Hammoud Emne, Jacob Christophe, Pinti Antonio, Khalil Nour, El Hage Zaher, Toumi Hechmi, El Hage Rawad
Department of Physiotherapy, Fatima College of Health Sciences, Al Ain, Abu Dhabi, UAE.
Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon.
J Clin Densitom. 2025 Jan-Mar;28(1):101556. doi: 10.1016/j.jocd.2024.101556. Epub 2024 Dec 24.
The purpose of this study was to explore the influence of a 12-month high-impact physical training program (descending stairs) on bone health in a group of young obese women who had undergone bariatric surgery (type sleeve). Fifty-two premenopausal women with a body mass index (BMI) > 35 kg/m (range: 35.06-60.97 kg/m), aged 19-47 years old were included in this study. Patients were randomized to either exercise group (EG), control group (CG) or observational group (OG). 2 to 3 weeks post-bariatric surgery (BS), EG underwent a 12-month semi-supervised high impact (descending stairs) exercise program, CG performed a 12-month oriental dance activity while the third OG received only standard medical care. Patients were assessed before BS and 12 months post-BS for body composition, bone mineral density (BMD) and femoral neck geometry. Bone parameters were evaluated by DXA. At baseline, there were no significant differences among the three groups in the clinical characteristics and the bone variables. 12 months after the surgery, there were some group*time interactions. The 3 groups showed significantly lower whole body BMD (-1.8; -2.9; -4.2 % respectively for EG; CG and OG). The EG showed a significant increase of the femoral neck BMD (+1.4 %; p < 0.05), the femoral neck cross-sectional area (+4.6 %; p < 0.05), and the femoral neck cross-sectional moment of inertia (+15.7 %; p < 0.01) while all these values decreased significantly in the 2 other groups. The total hip BMD decreased in all groups, but the EG showed less significant total hip variation, and lumbar spine BMD decreased significantly only in the OG. This study mainly shows that the stair descent can be considered as an effective high-impact physical exercise for obese women who have undergone bariatric surgery. This kind of exercise has significant effects in maintaining or reducing the loss of BMD at the femoral neck and the total hip. Finally, since the EG group showed significant increases in femoral neck geometry variables, this study suggests that this kind of training could be efficient at reducing the hip fracture risk.
本研究的目的是探讨一项为期12个月的高强度体育训练计划（下楼梯）对一组接受过袖状胃切除术的年轻肥胖女性骨骼健康的影响。本研究纳入了52名体重指数（BMI）> 35 kg/m²（范围：35.06 - 60.97 kg/m²）、年龄在19至47岁之间的绝经前女性。患者被随机分为运动组（EG）、对照组（CG）或观察组（OG）。在接受减重手术后2至3周，EG组进行了为期12个月的半监督高强度（下楼梯）运动计划，CG组进行了为期12个月的东方舞蹈活动，而第三组OG组仅接受标准医疗护理。在接受减重手术前和术后12个月对患者进行身体成分、骨密度（BMD）和股骨颈几何形状评估。骨参数通过双能X线吸收法（DXA）进行评估。在基线时，三组在临床特征和骨变量方面无显著差异。手术后12个月，存在一些组*时间交互作用。三组全身骨密度均显著降低（EG组、CG组和OG组分别降低 -1.8%、-2.9%、-4.2%）。EG组股骨颈骨密度显著增加（+1.4%；p < 0.05），股骨颈横截面积增加（+4.6%；p < 0.05），股骨颈截面惯性矩增加（+15.7%；p < 0.01），而其他两组这些值均显著下降。所有组的全髋骨密度均下降，但EG组全髋变化较小，且仅OG组腰椎骨密度显著下降。本研究主要表明，下楼梯可被视为接受减重手术的肥胖女性有效的高强度体育锻炼。这种运动在维持或减少股骨颈和全髋骨密度损失方面具有显著效果。最后，由于EG组股骨颈几何形状变量显著增加，本研究表明这种训练在降低髋部骨折风险方面可能有效。
