Efficacy of telehealth core exercises during COVID-19 after bariatric surgery: a randomized controlled trial

Abstract

BACKGROUND Bariatric surgery (BS) is presently the most durable and effective intervention to address severe obesity. BS results in significant weight loss and body composition changes, with reductions in both fat mass and lean mass. Conequently, muscle tissue wasting and a reduction in muscle strength and endurance seem to take place. Some studies have evaluated the impact of resistance training on changes in lean body mass and muscle strength either alone or along with protein supplementation in the first year after BS. However, the effects of core stabilization training on core endurance, postural control, and aerobic capacity in patients after BS have not been evaluated. AIM This study assessed the effect of a home telehealth core stabilization exercise program on core stability, postural control, and aerobic capacity in patients after BS. DESIGN A single-blinded randomized controlled trial. SETTING Home-based exercise program. POPULATION Patients after BS. METHODS Fifty-four patients who underwent BS randomly assigned into study and control groups. The study group followed a telehealth supervised home core stabilization program for 8 weeks, while the control group did not receive any form of exercises. Core endurance tests, postural stability, and aerobic capacity were assessed at baseline and after 8 weeks in both groups. RESULTS No significant difference was noted between groups at baseline (P>0.05). The outcome of the group comparisons showed significant improvement in core endurance tests, postural stability, and aerobic capacity in the study group. Between groups comparision showed that the study group scores significantly higher than the control group (P<0.05). However, the control group showed non-significant changes in any measured variables after eight weeks (P>0.05). CONCLUSIONS Eight weeks of a home-based telehealth core exercise program improves core endurance, postural stability, and aerobic capacity in patients after BS. CLINICAL REHABILITATION IMPACT The core stabilization exercise is an important rehabilitation program that should be implemented after BS. Telehealth is an alternative rehabilitation tool during the COVID -19 pandemic.

Exercise interventions following bariatric surgery are poorly reported: A systematic review and a call for action

“…Regarding randomization, 61% presented low risk of bias, 21,36–41,43,50–53,55,57,59,61,62 21% had some concerns, 44–46,48,58,60 and 18% presented high risk of bias 42,47,49,54,56 . For deviations from intended interventions, 36% had a low risk, 21,36,39,41–43,45,50–52 while 50% raised some concerns 38,40,44,46,48,49,53,56,57,59–62 . However, bias in measuring outcomes (79%) and selecting reported results (89%) was generally low in most studies (Figure S3).…”

Impact of the COVID-19 Pandemic on the Success of Bariatric Surgeries in Patients with Severe Obesity

“…Monitoring patients during follow-up, access to health care, and social support have to be provided more than before [ 45 ]. Also, telehealth, as a helpful method to improve patients' rehabilitation, should be considered more than before; telehealth core exercises and even telephone-based cognitive behavioral therapy may help patients have a better postoperative period [ 46 , 47 ]. So, further supports concerning food security, accessing health care, and new physical activity routines are mandatory to achieve better results [ 48 ].…”

Assessment of Isokinetic Trunk Muscle Strength and Fatigue Rate in Individuals after Bariatric Surgery

“…The most widely used indicators of muscle fatigue are the rate of the decrease in median frequency (MF) and the simultaneous rise in EMG amplitude (RMS) during submaximal sustained contraction [24]. Using McGill's torso muscular endurance tests, Ali et al [25] found that trunk muscle endurance decreased after BS in comparison to their controls.…”