose
tissue and body composition had decreased signifi-
cantly by the end of the 12-week program in both
groups, and only BMI, VAT and total FM showed
a significantly greater reduction in the DAA group
(two-way ANOVA: p for interaction). The calculated
effect size ranges are 0.27—1.07 in the DA group
and 0.35—1.54 in the DAA group.
Table 3 compares the two groups’ baseline phys-
ical fitness components, biochemical components
and response to the program. Only LDL cholesterol
(p= 0.005) was significantly different between the
groups at baseline. The program induced a sig-
nificant increase in VO
2
max in both groups, and
side-to-side steps did not differ significantly before
or after the program within each group. In the DAA
group, hand-grip, single-leg balance and the sit-
and-reach test were significantly increased after
the program (Fig. 1). However, we did not find a
significant difference between the groups in the
training effect on physical fitness variables. The
ranges of effect sizes for physical fitness compo-
nents are 0.05—1.69 in DA group and 0.2—1.14 in
the DAA group.
In the DA group, there was no significant
change in LDL cholesterol (p= 0.069), while in the
DAA group, HOMA-IR (p = 0.075), glucose (p= 0.076)
and diastolic blood pressure (p= 0.058) remained
unchanged. Although greater improvements in most
e
2
4
4

R
.

S
o

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t

a
l
.
Table 3 Physical fitness and biochemical components at baseline, post and changes.
DA (n = 12) Cohen’s d DAA (n = 16) Cohen’s d Group × time
interaction
p-value
Baseline Post Change Baseline Post Change
Physical fitness components
Hand-grip, kg 25.7 ± 4.0 25.9 ± 4.4
a
0.2 ± 1.6 0.05 27.2 ± 4.5 29.3 ± 3.0 2.1 ± 3.0
*
0.55 0.066
Side-to-side steps,
time/20 s
33.5 ± 5.4 34.4 ± 3.2 0.8 ± 4.4 0.20 35.4 ± 5.1 36.3 ± 3.9 0.9 ± 2.2 0.20 0.965
Single-leg balance, s 10.4 ± 5.1 15.1 ± 9.9
a
4.8 ± 9.9 0.60 15.9 ± 15.7 26.8 ± 18.7 11.0 ± 15.4
*
0.63 0.250
Sit-and-reach, cm 1.3 ± 7.0 5.8 ± 6.5 4.6 ± 5.3 0.67 2.0 ± 7.6 8.5 ± 7.7 6.5 ± 4.8
*
0.85 0.524
VO
2
max, ml/kg/min 22.9 ± 2.6 28.2 ± 3.6 5.3 ± 3.0
*
1.69 23.8 ± 4.2 28.1 ± 3.3 4.4 ± 3.6
*
1.14 0.454
Biochemical components
Total cholesterol, mg/dl 225.8 ± 33.6 206.9 ± 40.3 −18.9 ± 32.2
*
0.51 215.6 ± 24.1 198.7 ± 25.8 −16.9 ± 22.3
*
0.68 0.849
HDL cholesterol, mg/dl 59.0 ± 9.2 65.3 ± 14.2 5.3 ± 8.5
*
0.53 51.4 ± 11.3 53.4 ± 11.6 2.1 ± 5.5
*
0.18 0.239
LDL cholesterol, mg/dl 143.9 ± 35.4 128.3 ± 37.2 −15.6 ± 26.8
*
0.43 138.0 ± 20.2 125.7 ± 19.9 −12.3 ± 19.0
*
0.61 0.708
Triglycerides, mg/dl 115.2 ± 48.2 71.3 ± 23.2 −43.9 ± 42.0 1.16 131.1 ± 48.0 97.0 ± 47.3 −34.1 ± 35.7
*
0.72 0.511
Insulin, mg/dl 9.3 ± 3.9 5.1 ± 3.1 −4.2 ± 3.0
*
1.19 11.4 ± 5.2 8.1 ± 3.5 −3.3 ± 4.7
*
0.75 0.557
HOMA-IR 2.7 ± 1.9 1.4 ± 1.3 −1.3 ± 1.1
*
0.80 2.7 ± 1.2 1.9 ± 0.9 −0.8 ± 1.1 0.76 0.286
Glucose, mg/dl 109.8 ± 36.3 103.1 ± 39.0 −6.7 ± 12.1
*
0.18 96.0 ± 13.4 93.3 ± 7.9 −2.7 ± 11.0 0.25 0.372
Systolic blood pressure,
mmHg
131.2 ± 13.6 121.9 ± 14.3 −9.3 ± 12.1
*
0.67 126.9 ± 15.1 121.5 ± 14.9 −5.4 ± 9.1
*
0.36 0.342
Diastolic blood pressure,
mmHg
84.5 ± 7.8 78.0 ± 9.6 −6.5 ± 8.0
*
0.74 83.0 ± 10.1 79.0 ± 7.4 −4.0 ± 9.2 0.45 0.460
Abbreviations: BMI, body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; HOMA-IR, homeostasis model assessment of insulin resistance. Data values are
presented as mean ±standard deviation.
