Sivas Filiz, Moran Münevver, Yurdakul Fatma, Ulucaköy Koçak Rezan, Başkan Bedriye, Bodur Hatice
Department of Physical Medicine and Rehabilitation, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Department of General Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Turk J Phys Med Rehabil. 2020 Jun 24;66(3):281-290. doi: 10.5606/tftrd.2020.3694. eCollection 2020 Sep.
This study aims to evaluate physical activity, sleep, depression, quality of life, and musculoskeletal problems pre- and postoperatively in morbidly obese patients who underwent bariatric surgery and analyze the factors that are strongly associated with physical activity.
This prospective study conducted between January 2016 and May 2017 included 27 patients (4 males, 23 females; mean age 37.1±10.4 years; range, 18 to 52 years) who underwent bariatric surgery and 20 healthy controls (3 males, 17 females; mean age 32.0±5.7 years; range, 26 to 46 years). All patients were evaluated by using the short form of International Physical Activity Questionnaire (IPAQ), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and short form 36 (SF-36). Patients were evaluated for regional musculoskeletal pain including back, waist, hip, knee, ankle, heel, and metatarsal pain using Visual Analog Scale. Presence of pes planus was recorded. The examinations and tests performed in the preoperative period were repeated at postoperative six months and the results were compared with the control group.
The body mass index was 46.2±5.2 kg/m preoperatively and 33.8±5.0 kg/m postoperatively (p<0.001). The total IPAQ was 345.4±172.8 metabolic equivalent (MET)-min/week preoperatively and 672.8±227.8 MET-min/week postoperatively (p<0.001). Pittsburgh Sleep Quality Index was 7.6±3.0 preoperatively and 3.5±2.4 postoperatively, whereas BDI was 20.2±8.5 preoperatively and 9.9±7.4 postoperatively. The results were statistically significant (p<0.001, p<0.001, respectively). A statistically significant improvement was found in all subsections of the SF-36. Pre- and postoperative results of the 27 patients were compared with those of the control group.
Obesity is significantly associated with joint pain, physical function impairment, depression, and sleep disorders. Significant weight loss after bariatric surgery improves functional recovery and patient's psychology in a short time.
本研究旨在评估接受减肥手术的病态肥胖患者术前和术后的身体活动、睡眠、抑郁、生活质量和肌肉骨骼问题，并分析与身体活动密切相关的因素。
这项前瞻性研究于2016年1月至2017年5月进行，纳入了27例接受减肥手术的患者（4例男性，23例女性；平均年龄37.1±10.4岁；范围18至52岁）和20名健康对照者（3例男性，17例女性；平均年龄32.0±5.7岁；范围26至46岁）。所有患者均使用国际体力活动问卷简表（IPAQ）、匹兹堡睡眠质量指数（PSQI）、贝克抑郁量表（BDI）和简明健康状况调查量表（SF-36）进行评估。使用视觉模拟量表评估患者的局部肌肉骨骼疼痛，包括背部、腰部、髋部、膝盖、脚踝、足跟和跖骨疼痛。记录扁平足的情况。术前进行的检查和测试在术后六个月重复进行，并将结果与对照组进行比较。
术前体重指数为46.2±5.2kg/m，术后为33.8±5.0kg/m（p<0.001）。术前IPAQ总分是345.4±172.8代谢当量（MET）-分钟/周，术后为672.8±227.8MET-分钟/周（p<0.001）。匹兹堡睡眠质量指数术前为7.6±3.0，术后为3.5±2.4，而BDI术前为20.2±8.5，术后为9.9±7.4。结果具有统计学意义（分别为p<0.001，p<0.001）。SF-36的所有子量表均有统计学意义的改善。将27例患者的术前和术后结果与对照组进行比较。
肥胖与关节疼痛、身体功能障碍、抑郁和睡眠障碍显著相关。减肥手术后显著的体重减轻可在短时间内改善功能恢复和患者心理状态。
