title: Intervention-related increases in preoperative physical activity are maintained 6-months after Bariatric surgery: results from the bari-active trial.
abstract: Higher preoperative physical activity (PA) strongly predicts higher post-operative PA in bariatric surgery (BS) patients, providing rationale for preoperative PA interventions (PAIs). However, whether PAI-related increases can be maintained post-operatively has not been examined. This study compared PA changes across pre- (baseline, post-intervention) and post-operative (6-month follow up) periods in participants randomized to 6 weeks of preoperative PAI or standard care control (SC). Of 75 participants initially randomized, 36 (PAI n=22; SC n=14) underwent BS. Changes in daily bout-related (⩾10-min bouts) moderate-to-vigorous PA (MVPA) and steps were assessed via the SenseWear Armband monitor. PAI received weekly counseling to increase walking exercise. Retention (86%) at post-operative follow up was similar between groups. Intent-to-treat analyses showed that PAI vs SC had greater increases across time (baseline, post-intervention, follow up) in bout-related MVPA minutes/day (4.3±5.1, 26.3±21.3, 28.7±26.3 vs 10.4±22.9, 11.4±16.0, 18.5±28.2; P=0.013) and steps/day (5163±2901, 7950±3286, 7870±3936 vs 5163±2901, 5601±3368, 5087±2603; P<0.001). PAI differed from SC on bout-related MVPA at post-intervention (P=0.016; d=0.91), but not follow up (P=0.15; d=0.41), and steps at post-intervention (P=0.031; d=0.78) and follow up (P=0.024; d=0.84). PAI participants maintained preoperative PA increases post-operatively. Findings support preoperative PAIs and research to test whether PA changes can be sustained and influence surgical outcomes beyond the initial post-operative period.
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Bond
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Thomas
authors.affiliation: Department of Surgery, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA.
authors.forename: S
authors.initials: S
authors.lastname: Vithiananthan
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA.
authors.forename: J
authors.initials: J
authors.lastname: Unick
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA.
authors.forename: J
authors.initials: J
authors.lastname: Webster
authors.affiliation: Department of Surgery, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Roye
authors.affiliation: Department of Surgery, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Ryder
authors.affiliation: Department of Surgery, Cedars-Sinai Medicine, Hollywood, CA, USA.
authors.forename: H C
authors.initials: HC
authors.lastname: Sax
mesh_terms: D050110:Bariatric Surgery; D015444:Exercise / Q000502:physiology* / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009767:Obesity, Morbid / Q000503:physiopathology* / Q000517:prevention & control / Q000601:surgery*; D057234:Preoperative Period; D016138:Walking