Bond D S, Thomas J G, Vithiananthan S, Unick J, Webster J, Roye G D, Ryder B A, Sax H C
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA.
Department of Surgery, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA.
Int J Obes (Lond). 2017 Mar;41(3):467-470. doi: 10.1038/ijo.2016.237. Epub 2016 Dec 27.
Higher preoperative physical activity (PA) strongly predicts higher post-operative PA in bariatric surgery (BS) patients, providing rationale for preoperative PA interventions (PAIs). However, whether PAI-related increases can be maintained post-operatively has not been examined. This study compared PA changes across pre- (baseline, post-intervention) and post-operative (6-month follow up) periods in participants randomized to 6 weeks of preoperative PAI or standard care control (SC). Of 75 participants initially randomized, 36 (PAI n=22; SC n=14) underwent BS. Changes in daily bout-related (⩾10-min bouts) moderate-to-vigorous PA (MVPA) and steps were assessed via the SenseWear Armband monitor. PAI received weekly counseling to increase walking exercise. Retention (86%) at post-operative follow up was similar between groups. Intent-to-treat analyses showed that PAI vs SC had greater increases across time (baseline, post-intervention, follow up) in bout-related MVPA minutes/day (4.3±5.1, 26.3±21.3, 28.7±26.3 vs 10.4±22.9, 11.4±16.0, 18.5±28.2; P=0.013) and steps/day (5163±2901, 7950±3286, 7870±3936 vs 5163±2901, 5601±3368, 5087±2603; P<0.001). PAI differed from SC on bout-related MVPA at post-intervention (P=0.016; d=0.91), but not follow up (P=0.15; d=0.41), and steps at post-intervention (P=0.031; d=0.78) and follow up (P=0.024; d=0.84). PAI participants maintained preoperative PA increases post-operatively. Findings support preoperative PAIs and research to test whether PA changes can be sustained and influence surgical outcomes beyond the initial post-operative period.
术前较高的身体活动水平（PA）有力地预示着减重手术（BS）患者术后PA水平也较高，这为术前PA干预措施（PAIs）提供了理论依据。然而，与PAI相关的增加在术后能否维持尚未得到研究。本研究比较了随机分配至6周术前PAI或标准护理对照（SC）的参与者在术前（基线、干预后）和术后（6个月随访）期间的PA变化。在最初随机分组的75名参与者中，36人（PAI组n = 22；SC组n = 14）接受了BS手术。通过SenseWear臂带监测仪评估每日 bout相关（⩾10分钟 bout）中度至剧烈PA（MVPA）和步数的变化。PAI组每周接受增加步行锻炼的咨询。两组术后随访的保留率（86%）相似。意向性分析表明，PAI组与SC组相比，在整个时间段（基线、干预后、随访）内，bout相关的MVPA分钟/天（4.3±5.1，26.3±21.3，28.7±26.3 vs 10.4±22.9，11.4±16.0，18.5±28.2；P = 0.013）和步数/天（5163±2901，7950±3286，7870±3936 vs 5163±2901，5601±3368，5087±2603；P < 0.001）有更大的增加。PAI组与SC组在干预后bout相关的MVPA方面存在差异（P = 0.016；d = 0.91），但在随访时无差异（P = 0.15；d = 0.41），在干预后步数方面存在差异（P = 0.031；d = 0.78），在随访时也存在差异（P = 0.024；d = 0.84）。PAI组参与者在术后维持了术前PA的增加。研究结果支持术前PAIs，并支持进行研究以测试PA变化能否持续以及在术后初始阶段之后是否会影响手术结果。
