title: Aspects of Exercise before or after Bariatric Surgery: A Systematic Review.
abstract: BACKGROUND
  Bariatric surgery has a considerable effect on weight loss. A positive relation of exercise and weight loss has been described before. However, the mode of exercise and its timing pre- or postoperatively or a combination remains unclear.
  
  
  METHODS
  A multi-database search was conducted. Identified articles were reviewed on description of exercise, timing around a bariatric intervention, and outcome. Methodological quality of the included studies was rated using the Physiotherapy Evidence Database scale. A Cohen’s kappa score assessed the level of agreement. Outcome measurements were improvement of anthropometric and physical fitness variables, operation related complications, weight regain, and quality of life.
  
  
  RESULTS
  A total of 8 prospective studies were included. Four focused on training before and 4 on training after a bariatric procedure. Details of exercises varied from 45 min treadmill up to full descriptive programs. Supervision was frequently included. Significant improvement was encountered for biometric results physical fitness variables.
  
  
  CONCLUSIONS
  In the majority of reports on exercising in a (future) bariatric population, positive effects on anthropometrics, cardiovascular risk factors and physical fitness were described. However, the results were not unanimous, with a wide range of exercise programs and perioperative timing, therefore hampering adequate practical guidance.
authors.forename: Sjaak
authors.initials: S
authors.lastname: Pouwels
authors.forename: Marjon
authors.initials: M
authors.lastname: Wit
authors.forename: Joep A W
authors.initials: JA
authors.lastname: Teijink
authors.forename: Simon W
authors.initials: SW
authors.lastname: Nienhuijs
mesh_terms: D050110:Bariatric Surgery; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D015444:Exercise / Q000502:physiology*; D006801:Humans; D009765:Obesity / Q000601:surgery / Q000628:therapy*; D059035:Perioperative Period; D010809:Physical Fitness; D015431:Weight Loss