Associação entre a prática de atividade física, o reganho de peso, o comportamento sedentário, os fatores de risco metabólico e a qualidade de vida e do sono, em pacientes submetidos a cirurgia bariátrica
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2021
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Objetivo: Esta dissertação teve dois objetivos: 1) realizar uma revisão sistemática rápida da
literatura, que pretende analisar literatura publicada sobre a associação entre a atividade física,
o reganho de peso e a qualidade de vida nos pacientes submetidos a cirurgia bariátrica; e 2)
realizar um estudo observacional com objetivo de analisar a associação entre a atividade física,
o reganho de peso, os fatores de risco metabólico e a qualidade de vida nos pacientes
submetidos a cirurgia bariátrica. Também pretende avaliar como a atividade física,
comportamento sedentário, reganho de peso e qualidade do sono podem estar associados entre
si nesta população.
Método: Foi feita uma pesquisa na base de dados Pubmed e foram considerados para inclusão
no estudo, estudos randomizados controlados, estudos clínicos controlados, estudos coorte e
estudos transversais escritos em Inglês e Português. Foram encontrados 1279 estudos
possivelmente relevantes e incluídos na revisão 8 estudos, sendo 6 observacionais e 2 ensaios
clínicos randomizados, onde a qualidade foi considerada boa. Para o estudo observacional, foi
feita uma colheita retrospetiva de dados. O estudo contou com a participação de 84 indivíduos,
submetidos a cirurgia bariátrica de bypass gástrico há mais de 5 anos, num Centro de
Responsabilidade Integrada de Cirurgia da Obesidade e Doenças Metabólicas. Foi elaborado
um instrumento de recolha de dados, onde estavam incluídas perguntas de questionários
validados, mas também as questões retiradas do processo clínico dos pacientes. Os dados foram
recolhidos num único momento, através de uma entrevista telefónica. Alguns casos não foram
incluídos por falta de dados analíticos dos pacientes. A análise foi feita com recurso ao software
JASP.
Resultados: Na revisão sistemática rápida da literatura, verificou-se uma associação entre a
prática de atividade física e o reganho de peso, bem como na qualidade de vida e fatores de
risco metabólico. A prática de atividade física após cirurgia bariátrica é um preditor importante
na prevenção do reganho de peso após o tratamento cirúrgico. Na amostra estudada no estudo
observacional, apenas estavam presentes dois níveis de atividade física, o baixo e moderado,
com baixos níveis de atividade física a indicarem maior reganho de peso. Os fatores de risco
metabólico não estiveram associados com o reganho de peso nem com prática de atividade
física. A qualidade de vida, bem como a qualidade do sono estão inversamente relacionadas
com o reganho de peso.
Conclusões: A revisão sistemática rápida da literatura e o estudo observacional obtiveram
resultados, maioritariamente, concordantes, tais como o facto da cirurgia bariátrica induzir uma perda de peso significativa no primeiro ano pós cirurgia, que quando coadjuvada com a prática
de atividade física, se mantém pelos anos consecutivos. Um menor reganho peso permite
manter bons níveis de qualidade de vida e qualidade do sono. Um menor comportamento
sedentário está associado a menor reganho de peso. As comorbilidades associadas à obesidade
estão diretamente associadas à perda de peso, como referem os dados da revisão sistemática
rápida da literatura, no entanto, no estudo observacional, não obtivemos relação das
comorbilidades com a atividade física nem com o reganho de peso.
