Análise comparativa da eficácia dos exercícios aeróbicos e de força para aumentar/manter a capacidade funcional de obesos pós cirurgia bariátrica: revisão sistemática

Abstract

Introduction: Obesity has emerged as a pressing global health concern, forcing researchers, policymakers and healthcare professionals to unite in their efforts to combat this multifaceted epidemic. Its alarming prevalence, serious health consequences and significant socioeconomic burden make it a topic of paramount importance. Treatment encompasses several modalities ranging from lifestyle modifications to pharmacotherapy and surgical interventions, especially in cases of severe obesity. International guidelines address the need to increase the level of physical activity as one of the multi-behavioral interventions aimed at increasing energy expenditure, reducing weight and improving health. Objective: to synthesize evidence to answer the clinical question of which type of physical exercise, endurance exercise (aerobic exercise) or exercise to gain strength (resistance exercise), is more effective for maintaining/recovering the functional capacity of obese people post bariatric surgery (BS). Methodology: Systematic review of randomized clinical trials published in English, Spanish and Portuguese. The search took place from April 23 to June 10, 2023 in the databases MedLine via PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Excerpta Medica dataBASE (EMBASE), gray literature, and Cochrane Library. The primary outcome of interest was functional capacity. The risk of bias analysis was performed using the Revised Cochrane risk-of-bias tool for randomized trials (Rob 2) and the certainty of evidence and strength of recommendation using the Grading of Recommendations Assessment, Development and Evaluation system. Results: Of 10,436 publications identified, 6 studies were related to the primary outcome, functional capacity in obese people after bariatric surgery. The total population of the included studies totaled 175 obese people after bariatric surgery, the majority of whom were women, with ages ranging from 18 to 65 years. The main type of surgery covered in the studies was gastric bypass. The comparison measures used in the included clinical trials were: aerobic exercise, aerobic exercise combined with resistance exercise, and standard routine of usual care. Conclusion: With a weak recommendation and low level of evidence, we recommend that aerobic exercise be included in this program. Study registration: PROSPERO number CRD42023401411