effects of physical training on health markers of post-bariatric patients

Conditions: Bariatric Surgery

Summary: the purpose of this clinical trial is to study the effects of resistance training program on physical-functional fitness, muscle mass and strength, endothelial function, blood pressure, biochemical markers of cardiovascular risk and bone metabolism, density and microstructure and quality of life of post-bariatric patients (study 1). to compare the bone and muscle changes in post-bariatric patients by roux-en-y gastric bypass surgery with non-bariatric controls, as well as to correlate these health indicators with surgery time and weight loss (study 2).

randomized controlled trial (study 1) will feature post-bariatric patients in outpatient care at the public health unit. the post-bariatric patients will be randomized through a random code generator software (www.randomization.com) at a ratio of 1:1, into two groups: a) intervention group - that will perform a supervised rt program for 6-months or b) non-exercised control group - that will receive the standard clinical follow-up and shall not change their physical activity behavior. the exercise sessions will include: a) 10-min specific warm-up, consisting of one set of 20 repetitions with loads corresponding to 50% of the resistance used in the first exercise of the training session; b) 45-min of resistance exercises for the upper and lower body (8 single and multi-joint exercises with free weights and machines, including seated rowing, leg press, bench press, leg flexion, pull down, leg extension, shoulder press, and abdominal exercises), performed with 2-3 sets of 8 to 12 repetitions with loads ≥ 70% of one-repetition maximum (1rm) interspersed with 2 min intervals between sets; c) 5-min recovery with stretch and cool-down exercises. during six months, all training sessions will occur three times a week on nonconsecutive days. the outcomes will be assessed by dual energy x-ray emission densitometry (dxa); high resolution peripheral quantitative computed tomography (hr-pqct), repetition maximum, handgrip strength; biochemical analysis (blood lipid profile, blood glucose and biomarkers of bone formation and absorption and calcium metabolism); venous occlusion plethysmography and nailfold videocapillaroscopy; blood pressure measurement and 36-item short-form health survey. the cross-sectional study (study 2) will have 2 groups: post-bariatric patients group (bg) and control group (cg) - non-bariatric controls. outcomes will be assessed by dxa; hr-pqct; handgrip strength and biochemical analysis (blood lipid profile, blood glucose and biomarkers of bone formation and absorption and calcium metabolism).

Eligibility criteria:
inclusion criteria: * patients subjected to roux-en-y gastric bypass * aging 18 to 50-years * at least 12 months from surgery exclusion criteria: * smoking * alcoholism * gestation * cardiovascular disease * respiratory disease * neurological disease * infectious disease * endocrine disease * musculoskeletal impairments * use of hormonal replacement therapy that influence bone metabolism * use of medications that influence bone metabolism * start some physical exercise program during the study * excess weight loss \<50% * use drugs that interfere with weight * revisional bariatric surgery * regular physical exercise

Keywords: obesity muscle mass muscle strength bone mineral density bone microarchitecture