Musculoskeletal function following bariatric surgery

Iossi, Michael F.; Konstantakos, Emmanuel K.; Teel, Donovan; Sherwood, Richard J.; Laughlin, Richard T.; Coffey, Michael J.; Duren, Dana L.

doi:10.1002/oby.20155

Cited by 20 publications

(25 citation statements)

References 38 publications

(68 reference statements)

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“…Recruitment targeted previous participants in a 1-year follow-up study of weight loss and function following RYGB surgery [10], and inclusion criteria for which were scheduled RYGB surgery, female sex, age of ≥20 years, and no previous bariatric surgery. Of 47 women in that study, 11 agreed to participate in the present study, and 2 dropped out before data collection, leaving N =9 women in the current sample.…”

Section: Methodsmentioning

confidence: 99%

“…Roux-en-Y gastric bypass (RYGB), historically the most common procedure, creates a small gastric pouch, a gastrojejunostomy, and a jejunojejunostomy [10, 11], leading to weight loss via accelerated satiety, altered gut hormonal responses, and significant restriction of caloric intake [12]. Typically, RYGB results in loss of 55-75 % of excess weight [13-15], which is associated with functional improvement shortly after surgery [4, 10, 16-18]. It is not well-known whether postsurgical functional gains are sustained over longer time periods.…”

Section: Introductionmentioning

confidence: 99%

“…This study uses quantitative gait analysis along with the Short Musculoskeletal Functional Assessment (SMFA) questionnaire and the timed “get-up-and-go” (TGUG) test to examine functional status in women 4- to -5 years after RYGB weight loss surgery. The sample includes women from South-west Ohio who previously participated in a 1-year follow-up-to-surgery study [10] and a comparative age- and BMI-matched nonsurgical reference sample from the Fels Longitudinal Study. The study tests the hypotheses that current gait in the postsurgery bariatric patients is normal for their current BMI and that current gait patterns are related to longitudinal changes in weight, body composition, and functional status.…”

Section: Introductionmentioning

confidence: 99%

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Excess Body Weight Loss is Associated with Nonpathological Gait Patterns in Women 4 to 5 Years After Bariatric Surgery

et al. 2013

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Background This study examined relationships between excess body weight (EBW) loss and current gait and functional status in women 5 years after Roux-en-Y gastric bypass surgery. Methods Gait data were analyzed in nine female bariatric patients for relationships with longitudinal changes in weight, body composition, and physical function assessed by the Short Musculoskeletal Functional Assessment (SMFA) questionnaire and the timed “get-up-and-go” (TGUG) test. Gait characteristics in the bariatric sample were also compared to an age- and BMI-matched nonsurgical reference sample from the Fels Longitudinal Study. Results Bariatric patients lost an average of 36.4 kg (61.1 %) of EBW between preoperative and 5-year follow-up visits (P <0.01); SMFA function index scores and TGUG times also decreased (both P <0.01). Degree of EBW loss was correlated with less time spent in initial double support and more time in single support (both P =0.02), and for all gait variables, the bariatric sample fell within the 95 % confidence intervals of gait/EBW relationships in the reference sample. Conclusions Gait and function 5 years after bariatric surgery were characteristic of current weight, not preoperative obesity, suggesting that substantial, sustained recovery of physical function is possible with rapid surgical weight loss.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Excess Body Weight Loss is Associated with Nonpathological Gait Patterns in Women 4 to 5 Years After Bariatric Surgery

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“…47 More troublesome than absolute BMI ranges are the health effects associated with obesity. These effects include bodily pain, 48,49 medical comorbidities, 45,50 and frank disability, 51 all of which can compromise health and life. The implications of obesity for the individual are severe; for the health care system, they are expensive.…”

Section: The Patient Who Is Obesementioning

confidence: 99%

“…The obesity epidemic signals the need for new models of care that draw from the expertise of multiple disciplines to address the long-term implications of the condition. 47 Beyond valuing primary prevention of obesity, physical therapists' influence on pain, 48,49 function, 50 risk for injury, 53 and the need for compassionate care 52 is enough to justify substantial attention to this disturbingly prevalent condition during professional education. Given its epidemic nature, required experience during clinical education with patients who are obese will be readily available in current adult and pediatric settings.…”

Section: The Patient Who Is Obesementioning

confidence: 99%

Meeting Contemporary Expectations for Physical Therapists: Imperatives, Challenges, and Proposed Solutions for Professional Education

Deusinger¹,

Crowner²,

Burlis³

et al. 2014

Journal of Physical Therapy Education

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care always has been to improve health-first of individuals-and then of populations as science evolved and a more global view of human health emerged. 1 Advances in science and shifts in the structure of health care brought new expectations that shaped how the realities of practice must fit the changing demographics of health, illness, and disability. Currently emerging changes in health care policy and regulation have required physical therapists (PTs) to respond to many new expectations. 2 These changes are catalysts to lead the evolution of practice and capture opportunities to promote the health of our patients via new delivery models. This position paper proposes changes in professional education to allow PTs to respond to the complexities of health and health care, and be full partners in what must become an integrated and interdisciplinary service industry. POsITIOn AnD RATIOnALeWe address 3 focal areas to drive change in physical therapist didactic and clinical education. First, achieving true interdisciplinary practice demands that physical therapist educators create learning experiences that result in interprofessional competence. This expectation must apply initially and across the entire continuum of professional development. Second, while responding to new accountabilities of the federal Affordable Care Act (ACA) may be stressful for practitioners, there is opportunity to create new approaches to address current stresses in clinical education. We advocate expanding the breadth of clinical education to include experiences in accountable care organizations (ACOs) or patient-centered medical homes (PCMHs) as a strategy for building practice options for care across the lifespan of patients. Finally, providing focused and in-depth education in the care of patients with highly prevalent conditions may prepare graduates to implement new care models and pathways that The authors declare no conflicts of interest.Received October 1, 2013, and accepted February 7, 2014. the health of our patients via new delivery models-and thus lead the evolution of our profession. Position and Rationale. To lead, physical therapists must (1) demonstrate interprofessional competence in what is certain to be an interdisciplinary industry, (2) assume new roles and accountabilities within new structures of the health care system, and (3) devise models of care, particularly for patients with highly prevalent and chronic conditions, that address movement and function across the full continuum of health and life. In turn, professional education must require (1) early and persistent exposure to, and clinical mentorship by, practitioners in other disciplines; (2) accountability for expected treatment outcomes embedded in the Affordable Care Act; and (3) skill development in community health assessments, health promotion, and prevention of disability and disease across the lifespan. Discussion and Conclusion. The mission of health care is to improve the health of individuals and of populations. As science progresses and a more glo...

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