Skip to main content
Erschienen in: Obesity Surgery 8/2017

07.04.2017 | Original Contributions

Effects of a Physical Activity Program on Cardiorespiratory Fitness and Pulmonary Function in Obese Women after Bariatric Surgery: a Pilot Study

verfasst von: Tatiana Onofre, Renata Carlos, Nicole Oliver, Amanda Felismino, Davi Fialho, Renata Corte, Eliane Pereira da Silva, Eudes Godoy, Selma Bruno

Erschienen in: Obesity Surgery | Ausgabe 8/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

In severely obese individuals, reducing body weight induced by bariatric surgery is able to promote a reduction in comorbidities and improve respiratory symptoms. However, cardiorespiratory fitness (CRF) reflected by peak oxygen uptake (VO2peak) may not improve in individuals who remain sedentary post-surgery. The objective of this study was to evaluate the effects of a physical training program on CRF and pulmonary function in obese women after bariatric surgery, and to compare them to a control group.

Methods

Twelve obese female candidates for bariatric surgery were evaluated in the preoperative, 3 months postoperative (3MPO), and 6 months postoperative (6MPO) periods through anthropometry, spirometry, and cardiopulmonary exercise testing (CPX). In the 3MPO period, patients were divided into control group (CG, n = 6) and intervention group (IG, n = 6). CG received only general guidelines while IG underwent a structured and supervised physical training program involving aerobic and resistance exercises, lasting 12 weeks.

Results

All patients had a significant reduction in anthropometric measurements and an increase in lung function after surgery, with no difference between groups. However, only IG presented a significant increase (p < 0.05) in VO2peak and total CPX duration of 5.9 mL/kg/min (23.8%) and 4.9 min (42.9%), respectively.

