aspects of exercise before or after bariatric surgery pouwels, s; wit, m; teijink, ja; nienhuijs, sw...
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Aspects of Exercise before or after Bariatric Surgery
Pouwels, S; Wit, M; Teijink, JA; Nienhuijs, SW
Monday 13th of July 15:10-15:40
Welcome
Sjaak Pouwels, MD
Resident and PhD student
Catharina Hospital Obesity Centre Eindhoven, Netherlands
YOU DESERVE A RIBBONThe surprised lady in front of me looked at me in total disbelief: “I’m sorry??” “Yes, I believe you deserve a ribbon; It’s quite something what you’ve pulled off: you lost almost 100 pounds.!” (Van Hout et al. 2015)
We have some work to do!- Obesity = big problem
- Associated with various diseases; Diabetes, Hypertension, dyslipidemia, OSAS
- Bariatric surgery only treatment with longstanding effect
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Perioperative Exercise- A reduction of 1.5 kg was contributed to exercise
(Cochrane review Shaw et al. 2006)
- Physical training in obese patients 4% Excess Weight Loss (%EWL) (Livhits et al. 2010)
- Reduction of 3.6 kg related to exercise (Egberts et al. 2012)
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What do we have to do?- The positive relationship between exercise seems evident
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But what do we have to do? And when?
Materials and Methods (1)
P: Obese patients with a BMI ≥ 30 kg/m2
I: Exercise training
C: Regular care (no specific exercise training)
O: Improvement of anthropometric variables, physical fitness and cardiovascular risk factors
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Exercise before surgery
Significant improvement of anthropometric variables (Baillot et al. 2013, Funderburk et al. 2010, Marcon et al. 2011)
Significant improvement of cardiovascular risk factors and inflammation:
- Blood pressure (Funderburk et al. 2010, Marcon et al. 2011)
- Glucose, insulin and blood lipid profile (Marcon et al. 2011, Hickey et al. 1999)
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Exercise before surgery (2)Significant improvement of physical fitness and functional capacity:
-The six-minute walk test distance increased (Funderburk et al. 2010, Marcon et al. 2011, Baillot et al. 2013)
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Exercise after surgerySignificant improvement of anthropometric variables (Castello-Simoes et al. 2013, Stegen et al. 2011, Berggren et al. 2008, Shah et al. 2011)
No significant changes in cardiovascular risk and inflammation
Significant increase in fatty-acid oxidation (Berggren et al. 2008)
Prevention of a decrease in muscle strength by an exercise program (Stegen et al. 2011)
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Challenges in clinical practice
- Supervision (by whom?)
- Timing around surgery
- What do we have to do
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Conclusion- Exercise is good for everyone
- Even for a (future) bariatric patient population
- In current literature Wide range of exercise programs and peri-operative timing
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