Effect Of Strength Exercise on Respiratory Parameters, and Functional Capacity in Bariatric Surgery Patients

Study Overview
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Brief Summary
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The aim of the investigator's study is to investigate whether postoperative inspiratory muscle training and resistance exercise training has an effect on functional capacity, respiratory functions, respiratory muscle strength and endurance in patients undergoing bariatric surgery.

Detailed Description
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Obesity is an important health problem that can affect the entire organ and system of the body, leading to various disorders and even death. The fact that BMI is over 40 kg / m2 is defined as morbid obesity. The most effective treatment step in morbid obesity is bariatric surgery. The impairment of inspiratory muscle function related to obesity is associated with increased lung elastic load, excessive lengthening in the abdominal muscles, and dissolution of the diaphragm, leading to inspiratory muscle weakness and insufficiency. The decrease in its endurance is explained by the decrease of glycogen synthase activity in skeletal muscles. It was found that there was less decrease in the inspiratory muscle training patients whose MIP values were measured before bariatric surgery compared to those who could not do MIP values after surgery. Respiratory functions due to obesity are impaired due to restrictive mass increase in chest wall, tendency to breathe in low lung volumes and the effect of fat distribution on pleural pressure. Total lung volume, expiratory reserve volume (ERV), reserve volume (RV), vital capacity (VC), functional residual capacity (FRC), FVC, and FEV1 values are low. After bariatric surgery, patients' muscle strength decreased. In particular, there was a decrease in muscle strength in quadriceps, hamstring, biceps, triceps. The decrease in muscle strength after surgery has been associated with a decrease in muscle mass. It was stated that patients who did not exercise after surgery lost 7.6 kg of muscle, which was 29.7% of the total lost body weight. Resistance exercises performed after bariatric surgery have a positive impact on patients' muscle strength and functional capacity. Obesity causes a decrease in functional capacity. Increased step width, reduced walking speed and step length are shown for the main reasons. Decreased inspiratory muscle strength in patients undergoing surgery causes weakness in peripheral muscles. This weakness in peripheral muscles also reduces the functional capacity of patients. Inspiratory muscle training studies increase the functional capacity.

Official Title
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Effect Of Postoperative Inspiratory Muscle Training And Strength Exercise Training On Functional Capacity, Quality of Life, Respiratory Functions, Respiratory Muscle Strength And Endurance in Bariatric Surgery Patients

Conditions
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Obesity, Morbid

Intervention / Treatment
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* Other: Resistance Exercise Training
* Other: Inspiratory Muscle Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Having a body mass index (BMI) ≥40kg / m2 or (BMI) ≥35kg/m2 and at least one concomitant disease associated with obesity To participate regularly in treatment Exclusion Criteria: Using assistive device while walking Lung infection in the past 1 month Chronic obstructive pulmonary disease (COPD) Having an orthopedic, neurological disease that will prevent him/her from exercising Uncontrollable hypertension Pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Resistance Exercise Training Group<br>Resistance exercise training for 8 major muscle groups and 150 min per week walking suggestions were given | Other: Resistance Exercise Training<br>* 60 minutes resistance exercise training for 8 major muscle groups (quadriceps, hamstring, biceps, triceps, pectoralis major, gluteus medius , gluteus maximus, middle part of deltoid) for 8 weeks, 3 times per week<br>|
| Experimental: Inspiratory Muscle Training Group<br>Resistance exercise training for 8 major muscle groups and inspiratory muscle strength training and 150 min per week walking suggestions were given | Other: Resistance Exercise Training<br>* 60 minutes resistance exercise training for 8 major muscle groups (quadriceps, hamstring, biceps, triceps, pectoralis major, gluteus medius , gluteus maximus, middle part of deltoid) for 8 weeks, 3 times per week<br>Other: Inspiratory Muscle Training<br>* with % 30 of MIP, 20 minutes inspiratory muscle training for 8 weeks, 3 times per week<br>|
| No Intervention: Control Group<br>150 min per week walking suggestions were given. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Forced Vital Capacity (FVC) | Respiratory Function Test | 3 months | 
| Forced Expiratory Volume in 1 second (FEV1) | Respiratory Function Test | 3 months | 
| FEV1/FVC | Respiratory Function Test | 3 months | 
| Peak Expiratory Flow (PEF) | Respiratory Function Test | 3 months | 
| Forced expiratory flow over the middle one half of the FVC (FEF25-75%) | Respiratory Function Test | 3 months | 
| maximum inspiratory pressure (MIP) | Respiratory Muscle Strength Test | 3 months | 
| Maximal Voluntary Ventilation | Respiratory Muscle Endurance Test | 3 months | 
| Hand-held Dynamometer | Dynamic Muscle Strength Test | 3 months | 
| 5 times sit to stand test | Mobility Test | 3 months | 
| 6 minutes walking test | functional capacity test | 3 months | 
| Quality of Life Scale Specific for Obese Persons | Quality of Life | 3 months | 
| maximum expiratory pressure (MEP) | Respiratory Muscle Strength Test | 3 months | 
| Hand grip dynamometer | Static Peripheral Muscle Strength Test | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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bariatric surgery, inspiratory muscle strength, respiratory muscle endurance, functional capacity, peripheral muscle strength, quality of life, resistance exercise training, 6 - Minute Walk Test