Exercise and bariatric surgery: A systematic review and meta‐analysis of the feasibility and acceptability of exercise and controlled trial methods

Abstract

This systematic review and meta-analysis assessed the feasibility and acceptability of exercise and controlled trial methods in adults awaiting or having undergone bariatric surgery (BS). Search methods used to identify relevant articles were inclusion of articles identified in a systematic review, new database search of articles published 2019-2021, and hand searching reference lists. Titles/abstracts and full-texts were screened by two reviewers independently against inclusion criteria: adults awaiting or having undergone BS, controlled trial, exercise group compared with a comparison group without exercise. Twenty-eight articles were reviewed; most interventions were supervised, performed after BS, and lasted ≤13 weeks. Pooled data for exercise intervention attendance and dropout rates were 84% (k = 10) and 5% (k = 19), respectively, though possibly misestimated due to poor/selective reporting. Median study and recruitment duration were 18 weeks and 24 months, respectively, with a pooled enrollment rate of 2.5 participants/month. Pooled data for refusal to participate, enrollment, and retention rates were 23% (k = 16), 43% (k = 18), and 87% (k = 26), respectively. Despite the lack of data available in studies included, exercise and controlled trial methods seem feasible and acceptable for adults awaiting or having undergone BS. To better identify methodological or practical challenges, and assess bias, better reporting of feasibility and acceptability indicators is needed in future studies.

Exercise interventions following bariatric surgery are poorly reported: A systematic review and a call for action

“…Weight-restricted mobility, lack of cardiorespiratory fitness, body dissatisfaction, or lack of self-efficacy to regularly engage in physical activity have been suggested as key barriers to physical activity adherence in BS participants. 78,79 Given that adherence rates to the training program may influence the study results, 24,33 and effort for each session may become relatively lower. 75,76,80 Consequently, participants may complete the training sessions with a significantly different intensity than initially prescribed.…”

“…However, the criteria to properly report adherence in the CERT template may lack clarity, potentially leading to misreporting. In that sense, Baillot et al 33 emphasized the importance of considering both attendance (frequency) and compliance with the prescribed exercise dosage (duration and intensity) for transparency and accurately assess the efficacy of the exercise intervention.…”

“…For instance, Soriano‐Maldonado et al 24 highlighted poor reporting of an exercise intervention, which severely affected the interpretation of the trial results. In this line, the meta‐analysis by Baillot et al 33 concluding that exercise was feasible and acceptable for individuals undergoing BS, suggested that an improved reporting could help identify methodological challenges and assess bias more effectively. However, a comprehensive characterization of the content reporting of exercise‐based clinical trials following BS is currently lacking and would provide a clear standpoint for improving the quality of ongoing and future clinical trials in this population.…”

“…However, the criteria to properly report adherence in the CERT template may lack clarity, potentially leading to misreporting. In that sense, Baillot et al33 emphasized the importance of considering both attendance (frequency) and compliance with the prescribed exercise dosage (duration and intensity) for transparency and accurately assess the efficacy of the exercise intervention.This study has limitations that must be addressed. First, although we highlight potential factors that could contribute to the poor reporting of exercise interventions in BS participants, such as strict journal page limits or the limited involvement of strength and conditioning specialists in supervising interventions, we cannot provide a definitive explanation for this misreporting.…”

Effectiveness and Feasibility of Telehealth-Based Dietary Interventions Targeting Cardiovascular Disease Risk Factors: Systematic Review and Meta-Analysis

“…Continuous clinical outcome data included postintervention weight (kg or lbs), BMI (kg/m 2 ), systolic and diastolic blood pressure (mmHg), and levels of total cholesterol (mg/dL or mmol/L), LDL cholesterol (mg/dL or mmol/L), HDL cholesterol (mg/dL or mmol/L), triglycerides (mg/dL or mmol/L), or blood glucose (mg/dL or mmol/L) from intervention and UC groups, respectively. The dichotomous feasibility outcome data included the number of participants retained in intervention and UC groups [23][24][25][26][27][28].…”