Conclusions

Applying a physical training program to a group of obese women after 3 months of bariatric surgery could promote a significant increase in CRF only in the trained group, yet also showing that bariatric surgery alone caused an improvement in the lung function of both groups.
Literatur
2.
Zurück zum Zitat Gallagher MJ, Franklin BA, Ehrman JK, et al. Comparative impact of morbid obesity vs heart failure on cardiorespiratory fitness. Chest. 2005;127(6):2197–203.CrossRefPubMed Gallagher MJ, Franklin BA, Ehrman JK, et al. Comparative impact of morbid obesity vs heart failure on cardiorespiratory fitness. Chest. 2005;127(6):2197–203.CrossRefPubMed
3.
Zurück zum Zitat Crump C, Sundquist J, Winkleby MA, et al. Interactive effects of physical fitness and body mass index on the risk of hypertension. JAMA Intern Med. 2016;176(2):210–6.CrossRefPubMedPubMedCentral Crump C, Sundquist J, Winkleby MA, et al. Interactive effects of physical fitness and body mass index on the risk of hypertension. JAMA Intern Med. 2016;176(2):210–6.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Myers J, Prakash M, Froelicher V, et al. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346(11):793–801.CrossRefPubMed Myers J, Prakash M, Froelicher V, et al. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346(11):793–801.CrossRefPubMed
5.
Zurück zum Zitat Hergenroeder AL, Wert DM, Hile ES, et al. Association of body mass index with self-report and performance based measures of balance and mobility. Phys Ther. 2011;91(8):1223–34.CrossRefPubMedPubMedCentral Hergenroeder AL, Wert DM, Hile ES, et al. Association of body mass index with self-report and performance based measures of balance and mobility. Phys Ther. 2011;91(8):1223–34.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Arena R, Cahalin LP. Evaluation of cardiorespiratory fitness and respiratory muscle function in the obese population. Int J Cardiol. 2014;56(4):457–64. Arena R, Cahalin LP. Evaluation of cardiorespiratory fitness and respiratory muscle function in the obese population. Int J Cardiol. 2014;56(4):457–64.
7.
Zurück zum Zitat Telford RD. Low physical activity and obesity: causes of chronic disease or simply predictors? Med Sci Sports Exerc. 2007;39(8):1233–40.CrossRefPubMed Telford RD. Low physical activity and obesity: causes of chronic disease or simply predictors? Med Sci Sports Exerc. 2007;39(8):1233–40.CrossRefPubMed
8.
Zurück zum Zitat McAuley PA, Artero EG, Sui X, et al. The obesity paradox, cardiorespiratory fitness, and coronary heart disease. Mayo Clin Proc. 2012;87(5):443–51.CrossRefPubMedPubMedCentral McAuley PA, Artero EG, Sui X, et al. The obesity paradox, cardiorespiratory fitness, and coronary heart disease. Mayo Clin Proc. 2012;87(5):443–51.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.CrossRefPubMed Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.CrossRefPubMed
11.
Zurück zum Zitat Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.CrossRefPubMed Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.CrossRefPubMed
12.
Zurück zum Zitat de Zwaan M, Lancaster KL, Mitchell JE, et al. Health related quality of life in morbidly obese patients: effect of gastric bypass surgery. Obes Surg. 2002;12(6):773–80.CrossRefPubMed de Zwaan M, Lancaster KL, Mitchell JE, et al. Health related quality of life in morbidly obese patients: effect of gastric bypass surgery. Obes Surg. 2002;12(6):773–80.CrossRefPubMed
13.
Zurück zum Zitat Josbeno DA, Kalarchian M, Sparto PJ, et al. Physical activity and physical function in individuals post-bariatric surgery. Obes Surg. 2011;21(8):1243–9.CrossRefPubMedPubMedCentral Josbeno DA, Kalarchian M, Sparto PJ, et al. Physical activity and physical function in individuals post-bariatric surgery. Obes Surg. 2011;21(8):1243–9.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat King WC, Bond DS. The importance of preoperative and postoperative physical activity counseling in bariatric surgery. Exerc Sport Sci Rev. 2013;41(1):26–35.CrossRefPubMedPubMedCentral King WC, Bond DS. The importance of preoperative and postoperative physical activity counseling in bariatric surgery. Exerc Sport Sci Rev. 2013;41(1):26–35.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Baillot A, Audet M, Baillargeon JP, et al. Impact of physical activity and fitness in class II and III obese individuals: a systematic review. Obes Rev. 2014;15(9):721–39.CrossRefPubMed Baillot A, Audet M, Baillargeon JP, et al. Impact of physical activity and fitness in class II and III obese individuals: a systematic review. Obes Rev. 2014;15(9):721–39.CrossRefPubMed
