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Meta-Analysis
, 8 (10), e023208

Effect of Physical Exercise on Weight Loss and Physical Function Following Bariatric Surgery: A Meta-Analysis of Randomised Controlled Trials

Affiliations
Meta-Analysis

Effect of Physical Exercise on Weight Loss and Physical Function Following Bariatric Surgery: A Meta-Analysis of Randomised Controlled Trials

Zi-Qi Ren et al. BMJ Open.

Abstract

Objectives: We performed a meta-analysis of all of the available randomised controlled trials (RCTs) to investigate whether physical exercise contributes to weight loss or physical function improvement in adults receiving bariatric surgery.

Methods: We searched PubMed, Embase, the Cochrane Library, OVID and the CINAHL up through May 2018. RCTs that assigned adults with obesity to either an exercise training group or a no-exercise group after bariatric surgery were included. The primary outcomes were weight loss and physical function. Study bias was assessed using the Cochrane risk of bias tool, and the quality of evidence was assessed using GRADEpro.

Results: A total of eight studies met the inclusion criteria (n=347 participants). Most of the studies carried a low risk of bias due to randomisation and blinding. Compared with those without exercise intervention after surgery, patients engaging in physical exercise were associated with greater weight loss (weighted mean difference (WMD) -1.94 kg; 95% CI -3.18 to -0.69; n=8) and longer 6 min walk distance (6MWD; WMD29.67 m; 95% CI 25.97 to 33.37; n=2) during follow-up. By subgroup analyses, the additional weight loss in exercise group was related to the starting time and type of exercise: patients engaging in exercise 1 year or more after surgery and patients received aerobic-resistance exercise experienced more weight loss. Besides, patients in exercise training group also had lower systolic blood pressure and resting heart rate after surgery. The quality of evidence for these outcomes was moderate to very low.

Conclusions: Physical exercise after bariatric surgery provides 1.94 kg additional weight loss and 29.67 m longer 6MWD compared with surgery alone. Moreover, engaging in exercise 1 year or more after surgery, and a combined aerobic and resistance training programme may result in greater weight loss.

Keywords: bariatric surgery; exercise; obesity; physical function; weight loss.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Study selection flow chart.
Figure 2
Figure 2
Mean change in body weight (kilogram) after exercise intervention versus non-exercise treatment after bariatric surgery. Subgroup analysis was done on the studies that used different starting times for intervention after surgery (Forest plot). WMD, weighted mean difference.
Figure 3
Figure 3
Mean change in body weight (kilogram) after exercise intervention versus non-exercise treatment after bariatric surgery. Subgroup analysis was done on the studies that used different exercise prescriptions after surgery (Forest plot). WMD, weighted mean difference.
Figure 4
Figure 4
Weight loss: funnel plot of included studies. WMD, weighted mean difference.

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