INTRODUCTION: Exercise is thought to improve functional outcomes and weight loss. As little as thirty minutes of brisk exercise daily can increase weekly metabolic caloric expenditure to about 35000 Kcal. This study is designed to measure change in preoperative exercise activity and functional health status, and subsequent postoperative physical activity in bariatric surgical patients.
METHODS AND PROCEDURES: 41 patients, who were candidates for weight loss surgery, were prospectively randomized. Patients in the intervention group were contacted weekly and encouraged to exercise. Patients in the standard group were contacted regularly and no extra effort was made to ensure they were exercising. Patient activity was recorded using an accelerometer (Actical, Respironics, Inc) that was worn continuously for seven days prior to each data point. Data was recorded at baseline, 30 days after starting the exercise regimen and prior to the operation, and 8 weeks after the operation. Patient’s functional health status was recorded at each endpoint using the Short Form 36 Health Survey.
RESULTS: Intervention group (n=25) and the control group (n=16) underwent testing. 32% (13/41) patients dropped out because they did not exercise at all or refused to wear the accelerometer. At baseline the intervention group had an average total energy expenditure (AEE) of 37143 (± 5759) Kcal while the control group’s average was 31666 (± 9522) Kcal. After 30 days of exercise, the intervention group’s AEE was 34385 (±1386) Kcal while the control group’s average was 33625 (± 9895) Kcal (p = 0.50). Weight loss was noted in both groups prior to the operation: study group (3.10 ±4.66 lbs) and control group (6.39 ±8.03 lbs). Postoperatively the study group experienced a weight loss of 35.00 lbs ± 12.72 and the control group of 56.90 lbs ± 46.95.
CONCLUSIONS: Patients, receptive to exercise, were able to maintain an average energy expenditure equivalent to a brisk walk. This may lead to significant clinical weight loss in the perioperative period. Verbal encouragement alone did not increase activity and augment energy expenditure.
Program Number: P091