Functional capacity in patients with obesity before and after sleeve gastrectomy: implications for exercise prescription

Background Obesity is a chronic multifactorial pathology caused by environmental, behavioral and genetics factors, with negative impact on general health, quality of life, and increased risk to fall into disability and morbidity. Non-surgical management of obesity consisted on a multicomponent approach, including behavioral therapy, pharmacotherapies, and lifestyle change to reduce the energy intake with diet, and increase physical activity. Because few patients achieved an important weight loss with lifestyle change, many undergo to bariatric surgery. Materials and methods This study is divided into two phases. In the first phase, the aim is to evaluate functional capacity of patients with obesity before and after sleeve gastrectomy to analyzed changes of maximal oxygen consumption, muscular strength, static balance, level of physical activity and quality of life. In the second phase, the aim is to analyze the effect of 1 month supervised physical exercise protocol performed 6 months after surgery. One hundred and seventy-nine patients with obesity were recruited and valuated 1 month before and 6 months after sleeve gastrectomy. Physical functioning evaluation consisted on: cardiopulmonary capacity, muscle strength, static balance, level of physical activity, and quality of life. After surgery, 28 patients were recruited for a 10-sessions of supervised physical exercise protocol. Results As expected, after surgery were recorded significant reduction of body weight, body mass index and waist circumference. Absolute muscular strength of upper and lower limb decreased, while strength adjusted by body weight increased significantly. Static balance improved in females, while males tend to worsen their balance control. Also quality of life and level of physical activity increased after surgery. After physical exercise protocol, patients improved muscular strength, dynamic balance, and flexibility capacities. Conclusion After sleeve gastrectomy, patients with obesity improved their functional capacity, increased the time dedicated to physical activity, and improved quality of life. Even if the weight loss was detected mainly by surgery, physical activity is strongly recommended to avoid muscle mass reduction and to improve quality of life.