Postoperative Effect of Physical Therapy Related to Functional Capacity and Respiratory Muscle Strength in Patients Submitted to Bariatric Surgery

Abstract

Background: Respiratory physiotherapy plays an important role preventing complications in bariatric surgery. Aim: To assess the effects of out-patient physiotherapy during post-operative period through respiratory pressures and functional capacity in individuals submitted to bariatric surgery. Method: A prospective longitudinal and controlled study was done in adults with body mass index (BMI) equal or greater than 40 kg/m², who have been submitted to bariatric surgery. They were divided into two groups: intervention-group, who performed out-patient physiotherapy twice a week, from thirty to sixty days after surgery; and the control-group, who only followed home instructions. Both groups were evaluated before surgery and sixty days after surgery through manovacuometry, six-minute walk test and the Borg Scale of perceived exertion. Results:Twenty participants were included the intervention-group and twenty-three in the control-group. Both groups had significant and similar weight loss after surgery. The manovacuometry presented no differences comparing pre- and post-surgery and in the comparison between the groups. The result of the six-minute walk test for the intervention-group increased by 10.1% in the post-operative period in relation to pre-. The Borg scale of perceived exertion in the intervention-group in pre-surgery decreased by 13.5% in the post-surgery compared to pre-surgery. In the control-group there was no difference comparing pre- and post-operative values, as in the comparison with the intervention-group. Conclusion: The low-intensity exercise program, carried out between the 30th and the 60th day after bariatric surgery provided better functional capacity; did not change respiratory muscle strength; and improved the perceived exertion rate.

Effect of exercise training before and after bariatric surgery: A systematic review and meta‐analysis

“…Contradictory findings were reported regarding weight loss, with two systematic reviews and meta-analyses reporting greater weight loss in the exercise versus control group 7,8 and one review reporting no significant effect. 9 The latter review, 9 however, included two interventions based on respiratory muscle training, 10,11 a training modality that is not expected to impact weight loss. This highlights the importance of limiting inclusion criteria to whole-body exercise training based on aerobic or resistance training, or both, when assessing the effect of exercise on weight loss.…”

Exercício Após Bariátrica Como Estratégia De Recuperação: Revisão Da Literatura

“…Vê-se que o treinamento aeróbico foi o método utilizado em todos os artigos selecionados para as intervenções, existindo o pressuposto de que para a redução da gordura corporal esse método é o mais indicado. Levando em consideração isso, o programa de exercícios de baixa intensidade, realizado entre o primeiro ou segundo mês de pós-operatório de CB, proporciona melhor capacidade funcional (Oliveira, Freitas & Almeida, 2016). Outro método, também, utilizado foi o anaeróbico (com exercícios resistido e de força), assim, de acordo com Hassannejad et al (2017), o exercício físico contribuem para efeito positivo sobre a diminuição do peso após a cirurgia, levando a melhora significativa da capacidade aeróbia.…”

Airway Positive Pressure vs. Exercises With Inspiratory Loading Focused on Pulmonary and Respiratory Muscular Functions in the Postoperative Period of Bariatric Surgery

“…In addition, no other pulmonary impairment was found in the analysis of chest radiographs, being justified by the early onset and number of sessions performed in the physiotherapeutic care. Thus, it is suggested that interventions in both groups be effective, demonstrating the importance of physiotherapy in the prevention of pulmonary complications 23 .…”