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10.06.2024 | Review

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

verfasst von: Shima Ghannadi, Maryam Selk-Ghaffari, Hanieh-Sadat Ejtahed, Kazem Khalaji, Zahra Hoseini Tavassol, Mohammad Hossein Pourgharib Shahi, Shirin Hasani-Ranjbar

Erschienen in: Obesity Surgery | Ausgabe 7/2024

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Abstract

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.
Literatur
1.
Zurück zum Zitat NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627–42. https://doi.org/10.1016/S0140-6736(17)32129-3. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627–42. https://​doi.​org/​10.​1016/​S0140-6736(17)32129-3.
2.
Zurück zum Zitat Flegal KM, Graubard BI, Williamson DF, et al. Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA. 2007;298(17):2028–37.CrossRefPubMed Flegal KM, Graubard BI, Williamson DF, et al. Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA. 2007;298(17):2028–37.CrossRefPubMed
4.
Zurück zum Zitat Pan F, Laslett L, Blizzard L, et al. Associations between fat mass and multisite pain: a five-year longitudinal study. Arthritis Care Res. 2017;69(4):509–16.CrossRef Pan F, Laslett L, Blizzard L, et al. Associations between fat mass and multisite pain: a five-year longitudinal study. Arthritis Care Res. 2017;69(4):509–16.CrossRef
5.
Zurück zum Zitat Arterburn DE, Telem DA, Kushner RF, et al. Benefits and risks of bariatric surgery in adults: a review. JAMA. 2020;324(9):879–87.CrossRefPubMed Arterburn DE, Telem DA, Kushner RF, et al. Benefits and risks of bariatric surgery in adults: a review. JAMA. 2020;324(9):879–87.CrossRefPubMed
6.
Zurück zum Zitat Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery survey 2018: similarities and disparities among the 5 IFSO chapters. Obes Surg. 2021;31:1937–48.CrossRefPubMedPubMedCentral Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery survey 2018: similarities and disparities among the 5 IFSO chapters. Obes Surg. 2021;31:1937–48.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Wiggins T, Guidozzi N, Welbourn R, et al. Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: a systematic review and meta-analysis. PLoS Med. 2020;17(7):e1003206.CrossRefPubMedPubMedCentral Wiggins T, Guidozzi N, Welbourn R, et al. Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: a systematic review and meta-analysis. PLoS Med. 2020;17(7):e1003206.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Segelman J, Nygren J. Evidence or eminence in abdominal surgery: recent improvements in perioperative care. World J Gastroenterol: WJG. 2014;20(44):16615.CrossRefPubMedPubMedCentral Segelman J, Nygren J. Evidence or eminence in abdominal surgery: recent improvements in perioperative care. World J Gastroenterol: WJG. 2014;20(44):16615.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Senturk JC, Kristo G, Gold J, et al. The development of enhanced recovery after surgery across surgical specialties. J Laparoendosc Adv Surg Tech. 2017;27(9):863–70.CrossRef Senturk JC, Kristo G, Gold J, et al. The development of enhanced recovery after surgery across surgical specialties. J Laparoendosc Adv Surg Tech. 2017;27(9):863–70.CrossRef
10.
Zurück zum Zitat Dang JT, Szeto VG, Elnahas A, et al. Canadian consensus statement: enhanced recovery after surgery in bariatric surgery. Surg Endosc. 2020;34:1366–75.CrossRefPubMed Dang JT, Szeto VG, Elnahas A, et al. Canadian consensus statement: enhanced recovery after surgery in bariatric surgery. Surg Endosc. 2020;34:1366–75.CrossRefPubMed
11.