*
Significant change within group by two-way repeated ANOVA.
Effects of acceleration training on obesity e245
biochemical variables were observed in the DA
group, no significant time-intervention interaction
was observed between the groups (Table 3). The
ranges of effect sizes for biochemical components
are 0.18—1.19 in the DA group and 0.18—0.75 in the
DAA group.
Discussion
We demonstrated that adding AT to a weight-loss
diet and aerobic exercise program helped maintain
weight loss and improve physical fitness. Our data
clearly indicate that AT provides an additional ben-
efit in terms of improving obesity. We found that
despite the change in daily total energy intake and
total energy expenditure did not differ between DA
and DAA group, weight (p= 0 .055), BMI, and VAT
more decreased in DAA group than in DA group.
Although, we did not measure energy expenditure
during exercise in this study. But, we can sup-
pose possibility for the greater decrease in the DAA
group may be a difference in energy expenditure
between the DA and DAA groups during exercise.
Rittweger et al. reported that acceleration train-
ing increased energy metabolism through increased
oxygen uptake compared to values during moderate
walking. Furthermore, standing on an accelera-
tion platform at a frequency of 26 Hz increased
heart rate response, the Borg rating of perceived
exertion and blood lactate concentrations to levels
found when performing moderate exercise [35,36].
According to these reports, it seems the increase
in energy expenditure with acceleration training is
of sufficient magnitude to impact body composi-
tion. Also, in support of this finding, Rubin et al.
reported that short bursts of low-intensity vibra-
tion in young mice reduce the differentiation of
precursor cells to adipocytes, suggesting a plausi-
ble mechanism by which mechanical vibration may
prevent fat accumulation [37]. Although, there is
no determined difference in energy expenditure
between the DA and DAA groups, it is possible that
exercise on an AT platform increases energy expen-
diture.
Vissers et al. also had similar findings on AT
in their study of diet and exercise comparing
4 groups (control, diet only, diet + fitness and
diet + vibration) over a 6-month intervention period
and a 6-month no-intervention follow-up period
[22]. They observed the biggest reduction in
VAT in the vibration group after both 6 and 12
months (−47.8 ± 41.2 cm
2
and − 47.7 ± 45.7 cm
2
,
respectively) compared to the other 3 groups.
An interesting finding of Vissers’ study is that
the reduction in VAT from baseline to 12 months
was statistically significant only in the vibration
group (−47.8 ± 45.7 cm
2
). Although the reasons for
AT’s beneficial effect on VAT remain unclear, one
possible factor is the activation of the central sym-
pathetic nervous system (SNS). Ando et al. reported
that acute exposure to AT activates the SNS [38].
A major effect of SNS innervations on white adi-
pose tissue is the triggering of lipolysis. Bartness
and Song reported that SNS activity in white adi-
pose tissue can also inhibit fat cell proliferation
[39], suggesting that obesity is associated with fat
cell proliferation. Although, we could not investi-
gate SNS activation, our results, including reduction
of VAT and total FM, show that AT stimulation may
influence lipolysis activity.
