Exercise Modalities to Preserve Muscle Mass and Bone Health After Metabolic Bariatric Surgery
Abstract
Background: Metabolic bariatric surgery (MBS) effectively reduces fat mass (FM), but how to best preserve muscle and bone mass after MBS is unknown.
Objective: This study aimed to evaluate the effect of aerobic, resistance and combined exercise regimens on body composition, bone mineral density (BMD) and physical function in adults following MBS.
Methods: Patients were randomized into aerobic, resistance, combined and control groups after undergoing MBS. Exercise groups completed a 26-week supervised program (three sessions per week) with progressively increasing intensity. The primary outcome was the change in fat-free mass (FFM) measured by dual-energy X-ray absorptiometry (DXA). Secondary outcomes included FM, hip, femoral neck and lumbar spine BMD, serum collagen type I C-telopeptide (CTX) and physical function (e.g., 6-min walk test and handgrip strength). Between-group differences were assessed using Bayesian analysis of covariance (ANCOVA) adjusted for age, sex, surgery type and baseline body mass index, with credible differences inferred when the 95% credible interval of the standardized effect size excluded zero. Associations between outcomes were assessed using Pearson correlation.
Results: Of 443 eligible candidates, 58 participants (aged 18-65 years, 70% women, BMI 41.7 ± 4.4 kg/m2) were randomized to aerobic (n = 15), resistance (n = 13), combined (n = 14) or control (n = 16) groups, and 91.3% were included in the analysis. The combined exercise group preserved…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 58 participants or records.
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