Zurück zum Zitat Stenberg E, dos Reis Falcao LF, O’Kane M, et al. Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: a 2021 update. World J Surg. 2022;46(4):729–51.CrossRefPubMedPubMedCentral Stenberg E, dos Reis Falcao LF, O’Kane M, et al. Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: a 2021 update. World J Surg. 2022;46(4):729–51.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Shaw K, Gennat H, O’Rourke P, et al. Exercise for overweight or obesity. Cochrane Database Sys Rev. 2006;4(CD003817):2013. Shaw K, Gennat H, O’Rourke P, et al. Exercise for overweight or obesity. Cochrane Database Sys Rev. 2006;4(CD003817):2013.
13.
Zurück zum Zitat Carbone S, Del Buono MG, Ozemek C, et al. Obesity, risk of diabetes and role of physical activity, exercise training and cardiorespiratory fitness. Prog Cardiovasc Dis. 2019;62(4):327–33.CrossRefPubMed Carbone S, Del Buono MG, Ozemek C, et al. Obesity, risk of diabetes and role of physical activity, exercise training and cardiorespiratory fitness. Prog Cardiovasc Dis. 2019;62(4):327–33.CrossRefPubMed
14.
Zurück zum Zitat Pouwels S, Fiddelaers J, Teijink JA, et al. Preoperative exercise therapy in lung surgery patients: a systematic review. Respir Med. 2015;109(12):1495–504.CrossRefPubMed Pouwels S, Fiddelaers J, Teijink JA, et al. Preoperative exercise therapy in lung surgery patients: a systematic review. Respir Med. 2015;109(12):1495–504.CrossRefPubMed
15.
Zurück zum Zitat Pouwels S, Hageman D, Gommans LN, et al. Preoperative exercise therapy in surgical care: a scoping review. J Clin Anesth. 2016;33:476–90.CrossRefPubMed Pouwels S, Hageman D, Gommans LN, et al. Preoperative exercise therapy in surgical care: a scoping review. J Clin Anesth. 2016;33:476–90.CrossRefPubMed
16.
Zurück zum Zitat Pouwels S, Stokmans RA, Willigendael EM, et al. Preoperative exercise therapy for elective major abdominal surgery: a systematic review. Int J Surg. 2014;12(2):134–40.CrossRefPubMed Pouwels S, Stokmans RA, Willigendael EM, et al. Preoperative exercise therapy for elective major abdominal surgery: a systematic review. Int J Surg. 2014;12(2):134–40.CrossRefPubMed
17.
Zurück zum Zitat Pouwels S, Willigendael E, Van Sambeek M, et al. Beneficial effects of pre-operative exercise therapy in patients with an abdominal aortic aneurysm: a systematic review. Eur J Vasc Endovasc Surg. 2015;49(1):66–76.CrossRefPubMed Pouwels S, Willigendael E, Van Sambeek M, et al. Beneficial effects of pre-operative exercise therapy in patients with an abdominal aortic aneurysm: a systematic review. Eur J Vasc Endovasc Surg. 2015;49(1):66–76.CrossRefPubMed
18.
Zurück zum Zitat Baillot A, Mampuya WM, Dionne IJ, et al. Impacts of supervised exercise training in addition to interdisciplinary lifestyle management in subjects awaiting bariatric surgery: a randomized controlled study. Obes Surg. 2016;26:2602–10.CrossRefPubMed Baillot A, Mampuya WM, Dionne IJ, et al. Impacts of supervised exercise training in addition to interdisciplinary lifestyle management in subjects awaiting bariatric surgery: a randomized controlled study. Obes Surg. 2016;26:2602–10.CrossRefPubMed
19.