The enhanced physical fitness in the DAA group
can be attributed to the improved muscle strength
brought about by AT, as demonstrated in several
previous studies [37,38], suggesting that AT is use-
ful for enhancing muscle strength. Although, we
did not see any significant differences in physical
fitness components between groups, the hand-grip
effect size should be noted since this was statisti-
cally significant between the groups. The hand grip
effect sizes in the DA and DAA groups are 0.05 and
0.55, respectively. According to Cohen’s d, the DAA
has a medium hand grip effect size (small effect
size is between 0.2 and 0.5, medium effect size
is between 0.5 and 0.8). Thus, these results show
that AT may effectively strengthen muscle during a
weight-loss program for obese people (Table 3).
In the present study, we measured hand-grip as
our index of muscular strength because it is con-
sidered a limiting factor in manual lifting and load
carrying [40,41]. Moreover, normative hand-grip
strength data are needed to determine the effec-
tiveness of treatment [42]. Only the DAA group had
a significant improvement in hand-grip strength,
suggesting that the relative muscle load of the AT
was sufficient to induce change. One reason why
the AT exercise improves muscle strength is the
influence of acceleration created by the minute
vibration of the platform [43]. The force dur-
ing resistance training can be expressed by the
following equation: force = mass × acceleration. If
conventional resistance training can modulate
force by changing mass, acceleration training can
modulate force by changing acceleration through a
change in frequency (Hz) and amplitude (mm) of
vibration. For example, for a person with a mass of
70 kg plus a resistance training weight of 70 kg, the
force created is approximately 1400 N:
F = (70 kg + 70 kg)
×9.81 m/s
2
(gravitational acceleration).
e246 R. So et al.
Meanwhile, at 40 Hz and 4 mm amplitude the
acceleration goes up to 50.0 m/s
2
, and when a per-
son of 70 kg is standing on the platform, the force
created is 3500 N:
F = 70 kg × 50 m/s
2
.
Therefore, the force involved on a 70 kg person
is 2.5 times greater during AT than if that same
70 kg person used weights of 70 kg during resistance
training without AT.
Also, the single-leg balance test and the sit-and-
reach test improved significantly only in the DAA
group, which implies improved muscular perfor-
mance. The findings by Bosco et al. also suggest
that activating muscles through vibration may
improve strength and power performance in a sim-
ilar manner to strength training [44]. AT imposes
hypergravity due to high acceleration, and AT
mechanically produces fast and short changes in
the length of the muscle-tendon complex [45,46].
Excitatory inflow during vibratory stimulation is
related to the reflex activation of ␣-motor neurons.
Cardinal et al. explained the mechanism of this
vibratory stimulus, which is perceived by different
sensory structures and stimulates the neuromuscu-
lar system to produce reflex muscle activation [47].
However, it should be noted that AT’s mechanisms
may also work through the interaction of several
physiological systems such as skeletal, muscular,
endocrine, nervous and vascular [48].
Our findings show that AT may be an effec-
tive method for increasing general physical fitness
in obese individuals on a dietary weight-loss pro-
gram. To our knowledge, the present study is the
first to examine the effectiveness of AT on physi-
cal fitness in obese women on an energy-restricted
diet. Although, most previous studies focusing on AT
looked at athletes and sedentary individuals, this
study focused on improving weight-loss and phys-
ical fitness in obese individuals, and our findings
suggest that AT may be an appropriate addition
to a weight-loss program. Nevertheless, there are
several limitations of this study. First, the study
population was relatively small; an insufficient sam-
ple size may be concomitant with type II error.
Second, since the intervention program comprised
dietary modification, habitual aerobic exercise and
acceleration training, we could not confirm the
effects of acceleration training alone.
Taken together, our findings suggest that AT
may be effective in weight-loss intervention for
reducing VAT and enhancing muscle strength and
performance in overweight and obese women. Fur-
thermore, AT requires less technical skill and space
than conventional resistance training machines, as
well as less time to complete workouts.
Conflict of interest
None of the authors had a conflict of interest
regarding any aspect of this research.
Acknowledgment
We thank the participants and staff at the Univer-
sity of Tsukuba for assisting in the study.
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