The effects of core stabilization exercise program in obese people awaiting bariatric surgery: A randomized controlled study

Evaluation of the Effect of the Pre-Operative Exercise Training on Weight Loss, Quality of Life, and Cardiopulmonary Parameter in Bariatric Metabolic Surgery: A Systematic Review and Meta-Analysis

The purpose of this study is to assess the impact of pre-surgery exercise training on cardiopulmonary fitness. Ten articles (six RCTs and four non-RCTs) involving 281 individuals were finally included in the synthesis. Regarding the effect on VO2 peak, overall standardized mean differences were 0.71 (95% CI, 0.31 to 1.11, n = 103) with heterogeneity (I2 = 0%, P = 0.49). For 6MWT, overall weighted mean differences (distance in meters) were 31.87 (95% CI, 27.84 to 35.89, n = 100) with heterogeneity (I2 = 0%, P = 0.96). Engaging in pre-bariatric metabolic surgery exercise training might improve anthropometric parameters and cardiopulmonary fitness with no significant changes in components of quality of life. However, considering high levels of heterogeneity, the results should be generalized cautiously.

Assessment of Isokinetic Trunk Muscle Strength and Fatigue Rate in Individuals after Bariatric Surgery

Background and Objectives: Lean body mass loss after bariatric surgery (BS) is remarkable, despite an effective long-term mass reduction and significant declines in comorbidities. A person's functional capacity is adversely affected when their skeletal muscle strength declines by up to 30%. This study aimed to assess the isokinetic trunk muscle strength and fatigue rate in individuals after BS. Materials and Methods: This study included fifty-eight patients, both male and female, ranging in age from 19 to 45. Twenty-seven individuals had BS and twenty-seven healthy people served as the control group. The primary outcomes were the measurement of the concentric and eccentric isokinetic muscle strength of the trunk flexor and extensor muscles. An isokinetic dynamometer (Biodex Rehabilitation and Testing System 3) was used for the assessment of the isokinetic muscle strength. Noraxon EMG was used to determine a secondary outcome, which was the median frequency slop (MF/time) and root mean square slop (RMS/time) of the lumbar erector spinea muscle at 50% of the Maximum Voluntary Isometric Contraction (MVIC). Outcome measures were assessed for both groups. Results: Compared to the control group, the bariatric group showed a lower mean value of both concentric and eccentric isokinetic muscle strength for the flexor and extensor trunk muscles (p < 0.05). In terms of the EMG fatigue rate, the RMS slope increased significantly more than that of the control group, while the MF slope decreased (p > 0.05). Conclusions: The current study found that, in comparison to the healthy subjects, the BS group showed reduced levels of fatigue and isokinetic strength in the trunk muscles. Based on these results, it is recommended that individuals who underwent BS take part in tailored rehabilitation programs to avoid potential musculoskeletal issues in the future.

Efficacy of telehealth core exercises during COVID-19 after bariatric surgery: a randomized controlled trial

BACKGROUND

Bariatric surgery (BS) is presently the most durable and effective intervention to address severe obesity. BS results in significant weight loss and body composition changes, with reductions in both fat mass and lean mass. Conequently, muscle tissue wasting and a reduction in muscle strength and endurance seem to take place. Some studies have evaluated the impact of resistance training on changes in lean body mass and muscle strength either alone or along with protein supplementation in the first year after BS. However, the effects of core stabilization training on core endurance, postural control, and aerobic capacity in patients after BS have not been evaluated.

AIM

This study assessed the effect of a home telehealth core stabilization exercise program on core stability, postural control, and aerobic capacity in patients after BS.

DESIGN

A single-blinded randomized controlled trial.

SETTING

Home-based exercise program.

POPULATION

Patients after BS.

METHODS

Fifty-four patients who underwent BS randomly assigned into study and control groups. The study group followed a telehealth supervised home core stabilization program for 8 weeks, while the control group did not receive any form of exercises. Core endurance tests, postural stability, and aerobic capacity were assessed at baseline and after 8 weeks in both groups.

RESULTS

No significant difference was noted between groups at baseline (P>0.05). The outcome of the group comparisons showed significant improvement in core endurance tests, postural stability, and aerobic capacity in the study group. Between groups comparision showed that the study group scores significantly higher than the control group (P<0.05). However, the control group showed non-significant changes in any measured variables after eight weeks (P>0.05).

CONCLUSIONS

Eight weeks of a home-based telehealth core exercise program improves core endurance, postural stability, and aerobic capacity in patients after BS.

CLINICAL REHABILITATION IMPACT

The core stabilization exercise is an important rehabilitation program that should be implemented after BS. Telehealth is an alternative rehabilitation tool during the COVID -19 pandemic.

