Effects of resistance training on physical-functional fitness, endothelium, autonomic modulation, hemodynamics, bone metabolism and quality of life of patients after bariatric surgery: a controlled and randomized study

Abstract

Purposes: To study the effects of a concurrent training program on physical and functional fitness, physical activity level, endothelial function, blood pressure, biochemical markers of cardiovascular risk and bone metabolism, bone density and microstructure and quality of life of post-bariatric surgery (BS) (Study 1). To compare possible bone and muscle changes in post-bariatric patients by roux-enY gastric bypass (RYGB) surgery with non-bariatric controls, as correlating these health indicators with the time elapsed from the surgery and weight loss (Study 2). Methods: In the randomized controlled trial (Study 1) will be included post-bariatric patients followed in a medical set at the Policlínica Piquet Carneiro. Volunteers will be divided in two groups: physical training (PT - will perform aerobic and resistance exercise program, three times a week for six months) and control (CG - will not perform physical activities during the study period). The GT will perform aerobic (treadmill walking during 20 min) and resistance exercises (strength exercises involving large muscle groups for upper and lower limbs, consisting in 3 sets of 10 reps, with intensity set at 70-85% of 1 repetition maximum, with 2 min of resting between sets, during 40 min) 3 days a week for 6 months. The CG will not modify their routines, being prohibited from performing systematic physical activities during the period of the experiment. The following evaluations will be performed: a) body composition: dual X-ray absorptiometry (DXA); b) bone microarchitecture and volumetric bone mineral density (BMD): high-resolution peripheral quantitative computed tomography (HR-pQCT); c) muscle strength and cardiorespiratory fitness: one maximum repetition testing and cardiopulmonary exercise test; d) biochemical markers: lipid profile, glycemia and bone metabolism; e) endothelial function: doppler ultrasound and nailfold videocapillaroscopy; f) blood pressure: 24h ambulatory blood pressure; g) physical activity level: accelerometry (actiGraph GT3X+) and International Physical Activity Questionnaire (IPAQ) and h) quality of life: 36-Item Short-form Health Survey (SF-36). In the Cross-sectional study (Study 2) will be included two groups: bariatric surgery (BS) - postbariatric patients by RYGB and control non-bariatric (CG). Outcomes will be assessed: a) body composition: DXA; b) volumetric BMD and bone microarchitecture: HR-pQCT; c) muscle strength: handgrip; d) biochemical parameters. (AU)