16.
Zurück zum Zitat Coen PM, Tanner CJ, Helbling NL, et al. Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity. J Clin Invest. 2015;125(1):248–57.CrossRefPubMed Coen PM, Tanner CJ, Helbling NL, et al. Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity. J Clin Invest. 2015;125(1):248–57.CrossRefPubMed
17.
Zurück zum Zitat Bond DS, Phelan S, Wolfe LG, et al. Becoming physically active after bariatric surgery is associated with improved weight loss and health-related quality of life. Obesity (Silver Spring). 2009;17(1):78–83.CrossRef Bond DS, Phelan S, Wolfe LG, et al. Becoming physically active after bariatric surgery is associated with improved weight loss and health-related quality of life. Obesity (Silver Spring). 2009;17(1):78–83.CrossRef
18.
Zurück zum Zitat Aron-Wisnewsky J, Verger EO, Bounaix C, et al. Nutritional and protein deficiencies in the short term following both gastric bypass and gastric banding. PLoS One. 2016;11(2):e0149588.CrossRefPubMedPubMedCentral Aron-Wisnewsky J, Verger EO, Bounaix C, et al. Nutritional and protein deficiencies in the short term following both gastric bypass and gastric banding. PLoS One. 2016;11(2):e0149588.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Steele T, Cuthbertson DJ, Wilding JPH. Impact of bariatric surgery on physical functioning in obese adults. Obes Rev. 2015;16(3):248–58.CrossRefPubMed Steele T, Cuthbertson DJ, Wilding JPH. Impact of bariatric surgery on physical functioning in obese adults. Obes Rev. 2015;16(3):248–58.CrossRefPubMed
20.
Zurück zum Zitat Castello V, Simões RP, Bassi D, et al. Impact of aerobic exercise training on heart rate variability and functional capacity in obese women after gastric bypass surgery. Obes Surg. 2011;21(11):1739–49.CrossRefPubMed Castello V, Simões RP, Bassi D, et al. Impact of aerobic exercise training on heart rate variability and functional capacity in obese women after gastric bypass surgery. Obes Surg. 2011;21(11):1739–49.CrossRefPubMed
21.
Zurück zum Zitat Shah M, Snell PG, Rao S, et al. High-volume exercise program in obese bariatric surgery patients: a randomized, controlled trial. Obesity (Silver Spring). 2011;19(9):1826–34.CrossRef Shah M, Snell PG, Rao S, et al. High-volume exercise program in obese bariatric surgery patients: a randomized, controlled trial. Obesity (Silver Spring). 2011;19(9):1826–34.CrossRef
22.
Zurück zum Zitat American Thoracic Society; American College of Chest Physicians. ATS/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003;167(2):211–77.CrossRef American Thoracic Society; American College of Chest Physicians. ATS/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003;167(2):211–77.CrossRef
23.
Zurück zum Zitat Wasserman K, Hansen JE, Sue DY. Prova de Esforço: princípios e interpretação. 3th ed. Rio de Janeiro: Revinter; 2005. Wasserman K, Hansen JE, Sue DY. Prova de Esforço: princípios e interpretação. 3th ed. Rio de Janeiro: Revinter; 2005.
24.
Zurück zum Zitat Wei YF, Tseng WK, Huang CK, et al. Surgically induced weight loss, including reduction in waist circumference, is associated with improved pulmonary function in obese patients. Surg Obes Relat Dis. 2011;7(5):599–604.CrossRefPubMed Wei YF, Tseng WK, Huang CK, et al. Surgically induced weight loss, including reduction in waist circumference, is associated with improved pulmonary function in obese patients. Surg Obes Relat Dis. 2011;7(5):599–604.CrossRefPubMed
25.
