Copyright @ 2008 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited. Intermittent Versus Continuous Exercise: Effects of Lower Exercise in Obese Women JE ´ RE ´ MY B. J. COQUART 1 , CHRISTINE LEMAIRE 2 , ALAIN-ERIC DUBART 3 , DAVID-POL LUTTEMBACHER 3 , CLAIRE DOUILLARD 2 , and MURIELLE GARCIN 1 1 Laboratory of Human Movement Studies, University of Lille, Ronchin, FRANCE; and 2 Departments of Endocrinology, and 3 Cardiology, Hospital Germon and Gauthier, Be ´thune, FRANCE ABSTRACT COQUART, J. B., C. LEMAIRE, A.-E. DUBART, D.-P. LUTTEMBACHER, C. DOUILLARD, and M. GARCIN. Intermittent Versus Continuous Exercise: Effects of Lower Exercise in Obese Women. Med. Sci. Sports Exerc., Vol. 40, No. 8, pp. 000–000, 2008. Introduction: Exercise has beneficial effects on obesity and diabetes treatments. However, obese subjects do not closely adhere to training programs probably because of the monotony of the continuous exercise that is frequently proposed. To increase adherence to training programs, intermittent exercise, which is less monotonous, may be more appropriate. Purpose: The purposes of this study were to determine the perceptually less hard exercise (continuous vs intermittent exercise) and to analyze the impact of a training program on the basis of this exercise in obese women with and without type 2 diabetes. Methods: Twenty type 2 diabetic obese women and 20 obese women without diabetes were recruited. In each group, 10 patients integrated a training program (i.e., training groups), whereas the remaining patients were untrained (i.e., control groups). The training groups performed a continuous exercise and an intermittent exercise to determine the perceptually less hard exercise thanks to lower ratings of perceived exertion (RPE). Then, a training program that included 32 min (3 dIwk j1 I10 wk j1 ) of the perceptually less hard exercise was proposed to training groups. Results: RPE were significantly lower during the intermittent exercise compared to the continuous exercise in the obese women with or without diabetes (RPE = 12.3 T 2.3 vs 13.7 T 2.3 and RPE = 11.9 T 1.1 vs 13.2 T 1.6, respectively). After the training program, significant beneficial effects on the glycosylated hemoglobin (6.8 T 1.4% vs 6.5 T 1.2%), body mass (97.1 T 16.9 vs 95.2 T 16.2 kg), body mass index (37.6 T 6.1 vs 36.8 T 6.0 kgIm j2 ), and on the HR and the walked distance limit were noticed in the training groups. Conclusion: The obese women with or without diabetes perceived the intermittent exercise as being less hard than the continuous exercise, and a training program based on intermittent exercises produced beneficial effects on obesity and type 2 diabetes. Key Words: RATINGS OF PERCEIVED EXERTION SCALE OF BORG, PERCEPTUAL PREFERENCE, INTERVAL TRAINING, ADHESION, INDIVIDUALIZED EXERCISE THERAPY I t has been established that obesity, especially abdominal adiposity, is by far the most important factor in the development of type 2 diabetes (24); for this reason, most type 2 diabetic patients are obese. On the other hand, type 2 diabetes is characterized by varying degrees of insulin resistance and relative insulin deficiency (2) that lead to chronic hyperglycemia. As weight loss is often associated with lower blood glucose concentration and increased insulin sensitivity, it is considered as the corner- stone of therapy for type 2 diabetic obese patients (28). To enhance weight loss and also to maintain this loss, the prescription of a training program may be appropriate, particularly when an adequate calorie-controlled meal plan is used (3). However, it has already been reported that long- term effects with training programs are disappointing, largely because of poor patient adherence (28). Frequently, people who begin a training program do not continue it or they only participate on an irregular basis, and so the performed exercise volume remains low (16). This poor adherence might be explained by prescribed continuous exercise monotony among others. Thus, to limit this phenomenon and increase the adherence to the training program, other exercise types such as intermittent exercise may seem more appropriate. Perceived exertion, which can be defined as the intensity of subjective effort, strain, discomfort, and the fatigue that one feels during exercise, has been used for clinical, ergonomic, pedagogical, and sporting applications (23) with several objectives. Among the numerous interests for the Ratings of Perceived Exertion (RPE) scale of Borg (5), perceptual preference determination has already been proposed but rarely to compare different types of exercise. According to Robertson and Noble (23), perceptual prefer- ence is expressed as the exercise conditions that are associated with the lowest RPE. Therefore, RPE values measured during continuous exercise may be compared Address for correspondence: Je ´re ´my B. J. Coquart, Ph.D., Laboratory of Human Movement Studies, University of Lille 2, 9 rue de l’Universite ´, 59790 Ronchin, France; E-mail: jeremy.coquart@univ-lille2.fr. Submitted for publication November 2007. Accepted for publication February 2008. 0195-9131/08/4008-0000/0 MEDICINE & SCIENCE IN SPORTS & EXERCISE Ò Copyright Ó 2008 by the American College of Sports Medicine DOI: 10.1249/MSS.0b013e31816fc30c 1 APPLIED SCIENCES