Objective: This dissertation had two objectives: 1) to conduct a rapid systematic review of the literature, which aims to analyze published literature on the association between physical activity, weight regain and quality of life in patients undergoing bariatric surgery; and 2) to conduct a cross-sectional observational study with the objective of analyzing the association between physical activity, weight gain, metabolic risk factors and quality of life in patients undergoing bariatric surgery. It also intends to evaluate how physical activity, sedentary behavior, weight gain and sleep quality may be associated with each other in this population. Method: A search was conducted in the PubMed database and were considered for inclusion in the study, randomized controlled studies, controlled clinical studies, cohort studies and cross-sectional studies written in English and Portuguese. We found 1279 studies possibly relevant and included in the review 8 studies, 6 observational and 2 randomized clinical trials, where quality was considered good. For the observational study, a retrospective data collection was performed. The study had the participation of 84 individuals, who underwent bariatric gastric bypass surgery for more than 5 years, in a Center for Integrated Responsibility for Surgery of Obesity and Metabolic Diseases. A data collection instrument was elaborated, which included questions from validated questionnaires, but also the questions taken from the patients' clinical process. The data was collected in a single moment through a telephone interview. Some cases were not included due to lack of analytical data from patients. The analysis was made using JASP software. Results: In the rapid systematic review of the literature, there was an association between the practice of physical activity and weight gain, as well as in quality of life and metabolic risk factors. The practice of physical activity after bariatric surgery is an important predictor in the prevention of weight gain after surgical treatment. In the sample studied in the cross-sectional study, only two levels of physical activity were present, the low and moderate, with low levels of physical activity indicating greater weight gain. Metabolic risk factors were not associated with weight gain or physical activity. Quality of life as well as sleep quality are inversely related to weight gain. Conclusions: the rapid systematic review of the literature and the observational study obtained results, mostly concordant, such as the fact that bariatric surgery induces a significant weight loss in the first year after surgery, which when assisted with the practice off activity, is maintained for consecutive years. A lower weight gain allows to maintain good levels of quality of life and sleep quality. A lower sedentary behavior is associated with less weight gain. The comorbidities associated with obesity are directly associated with weight loss, as reported in the data from the rapid systematic review of the literature, however, in the observational study, we did not obtain a relationship between the comorbidities with physical activity or with weight gain.
Objective: This dissertation had two objectives: 1) to conduct a rapid systematic review of the literature, which aims to analyze published literature on the association between physical activity, weight regain and quality of life in patients undergoing bariatric surgery; and 2) to conduct a cross-sectional observational study with the objective of analyzing the association between physical activity, weight gain, metabolic risk factors and quality of life in patients undergoing bariatric surgery. It also intends to evaluate how physical activity, sedentary behavior, weight gain and sleep quality may be associated with each other in this population. Method: A search was conducted in the PubMed database and were considered for inclusion in the study, randomized controlled studies, controlled clinical studies, cohort studies and cross-sectional studies written in English and Portuguese. We found 1279 studies possibly relevant and included in the review 8 studies, 6 observational and 2 randomized clinical trials, where quality was considered good. For the observational study, a retrospective data collection was performed. The study had the participation of 84 individuals, who underwent bariatric gastric bypass surgery for more than 5 years, in a Center for Integrated Responsibility for Surgery of Obesity and Metabolic Diseases. A data collection instrument was elaborated, which included questions from validated questionnaires, but also the questions taken from the patients' clinical process. The data was collected in a single moment through a telephone interview. Some cases were not included due to lack of analytical data from patients. The analysis was made using JASP software. Results: In the rapid systematic review of the literature, there was an association between the practice of physical activity and weight gain, as well as in quality of life and metabolic risk factors. The practice of physical activity after bariatric surgery is an important predictor in the prevention of weight gain after surgical treatment. In the sample studied in the cross-sectional study, only two levels of physical activity were present, the low and moderate, with low levels of physical activity indicating greater weight gain. Metabolic risk factors were not associated with weight gain or physical activity. Quality of life as well as sleep quality are inversely related to weight gain. Conclusions: the rapid systematic review of the literature and the observational study obtained results, mostly concordant, such as the fact that bariatric surgery induces a significant weight loss in the first year after surgery, which when assisted with the practice off activity, is maintained for consecutive years. A lower weight gain allows to maintain good levels of quality of life and sleep quality. A lower sedentary behavior is associated with less weight gain. The comorbidities associated with obesity are directly associated with weight loss, as reported in the data from the rapid systematic review of the literature, however, in the observational study, we did not obtain a relationship between the comorbidities with physical activity or with weight gain.
Descrição
Orientação: António João Labisa da Silva Palmeira
Palavras-chave
MESTRADO EM EXERCÍCIO E BEM-ESTAR, EDUCAÇÃO FÍSICA, ATIVIDADE FÍSICA, CIRURGIA BARIÁTRICA, PESO CORPORAL, QUALIDADE DE VIDA, FATORES DE RISCO, SONO, PHYSICAL EDUCATION, PHYSICAL ACTIVITY, BARIATRIC SURGERY, BODY WEIGHT, QUALITY OF LIFE, RISK FACTORS, SLEEP