Zurück zum Zitat Bellicha A, van Baak MA, Battista F, et al. Effect of exercise training before and after bariatric surgery: a systematic review and meta-analysis. Obes Rev. 2021;22:e13296.CrossRefPubMedPubMedCentral Bellicha A, van Baak MA, Battista F, et al. Effect of exercise training before and after bariatric surgery: a systematic review and meta-analysis. Obes Rev. 2021;22:e13296.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Carretero-Ruiz A, Martínez-Rosales E, Cavero-Redondo I, Álvarez-Bueno C, Martínez-Vizcaíno V, Gómez Navarro C, Reyes Parrilla R, Ferrer-Márquez M, Soriano-Maldonado A, Artero EG. Impact of exercise training after bariatric surgery on cardiometabolic risk factors: a systematic review and meta-analysis of controlled trials. Rev Endocr Metab Disord. 2021;22(4):891–912. https://doi.org/10.1007/s11154-021-09651-3. Carretero-Ruiz A, Martínez-Rosales E, Cavero-Redondo I, Álvarez-Bueno C, Martínez-Vizcaíno V, Gómez Navarro C, Reyes Parrilla R, Ferrer-Márquez M, Soriano-Maldonado A, Artero EG. Impact of exercise training after bariatric surgery on cardiometabolic risk factors: a systematic review and meta-analysis of controlled trials. Rev Endocr Metab Disord. 2021;22(4):891–912. https://​doi.​org/​10.​1007/​s11154-021-09651-3.
21.
Zurück zum Zitat Herrera-Santelices A, Argüello-Florencio G, Westphal G, et al. 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. J Clin Med. 2022;11(17):5091.CrossRefPubMedPubMedCentral Herrera-Santelices A, Argüello-Florencio G, Westphal G, et al. 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. J Clin Med. 2022;11(17):5091.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Marc-Hernández A, Ruiz-Tovar J, Aracil A, et al. Impact of exercise on body composition and cardiometabolic risk factors in patients awaiting bariatric surgery. Obes Surg. 2019;29:3891–900.CrossRefPubMed Marc-Hernández A, Ruiz-Tovar J, Aracil A, et al. Impact of exercise on body composition and cardiometabolic risk factors in patients awaiting bariatric surgery. Obes Surg. 2019;29:3891–900.CrossRefPubMed
24.
Zurück zum Zitat Marcon ER, Baglioni S, Bittencourt L, et al. What is the best treatment before bariatric surgery? Exercise, exercise and group therapy, or conventional waiting: a randomized controlled trial. Obes Surg. 2017;27:763–73.CrossRefPubMed Marcon ER, Baglioni S, Bittencourt L, et al. What is the best treatment before bariatric surgery? Exercise, exercise and group therapy, or conventional waiting: a randomized controlled trial. Obes Surg. 2017;27:763–73.CrossRefPubMed
25.
Zurück zum Zitat Baillot A, Vallée C-A, Mampuya WM, et al. Effects of a pre-surgery supervised exercise training 1 year after bariatric surgery: a randomized controlled study. Obes Surg. 2018;28:955–62.CrossRefPubMed Baillot A, Vallée C-A, Mampuya WM, et al. Effects of a pre-surgery supervised exercise training 1 year after bariatric surgery: a randomized controlled study. Obes Surg. 2018;28:955–62.CrossRefPubMed
26.
Zurück zum Zitat Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, Thomas J. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev. 2019;10(10):ED000142. https://doi.org/10.1002/14651858.ED000142. Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, Thomas J. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev. 2019;10(10):ED000142. https://​doi.​org/​10.​1002/​14651858.​ED000142.
27.
Zurück zum Zitat Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1–9.CrossRefPubMedPubMedCentral Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1–9.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Eldridge S, Campbell M, Campbell M, Dahota A, Giraudeau B, Higgins J, Reeves B, Siegfried N. Revised Cochrane risk of bias tool for randomized trials (RoB 2.0): additional considerations for cluster-randomized trials. Cochrane Methods. Cochrane Database Syst Rev. 2016;10. Eldridge S, Campbell M, Campbell M, Dahota A, Giraudeau B, Higgins J, Reeves B, Siegfried N. Revised Cochrane risk of bias tool for randomized trials (RoB 2.0): additional considerations for cluster-randomized trials. Cochrane Methods. Cochrane Database Syst Rev. 2016;10.
29.
