Cano M.1, Ibacache P.2,3, Miranda C.3
1Universidad de Chile, Departamento de Kinesiología, Santiago, Chile, 2Universidad de las Américas, Departamento de Morfología y Función, Viña del Mar, Chile, 3Universidad Andrés Bello, Carrera de Kinesiología, Viña del Mar, Chile
Background: Obesity as became a major health problem worldwide and it has been associated to several comorbidities as cancer, type 2 diabetes, blood hypertension, osteoarthritis, sleep apnoea, dyslipidemia, hepatic steatosis and autonomic dysfunction. As a response to this problem there has been a huge increment in the number of bariatric surgery as a procedure to limit the volume of the stomach and decrease quickly the body weight. However there is controversial evidence related to the impact on muscle strength (a marker about survival and quality of life) and heart rate variability (as an indicator of cardiovascular health and survival).
Purpose: To assess the impact of sleeve gastrectomy on muscle strength and heart rate variability three months after the surgery.
Methods: 24 women (36 ± 11 years old) were assessed before and after three months of the sleeve gastrectomy. To assess the muscle force, three isometric quadriceps muscle contraction of 5 seconds length (patient seated with the knee on 90° of flexion) were done, recording the best value with a dynamometer FMON-1 for right and left side and then used the mean between them. The hand grip strength (HGS) was measured with a dynamometer Dynatron (using the EUROFIT protocol), considering the mean value between right and left sides.
Heart rate variability (HRV) was assessed with the patient in supine, controlling breathing frequency with a metronome (14 breathing per minute) during 10 minutes, registering the RR intervals with a Polar RS 800 device and later analysing data with Kubios software (University of Eastern Finland) using a time domain, frequency domain and non-lineal analysis for HRV.
SPSS 21.0 software was used for statistical analysis and p 0.05 was considered significant.
Results: The women had an initial BMI of 35.1 ± 3.4 kg/m2 and 28.3 ± 3.1 kg/ m2 three month after surgery. There was a reduction in HGS from 32.0 ± 4.2 to 27.8 ± 4.0 kg (p 0.001) and in quadriceps strength from 121.3 ± 45.3 to 95.6 ± 29.8 N (p=0.003) with the surgery.
There was an improvement in HRV time domain variables SDNN from 55.4 [12.8-135.4] to 74.8 [27.5-142.7] milliseconds (p=0.006), pNN50 from 22.1 [0-66.6] to 39.2 [2.6-78.5] % (p=0.005) and RMSSD from 47.5 [7.3-122.4] to 76.6 [20.8-177.9] milliseconds (p=0.005) and in non-lineal analysis with an increase in SD1 from 33.7 [5.2-86.7] to 54.3 [14.7-126.0] milliseconds (p=0.005) and SD2 from 70.2 [17.4-171.0] to 89.7 [34.9-167.5] milliseconds (p=0.014). There was no changes in the frequency domain analysis. All HRV results are expressed as median [minimum-maximum].
Conclusion(s): Three month after a bariatric surgery, there was an improvement in autonomic balance assessed through HRV and a reduction in handgrip and quadriceps strength.
Implications: A female patient who will be submitted to sleeve gastrectomy will have a great loss in muscle strength maybe due to a loss in muscle mass and she improve her heart rate variability, so it would be advisable introduce a strengthening program after the surgery.
Funding acknowledgements: This work was partially funded with resources of the Universidad de Chile and Universidad Andrés Bello.
Topic: Professional practice: other
Ethics approval: This research was approved by the Ethic Committee of Human Beings Research at Universidad de Chile (reg. number 149-2014)
All authors, affiliations and abstracts have been published as submitted.
