Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.
SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain.
Rev Endocr Metab Disord. 2021 Dec;22(4):891-912. doi: 10.1007/s11154-021-09651-3. Epub 2021 Apr 16.
The purpose of this systematic review was to provide updated evidence synthesis of the effectiveness of exercise training in patients with obesity undergoing bariatric surgery to improve cardio-metabolic risk. We systematically searched the MEDLINE, EMBASE, Scopus, Cochrane, and Web of Science databases. The studies selected were those in which an exercise-based intervention was performed after bariatric surgery, a control group was present, and at least one of the following outcomes was investigated: VO or VO, resting heart rate (RHR), blood pressure, lipid profile, glucose, and insulin. The study quality was assessed using the PEDro scale and the data were meta-analyzed with a random effects model, comparing control groups to intervention groups using standardized measurements. Twenty articles were included in the systematic review and fourteen (70%) in the meta-analysis. Significant differences were observed between the control and intervention groups (always in favor of exercise) for absolute VO / VO (ES = 0.317; 95% CI = 0.065, 0.569; p = 0.014), VO / peak relative to body weight (ES = 0.673; 95% CI = 0.287, 1.060; p = 0.001), HDL cholesterol (ES = 0.22; 95% CI = 0.009, 0.430; p = 0.041) and RHR (ES = -0.438; 95% CI = -0.753, -0.022; p = 0.007). No effects were observed for either systolic or diastolic blood pressure. Exercise training for patients undergoing bariatric surgery appears to be effective in improving absolute and relative VO / VO, HDL cholesterol and reducing the RHR. More intervention studies using (better) exercise interventions are needed before discarding their effects on other cardiometabolic risk factors. This systematic review and meta-analysis has been registered in Prospero (CRD42020153398).
本系统评价的目的是提供更新的循证综合证据，评估肥胖患者在接受减重手术后进行运动训练以改善心血管代谢风险的效果。我们系统地检索了 MEDLINE、EMBASE、Scopus、Cochrane 和 Web of Science 数据库。纳入的研究为术后进行基于运动的干预，有对照组，且至少调查了以下一项结局的研究：VO 或 VO、静息心率（RHR）、血压、血脂谱、血糖和胰岛素。使用 PEDro 量表评估研究质量，并使用随机效应模型对数据进行荟萃分析，使用标准化测量值比较对照组和干预组。系统评价纳入 20 篇文章，14 篇（70%）纳入荟萃分析。对照组和干预组之间观察到显著差异（始终有利于运动），绝对 VO/VO（ES=0.317；95%CI=0.065，0.569；p=0.014）、VO/峰值与体重的比值（ES=0.673；95%CI=0.287，1.060；p=0.001）、高密度脂蛋白胆固醇（ES=0.22；95%CI=0.009，0.430；p=0.041）和 RHR（ES=-0.438；95%CI=-0.753，-0.022；p=0.007）。血压的收缩压或舒张压均无显著变化。对于接受减重手术的患者，运动训练似乎可以有效提高绝对和相对 VO/VO、高密度脂蛋白胆固醇并降低 RHR。在放弃其对其他心血管代谢危险因素的影响之前，需要更多使用（更好）运动干预的干预研究。本系统评价和荟萃分析已在 PROSPERO（CRD42020153398）中注册。