Zurück zum Zitat Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan AW, Churchill R, Deeks JJ, Hróbjartsson A, Kirkham J, Jüni P, Loke YK, Pigott TD, Ramsay CR, Regidor D, Rothstein HR, Sandhu L, Santaguida PL, Schünemann HJ, Shea B, Shrier I, Tugwell P, Turner L, Valentine JC, Waddington H, Waters E, Wells GA, Whiting PF, Higgins JP. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. https://doi.org/10.1136/bmj.i4919. Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan AW, Churchill R, Deeks JJ, Hróbjartsson A, Kirkham J, Jüni P, Loke YK, Pigott TD, Ramsay CR, Regidor D, Rothstein HR, Sandhu L, Santaguida PL, Schünemann HJ, Shea B, Shrier I, Tugwell P, Turner L, Valentine JC, Waddington H, Waters E, Wells GA, Whiting PF, Higgins JP. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. https://​doi.​org/​10.​1136/​bmj.​i4919.
30.
Zurück zum Zitat Picó-Sirvent I, Aracil-Marco A, Pastor D, et al. Effects of a combined high-intensity interval training and resistance training program in patients awaiting bariatric surgery: a pilot study. Sports. 2019;7(3):72.CrossRefPubMedPubMedCentral Picó-Sirvent I, Aracil-Marco A, Pastor D, et al. Effects of a combined high-intensity interval training and resistance training program in patients awaiting bariatric surgery: a pilot study. Sports. 2019;7(3):72.CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Picó-Sirvent I, Manresa-Rocamora A, Aracil-Marco A, et al. A combination of aerobic exercise at fatmax and low resistance training increases fat oxidation and maintains muscle mass, in women waiting for bariatric surgery. Obes Surg. 2022;32(4):1130–40.CrossRefPubMedPubMedCentral Picó-Sirvent I, Manresa-Rocamora A, Aracil-Marco A, et al. A combination of aerobic exercise at fatmax and low resistance training increases fat oxidation and maintains muscle mass, in women waiting for bariatric surgery. Obes Surg. 2022;32(4):1130–40.CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Gilbertson NM, Eichner NZM, Khurshid M, Rexrode EA, Kranz S, Weltman A, Hallowell PT, Malin SK. Impact of pre-operative aerobic exercise on cardiometabolic health and quality of life in patients undergoing bariatric surgery. Front Physiol. 2020;11:1018. https://doi.org/10.3389/fphys.2020.01018. Gilbertson NM, Eichner NZM, Khurshid M, Rexrode EA, Kranz S, Weltman A, Hallowell PT, Malin SK. Impact of pre-operative aerobic exercise on cardiometabolic health and quality of life in patients undergoing bariatric surgery. Front Physiol. 2020;11:1018. https://​doi.​org/​10.​3389/​fphys.​2020.​01018.
33.
Zurück zum Zitat Arman N, Tokgoz G, Seyit H, et al. The effects of core stabilization exercise program in obese people awaiting bariatric surgery: a randomized controlled study. Complement Ther Clin Pract. 2021;43:101342.CrossRefPubMed Arman N, Tokgoz G, Seyit H, et al. The effects of core stabilization exercise program in obese people awaiting bariatric surgery: a randomized controlled study. Complement Ther Clin Pract. 2021;43:101342.CrossRefPubMed
34.
35.
Zurück zum Zitat Funderburk J, Callis S. Aquatic intervention effect on quality of life prior to obesity surgery: a pilot study. Annu Ther Recreation. 2010;18:66–78. Funderburk J, Callis S. Aquatic intervention effect on quality of life prior to obesity surgery: a pilot study. Annu Ther Recreation. 2010;18:66–78.
36.
Zurück zum Zitat Bond DS, Thomas JG, King WC, et al. Exercise improves quality of life in bariatric surgery candidates: results from the B ari-A ctive trial. Obesity. 2015;23(3):536–42.CrossRefPubMed Bond DS, Thomas JG, King WC, et al. Exercise improves quality of life in bariatric surgery candidates: results from the B ari-A ctive trial. Obesity. 2015;23(3):536–42.CrossRefPubMed
37.