Zurück zum Zitat Shin SH, Lee YJ, Heo YS, Park SD, Kwon SW, Woo SI, et al. Beneficial effects of bariatric surgery on cardiac structure and function in obesity. Obes Surg. 2016 Aug 10. [Epub ahead of print]. Shin SH, Lee YJ, Heo YS, Park SD, Kwon SW, Woo SI, et al. Beneficial effects of bariatric surgery on cardiac structure and function in obesity. Obes Surg. 2016 Aug 10. [Epub ahead of print].
27.
Zurück zum Zitat Toledo FG, Menshikova EV, Azuma K, et al. Mitochondrial capacity in skeletal muscle is not stimulated by weight loss despite increases in insulin action and decreases in intramyocellular lipid content. Diabetes. 2008;57(4):987–94.CrossRefPubMed Toledo FG, Menshikova EV, Azuma K, et al. Mitochondrial capacity in skeletal muscle is not stimulated by weight loss despite increases in insulin action and decreases in intramyocellular lipid content. Diabetes. 2008;57(4):987–94.CrossRefPubMed
28.
Zurück zum Zitat He J, Watkins S, Kelley DE. Skeletal muscle lipid content and oxidative enzyme activity in relation to muscle fiber type in type 2 diabetes and obesity. Diabetes. 2001;50(4):817–23.CrossRefPubMed He J, Watkins S, Kelley DE. Skeletal muscle lipid content and oxidative enzyme activity in relation to muscle fiber type in type 2 diabetes and obesity. Diabetes. 2001;50(4):817–23.CrossRefPubMed
29.
Zurück zum Zitat Toledo FG, Goodpaster BH. The role of weight loss and exercise in correcting skeletal muscle mitochondrial abnormalities in obesity, diabetes and aging. Mol Cell Endocrinol. 2013;379(1–2):30–4.CrossRefPubMed Toledo FG, Goodpaster BH. The role of weight loss and exercise in correcting skeletal muscle mitochondrial abnormalities in obesity, diabetes and aging. Mol Cell Endocrinol. 2013;379(1–2):30–4.CrossRefPubMed
30.
Zurück zum Zitat Short KR, Vittone JL, Bigelow ML, et al. Impact of aerobic exercise training on age-related changes in insulin sensitivity and muscle oxidative capacity. Diabetes. 2003;52(8):1888–96.CrossRefPubMed Short KR, Vittone JL, Bigelow ML, et al. Impact of aerobic exercise training on age-related changes in insulin sensitivity and muscle oxidative capacity. Diabetes. 2003;52(8):1888–96.CrossRefPubMed
31.
Zurück zum Zitat Phielix E, Meex R, Moonen-Kornips E, et al. Exercise training increases mitochondrial content and ex vivo mitochondrial function similarly in patients with type 2 diabetes and in control individuals. Diabetologia. 2010;53(8):1714–21.CrossRefPubMedPubMedCentral Phielix E, Meex R, Moonen-Kornips E, et al. Exercise training increases mitochondrial content and ex vivo mitochondrial function similarly in patients with type 2 diabetes and in control individuals. Diabetologia. 2010;53(8):1714–21.CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Zalesin KC, Franklin BA, Lillystone MA, et al. Differential loss of fat and lean mass in the morbidly obese after bariatric surgery. Metab Syndr Relat Disord. 2010;8(1):15–20.CrossRefPubMed Zalesin KC, Franklin BA, Lillystone MA, et al. Differential loss of fat and lean mass in the morbidly obese after bariatric surgery. Metab Syndr Relat Disord. 2010;8(1):15–20.CrossRefPubMed
33.
Zurück zum Zitat Carey DG, Pliego GJ, Raymond RL. Body composition and metabolic changes following bariatric surgery: effects on fat mass, lean mass and basal metabolic rate: six months to one-year follow-up. Obes Surg. 2006;16(12):1602–8.CrossRefPubMed Carey DG, Pliego GJ, Raymond RL. Body composition and metabolic changes following bariatric surgery: effects on fat mass, lean mass and basal metabolic rate: six months to one-year follow-up. Obes Surg. 2006;16(12):1602–8.CrossRefPubMed
34.
Zurück zum Zitat Vaurs C, Diméglio C, Charras L, et al. Determinants of changes in muscle mass after bariatric surgery. Diabetes Metab. 2015;41(5):416–21.CrossRefPubMed Vaurs C, Diméglio C, Charras L, et al. Determinants of changes in muscle mass after bariatric surgery. Diabetes Metab. 2015;41(5):416–21.CrossRefPubMed
35.
Zurück zum Zitat Bergman RN, Stefanovski D, Buchanan DA, et al. A better index of body adiposity. Obesity (Silver Spring). 2011;19(5):1083–9.CrossRefPubMedCentral Bergman RN, Stefanovski D, Buchanan DA, et al. A better index of body adiposity. Obesity (Silver Spring). 2011;19(5):1083–9.CrossRefPubMedCentral
