Background: Beyond obesity-related comorbidities, overweight patients have a high risk of developing osteoarticular pathologies. Moreover, weight loss following bariatric surgery induces a decrease in fat mass but also in muscle mass, thus affecting the physical capacities of these patients. Functional rehabilitation is a solution to correct these imbalances. The aim of this study was to evaluate the effectiveness of a functional rehabilitation program after bariatric surgery.
Methods: Twenty-three patients with severe obesity (BMI = 37.9 ± 5.7 kg/m2; 41.1 ± 12.9 years) participated in a functional rehabilitation protocol, 2 months after sleeve gastrectomy. Rehabilitation program consisted of 20 sessions of 1h30 (two sessions per week), based on endurance training, muscle strengthening, and proprioception work. An initial and final assessment included bioelectrical impedance measurements, questionnaires, and physical function tests.
Results: All impedance parameters were significantly improved in 20 sessions: % excess weight loss (%EWL) from 27.6 ± 9.1 to 51.1 ± 13.4% and % fat-free mass from 52.7 ± 5.6 to 57.6 ± 6.7%. Waist and hip circumferences were significantly reduced in 20 sessions: from 107.4 ± 13.7 to 94.5 ± 12.6 cm and from 120.5 ± 12.4 to 108.7 ± 11.7 cm, respectively (p < 0.001). Physical function tests were significantly improved between the 1st and the 20th sessions (p < 0.001). The cycloergometer stress test progressed from 77.7 ± 24.1 to 93.6 ± 27.2 W, and the sit-to-stand test from 20 ± 5.2 to 24.8 ± 7.6 flexions in 30 s. The Quality Of Life, Obesity and Dietetics (QOLOD) scale increased by 12.6%.
Conclusions: The functional rehabilitation protocol of 20 sessions significantly improved patients' body composition, functional tests, and quality of life. The standardization of tests and sessions allowed to objectively assess progress.
Keywords: Exercise; Fat mass; Physical fitness; Severe obesity; Sleeve gastrectomy.