Zurück zum Zitat Schroeder R, Harrison TD, McGraw SL. Treatment of adult obesity with bariatric surgery. Am Fam Physician. 2016;93(1):31–7. Schroeder R, Harrison TD, McGraw SL. Treatment of adult obesity with bariatric surgery. Am Fam Physician. 2016;93(1):31–7.
38.
Zurück zum Zitat Hansen D, Decroix L, Devos Y, et al. Towards optimized care after bariatric surgery by physical activity and exercise intervention: a review. Obes Surg. 2020;30:1118–25.CrossRefPubMed Hansen D, Decroix L, Devos Y, et al. Towards optimized care after bariatric surgery by physical activity and exercise intervention: a review. Obes Surg. 2020;30:1118–25.CrossRefPubMed
39.
Zurück zum Zitat Belligoli A, Bettini S, Segato G, et al. Predicting responses to bariatric and metabolic surgery. Curr Obes Rep. 2020;9:373–9.CrossRefPubMed Belligoli A, Bettini S, Segato G, et al. Predicting responses to bariatric and metabolic surgery. Curr Obes Rep. 2020;9:373–9.CrossRefPubMed
42.
Zurück zum Zitat Anderin C, Gustafsson UO, Heijbel N, et al. Weight loss before bariatric surgery and postoperative complications: data from the Scandinavian Obesity Registry (SOReg). Ann Surg. 2015;261(5):909–13.CrossRefPubMed Anderin C, Gustafsson UO, Heijbel N, et al. Weight loss before bariatric surgery and postoperative complications: data from the Scandinavian Obesity Registry (SOReg). Ann Surg. 2015;261(5):909–13.CrossRefPubMed
43.
Zurück zum Zitat Livhits M, Mercado C, Yermilov I, et al. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis. 2009;5(6):713–21.CrossRefPubMed Livhits M, Mercado C, Yermilov I, et al. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis. 2009;5(6):713–21.CrossRefPubMed
44.
Zurück zum Zitat Van Gaal L, Wauters M, De Leeuw I. The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obes Relat Metab Disord: J Int Assoc Study Obes. 1997;21:S5-9. Van Gaal L, Wauters M, De Leeuw I. The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obes Relat Metab Disord: J Int Assoc Study Obes. 1997;21:S5-9.
45.
Zurück zum Zitat Liu RC, Sabnis AA, Forsyth C, et al. The effects of acute preoperative weight loss on laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15(10):1396–402.CrossRefPubMed Liu RC, Sabnis AA, Forsyth C, et al. The effects of acute preoperative weight loss on laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15(10):1396–402.CrossRefPubMed
47.
Zurück zum Zitat Hennis PJ, Meale PM, Grocott MP. Cardiopulmonary exercise testing for the evaluation of perioperative risk in non-cardiopulmonary surgery. Postgrad Med J. 2011;87(1030):550–7.CrossRefPubMed Hennis PJ, Meale PM, Grocott MP. Cardiopulmonary exercise testing for the evaluation of perioperative risk in non-cardiopulmonary surgery. Postgrad Med J. 2011;87(1030):550–7.CrossRefPubMed
48.
Zurück zum Zitat McCullough PA, Gallagher MJ, Dejong AT, et al. Cardiorespiratory fitness and short-term complications after bariatric surgery. Chest. 2006;130(2):517–25.CrossRefPubMed McCullough PA, Gallagher MJ, Dejong AT, et al. Cardiorespiratory fitness and short-term complications after bariatric surgery. Chest. 2006;130(2):517–25.CrossRefPubMed
Metadaten
Titel
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
verfasst von
Shima Ghannadi
Maryam Selk-Ghaffari
Hanieh-Sadat Ejtahed
Kazem Khalaji
Zahra Hoseini Tavassol
Mohammad Hossein Pourgharib Shahi
Shirin Hasani-Ranjbar
Publikationsdatum
10.06.2024
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 7/2024
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-024-07333-y

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