Abstract
BackgroundEvidence supports the association between exercise and outcomes following bariatric surgery. However, there is a lack of knowledge regarding the short-term benefits of preoperative exercise.ObjectivesThe objective of this pilot study was to evaluate the feasibility and functional benefits of a 12-week preoperative exercise program in patients awaiting bariatric surgery. The primary aim was the six-minute walk test (6MWT). The secondary aim of this study included anthropometric measures, strength, and quality of life.MethodsA total of 54 patients were enrolled in this pilot randomized controlled study. Of them, 29 patients received standard multidisciplinary preoperative care, while 25 patients participated in a 12-week supervised exercise program in addition to standard preoperative care consisting of strength and aerobic exercises three times per week in a fitness facility. The primary outcome was improvement in 6MWT. Secondary outcomes included other functional outcomes, quality of life, and anthropometric measures.ResultsAverage attendance for the intervention group was 27.2 (75.6%) of 36 sessions. There was a mean improvement of 27 ± 10 meters in the intervention group compared with a reduction of 5 ± 10 meters in the control group (p = 0.003). Patients in the intervention group had significant improvement in all self-reported quality-of-life domains, particularly in the variables related to symptoms, hygiene, and emotions.ConclusionsA 12-week preoperative exercise intervention was feasible and showed association with a statistically significant improvement in 6MWT and quality-of-life measures in patients awaiting bariatric surgery. The results of this study will inform sample size calculations and recruitment planning for a future study that will assess the longer-term benefits of a pre-surgical fitness intervention.
Highlights
29 patients received standard multidisciplinary preoperative care, while 25 patients participated in a 12-week supervised exercise program in addition to standard preoperative care consisting of strength and aerobic exercises three times per week in a fitness facility
All adult patients (>18 years old) awaiting publicly funded bariatric surgery in Manitoba were introduced to the study by a certified trainer from the Canadian Society for Exercise Physiology at the Centre for Metabolic and Bariatric Surgery (CMBS), Winnipeg, Manitoba, Canada, over a 15-month period
Inclusion criteria were tentatively scheduled for bariatric surgery within six months and able to participate in an exercise program
Summary
Most individuals achieve a modest weight loss of 5-7% with lifestyle interventions including diet, exercise, and behavioral modification [2]. Bariatric surgery is recommended for obese patients who are unable to lose weight despite lifestyle modifications. Bariatric surgery is the most efficacious intervention for sustained weight loss, comorbidity resolution, and mortality reduction [4]. According to the IFSO (International Federation for the Surgery of Obesity and Metabolic Disorders) Global Registry data, the roux-en-Y gastric bypass (RYGB) (38.2%) and the sleeve gastrectomy (46.0%) are the most commonly performed bariatric procedures worldwide. The RYGB is associated with 70% excess weight loss at two years following the procedure [5]. Several studies have demonstrated improved weight loss, comorbidity resolution, and mortality reduction with bariatric surgery [4]. There is a lack of knowledge regarding the short-term benefits of preoperative exercise
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