Exercise and bariatric surgery: A systematic review and meta-analysis of the feasibility and acceptability of exercise and controlled trial methods

This systematic review and meta-analysis assessed the feasibility and acceptability of exercise and controlled trial methods in adults awaiting or having undergone bariatric surgery (BS). Search methods used to identify relevant articles were inclusion of articles identified in a systematic review, new database search of articles published 2019-2021, and hand searching reference lists. Titles/abstracts and full-texts were screened by two reviewers independently against inclusion criteria: adults awaiting or having undergone BS, controlled trial, exercise group compared with a comparison group without exercise. Twenty-eight articles were reviewed; most interventions were supervised, performed after BS, and lasted ≤13 weeks. Pooled data for exercise intervention attendance and dropout rates were 84% (k = 10) and 5% (k = 19), respectively, though possibly misestimated due to poor/selective reporting. Median study and recruitment duration were 18 weeks and 24 months, respectively, with a pooled enrollment rate of 2.5 participants/month. Pooled data for refusal to participate, enrollment, and retention rates were 23% (k = 16), 43% (k = 18), and 87% (k = 26), respectively. Despite the lack of data available in studies included, exercise and controlled trial methods seem feasible and acceptable for adults awaiting or having undergone BS. To better identify methodological or practical challenges, and assess bias, better reporting of feasibility and acceptability indicators is needed in future studies.

Effects of Supervised Physical Exercise as Prehabilitation on Body Composition, Functional Capacity and Quality of Life in Bariatric Surgery Candidates: A Systematic Review and Meta-Analysis

Background: Prehabilitation is a strategy used aiming to reduce the risk factors and complications of surgery procedures, but there is no consensus on the effectiveness of supervised physical exercise and its optimal prescription during this phase. Objectives: To determine the effects of exercise prehabilitation on body composition, functional capacity and quality of life in candidates for bariatric surgery. Search methods: A search was conducted in PubMed, Web of Science, SciELO, Scopus, MEDLINE and CINAHL. Selection criteria: Only randomized clinical trials that examined the effectiveness of supervised physical exercise were included. The main outcomes were body composition, functional capacity, quality of life and surgical outcomes. Data collection and analysis: Two researchers independently selected the literature, extracted the data and evaluated the risk of bias. A third researcher was consulted when a consensus was not reached. The risk of bias was assessed by the tool recommended by the Cochrane Collaboration, the quality of the evidence by GRADE, and to analyze the effects of prehabilitation on the primary objectives, RevMan software, version 5.3 was used. Main results: The search resulted in 4550 articles, of which 22 met the eligibility criteria, leaving 5 articles selected for this review. One article was assessed as a high bias risk and four as an uncertain risk, which included 139 candidates for bariatric surgery. Most of the studies evaluated the body composition, functional capacity and quality of life; none reported surgical outcomes. Conclusions: Supervised physical exercise has positive effects on the body composition, functional capacity and quality of life; there was no evidence for surgical outcomes, which opens up a field of study for future research of this population.

Effects of pre-surgical aerobic dance-based exercise on lower extremity in people with morbid obesity awaiting bariatric surgery: Randomized controlled study

To investigate what are the effects of pre-surgical aerobic dance-based exercise programme (PSADBE) and physical activity counselling (PAC) programme on lower extremity functions after surgery in people with morbid obesity awaiting bariatric surgery (PMOABS). This study was a single-blind, randomized controlled study. Groups were divided into Group I (PSADBE and PAC) and Group II (PAC). Both groups received PAC, Group I completed the PSADBE programme accompanied by music for 60 min/2 days/8 weeks. Thirty-four PMOABS were included in the study. The 6-Minute Walking Test, as primary outcomes, and The Stair Climbing Up-Down Test for evaluating functional capacity, Biodex Isokinetic Test and Exercise System® for evaluating muscle strength were used. Besides, muscle endurance, physical activity (PA) level, fatigue and quality of life (QoL) were also assessed. All measurements were repeated three times; pre-treatment, post-treatment and the fifth-month post-surgery. After 8 weeks, significant changes were found in functional capacity, muscle strength and endurance, PA level, fatigue and QoL in both groups (p < .05). Comparing the groups, the changes in functional capacity, muscle strength and endurance, PA and fatigue scores after treatment and the fifth-month post-surgery were statistically superior in Group I (p < .05). Adding an 8-week PSADBE programme to PAC is an effective treatment option for improving postoperative functional capacity, muscle strength and endurance, PA level and fatigue in PMOABS.

A broad focus on additional programmes prior to bariatric surgery: A systematic review

Additional preoperative programmes may be beneficial for candidates who seek bariatric surgery, but there is no consensus on the optimal preparation. This systematic review aimed to summarize the effects of a preoperative programme on weight loss. A literature search was performed for Embase, Cinahl, PubMed and Cochrane Library. Studies on preoperative exercise, behaviour and/or diet programmes administered in adult patients in a bariatric trajectory measuring weight loss were included. Initial results yielded 2148 titles, 70 of which were thoroughly analysed and 37 articles were included, comprising 10 333 patients. Eleven out of 37 studies included postoperative weight loss as an outcome in interventions focused on diet (n = 5), behaviour (n = 2), exercise (n = 2) and a combination of interventions (n = 2). Only one study (9%) which administered exercise as a preoperative programme showed a significant effect on postoperative weight loss. In total, 33 studies included preoperative weight loss as an outcome, which was significant in 64% of the cases. It is difficult to draw conclusions from the investigated data as it was extremely heterogeneous concerning the intensity, duration and administration of a programme. Nevertheless, it seems that a preoperative weight loss programme seems beneficial in terms of preoperative weight loss, postoperative physical activity and improved mental health postinterventional. The use of a core outcome set is recommended for future studies.