Clinical Studies and Practice

The effects of supervised exercise training 12–24 months after bariatric surgery on physical function and body composition: a randomised controlled trial

Abstract

Background:

Bariatric surgery is effective for the treatment of stage II and III obesity and its related diseases, although increasing evidence is showing weight regain ~12–24 months postsurgery. Weight regain increases the risk of physical function decline, which negatively affects an individual's ability to undertake activities of daily living. The study assessed the effects of a 12-week supervised exercise intervention on physical function and body composition in patients between 12 and 24 months post bariatric surgery.

Methods:

Twenty-four inactive adult bariatric surgery patients whose body mass index remained 30 kg m2 12 to 24 months post surgery were randomised to an exercise intervention (n=12) or control group (n=12). Supervised exercise consisted of three 60-min gym sessions per week of moderate intensity aerobic and resistance training for 12 weeks. Control participants received usual care. The incremental shuttle walk test (ISWT) was used to assess functional walking performance after the 12-week exercise intervention, and at 24 weeks follow-up. Measures of anthropometric, physical activity, cardiovascular and psychological outcomes were also examined. Using an intention-to-treat protocol, independent t-tests were used to compare outcome measures between groups.

Results:

Significant improvements in the exercise group were observed for the ISWT, body composition, physical function, cardiovascular and self-efficacy measures from baseline to 12 weeks. A large baseline to 12-week change was observed for the ISWT (exercise: 325.00±117.28 m; control: 355.00±80.62 m, P<0.001). The exercise group at 24 weeks recorded an overall mean improvement of 143.3±86.6 m and the control group recorded a reduction of −32.50±75.93 m. Findings show a 5.6 kg difference between groups in body mass change from baseline to 24 weeks favouring the exercise group.

Conclusions:

A 12-week supervised exercise intervention led to significant improvements in body mass and functional walking ability post intervention, with further improvements at the 24-week follow-up.

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Acknowledgements

The research was supported by the National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester; the NIHR Collaboration for Leadership in Applied Health Research and Care—East Midlands (NIHR CLAHRC—EM), and the Leicester Clinical Trials Unit. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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Correspondence to L Y Herring.

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Competing interests

Professor MJD has acted as consultant, advisory board member and speaker for Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp and Dohme, Boehringer Ingelheim, AstraZeneca and Janssen and as a speaker for Mitsubishi Tanabe Pharma Corporation. She has received grants in support of investigator and investigator initiated trials from Novo Nordisk, Sanofi-Aventis and Lilly. Professor SJHB reports that funding has been received since 2013 for consultancy work from Fitness First, Nuffield Health and Unilever. None of these are currently active. Funding was received in 2016 for consultancy work for Halpern Limited. In-kind support through the provision of a sit-to-stand desk was provided by Ergotron from 2012 to 2014. Advice has been requested by and offered to Active Working, Get Britain Standing and Bluearth, none with funding. DJB reports grants and non-financial support from Fresenius-Kabi, non-financial support from Nutricia, outside the submitted work. The other authors declare no conflict of interest.

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Herring, L., Stevinson, C., Carter, P. et al. The effects of supervised exercise training 12–24 months after bariatric surgery on physical function and body composition: a randomised controlled trial. Int J Obes 41, 909–916 (2017). https://doi.org/10.1038/ijo.2017.60

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