37.
Zurück zum Zitat Pereira CAC, Sato T, Rodrigues SC. New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol. 2007;33(4):397–406.CrossRefPubMed Pereira CAC, Sato T, Rodrigues SC. New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol. 2007;33(4):397–406.CrossRefPubMed
38.
Zurück zum Zitat Wasserman K, Whipp BJ, Koyl SN, et al. Anaerobic threshold and respiratory gas exchange during exercise. J Appl Physiol. 1973;35(2):236–43.PubMed Wasserman K, Whipp BJ, Koyl SN, et al. Anaerobic threshold and respiratory gas exchange during exercise. J Appl Physiol. 1973;35(2):236–43.PubMed
39.
Zurück zum Zitat Coen PM, Menshikova EV, Distefano G, et al. Exercise and weight loss improve muscle mitochondrial respiration, lipid partitioning, and insulin sensitivity after gastric bypass surgery. Diabetes. 2015;64(11):3737–50.CrossRefPubMedPubMedCentral Coen PM, Menshikova EV, Distefano G, et al. Exercise and weight loss improve muscle mitochondrial respiration, lipid partitioning, and insulin sensitivity after gastric bypass surgery. Diabetes. 2015;64(11):3737–50.CrossRefPubMedPubMedCentral
40.
Zurück zum Zitat Stegen S, Derave W, Calders P, et al. Physical fitness in morbidly obese patients: effect of gastric bypass surgery and exercise training. Obes Surg. 2011;21(1):61–70.CrossRefPubMed Stegen S, Derave W, Calders P, et al. Physical fitness in morbidly obese patients: effect of gastric bypass surgery and exercise training. Obes Surg. 2011;21(1):61–70.CrossRefPubMed
41.
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
42.
Zurück zum Zitat Kavanagh T, Mertens DJ, Hamm LF, et al. Peak oxygen intake and cardiac mortality in women referred for cardiac rehabilitation. J Am Coll Cardiol. 2003;42(12):2139–43.CrossRefPubMed Kavanagh T, Mertens DJ, Hamm LF, et al. Peak oxygen intake and cardiac mortality in women referred for cardiac rehabilitation. J Am Coll Cardiol. 2003;42(12):2139–43.CrossRefPubMed
43.
Zurück zum Zitat Chlif M, Keochkeriana D, Choquet D, et al. Effects of obesity on breathing pattern, ventilatory neural drive and mechanics. Respir Physiol Neurobiol. 2009;168(3):198–202.CrossRefPubMed Chlif M, Keochkeriana D, Choquet D, et al. Effects of obesity on breathing pattern, ventilatory neural drive and mechanics. Respir Physiol Neurobiol. 2009;168(3):198–202.CrossRefPubMed
44.
45.
Zurück zum Zitat Sabbahi A, Arena R, Elokda A, Phillips SA. Exercise and hypertension: uncovering the mechanisms of vascular control. Prog Cardiovasc Dis. 2016; pii: S0033–0620(16)30106–2. Sabbahi A, Arena R, Elokda A, Phillips SA. Exercise and hypertension: uncovering the mechanisms of vascular control. Prog Cardiovasc Dis. 2016; pii: S0033–0620(16)30106–2.
46.
Zurück zum Zitat Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f5934.CrossRefPubMedPubMedCentral Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f5934.CrossRefPubMedPubMedCentral
47.
Zurück zum Zitat Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.CrossRefPubMed Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.CrossRefPubMed
48.
Zurück zum Zitat Chang SH, Stoll CR, Song J, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003–2012. JAMA Surg. 2014;149(3):275–87.CrossRefPubMedPubMedCentral Chang SH, Stoll CR, Song J, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003–2012. JAMA Surg. 2014;149(3):275–87.CrossRefPubMedPubMedCentral
Metadaten
Titel
Effects of a Physical Activity Program on Cardiorespiratory Fitness and Pulmonary Function in Obese Women after Bariatric Surgery: a Pilot Study
verfasst von
Tatiana Onofre
Renata Carlos
Nicole Oliver
Amanda Felismino
Davi Fialho
Renata Corte
Eliane Pereira da Silva
Eudes Godoy
Selma Bruno
Publikationsdatum
07.04.2017
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 8/2017
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2584-y

Weitere Artikel der Ausgabe 8/2017

Obesity Surgery 8/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.