P. Ibacache1, T. Cruces2, F. González2, C. Leyton2, J. Marchant2
1Universidad Andres Bello, Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Santiago, Chile, 2Universidad Andres Bello, School of Physical Therapy, Faculty of Rehabilitation Sciences, Viña del Mar, Chile
Background: The increasing prevalence of obesity is a major health burden worldwide and has been associated with several comorbidities such as diabetes, dyslipidemia, osteoarthritis, some cancers, sleep apnea, hypertension, and coronary heart disease. Likewise, obesity has deleterious effects on strength (MS) and muscle quality (MQ). The muscle strength is a determinant of morbidity and mortality. On the other hand, MQ, usually expressed as muscle strength or muscle power per unit of muscle mass ratio, has been highlighted as one of the most important biomarkers for improving physical performance in elderly and also in young adults. Although bariatric surgery (BS) is recognized as an effective strategy for body weight loss and comorbidities, its impact on strength and muscle quality is still unclear.
Purpose: We aimed to examine postoperative changes in strength and MQ among adults undergoing BS.
Methods: This systematic review was registered in PROSPERO (CRD42022332581). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist, together with the Cochrane Handbook for Systematic Reviews of Interventions, was strictly followed in the design and implementation of this study. We systematically searched the WoS, PubMed, EBSCO, and Scopus databases from inception to May 2022. Observational and intervention studies were selected reporting the presurgery and postsurgery muscle strength and/or muscle quality.
Results: The search identified 1706 records (Pubmed 329, WoS 358, EBSCO 572, and Scopus 447). After eliminating duplicates, 663 records remained. After initial screening based on titles and abstracts, 83 articles remained for further evaluation. Of these, 51 were excluded in the subsequent detailed assessments. Thirty-two publications met the selection criteria for the systematic review.
The systematic review includes 16 observational studies, 8 randomized controlled trials, and 8 nonrandomized controlled trials, comprising a total of 765 persons. The BS technique varied between studies, being Roux-en-Y gastric bypass the most frequent.
Most of the studies reported muscle strength in absolute terms and relative to body weight. Only three studies reported muscle strength relative to fat-free mass, and six presented changes in muscle composition (a less studied dimension of MQ).
Muscular strength was evaluated using different instruments and/or tests, such as isometric or isokinetic dynamometer, 1RM, handgrip dynamometer, and other functional tests. Handgrip strength was the most reported issue. The body composition and muscle composition methods used were DXA, computed tomography, nuclear magnetic resonance, and bioelectrical impedance analysis.
Most of the studies showed a significant decrease in MS in absolute terms and an increase in MS relative to body weight. Muscle fat content decreased after surgery in all studies that reported muscle composition.
The systematic review includes 16 observational studies, 8 randomized controlled trials, and 8 nonrandomized controlled trials, comprising a total of 765 persons. The BS technique varied between studies, being Roux-en-Y gastric bypass the most frequent.
Most of the studies reported muscle strength in absolute terms and relative to body weight. Only three studies reported muscle strength relative to fat-free mass, and six presented changes in muscle composition (a less studied dimension of MQ).
Muscular strength was evaluated using different instruments and/or tests, such as isometric or isokinetic dynamometer, 1RM, handgrip dynamometer, and other functional tests. Handgrip strength was the most reported issue. The body composition and muscle composition methods used were DXA, computed tomography, nuclear magnetic resonance, and bioelectrical impedance analysis.
Most of the studies showed a significant decrease in MS in absolute terms and an increase in MS relative to body weight. Muscle fat content decreased after surgery in all studies that reported muscle composition.
Conclusions: This study provides evidence that the weight loss induced by BS can reduce absolute muscle strength, which represents a therapeutic target to optimize BS outcomes through physical training.
Implications: The inclusion of physical training programs before and after a BS would be recommended to prevent the loss of muscle strength after this surgery as a deleterious side effects of this procedure.
Funding acknowledgements: No external funding was recieved to conduct this research
Keywords:
Bariatric surgery
Muscle strength
Muscle function
Bariatric surgery
Muscle strength
Muscle function
Topics:
Non-communicable diseases (NCDs) & risk factors
Musculoskeletal: peripheral
Health promotion & wellbeing/healthy ageing/physical activity
Non-communicable diseases (NCDs) & risk factors
Musculoskeletal: peripheral
Health promotion & wellbeing/healthy ageing/physical activity
Did this work require ethics approval? No
Reason: There is no need of an ethical approval for a sistematic review
All authors, affiliations and abstracts have been published as submitted.
