Articles In Press / Online First                   Back to the articles list | Back to browse issues page

XML Print

1- College of Sport Science, University of Kalba, Sharjah, United Arab Emirates. ,
2- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece.
3- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
4- Laboratory of Experimental Physiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
5- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kelantan, Malaysia.
6- Laboratory of Sports Medicine, Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Abstract:   (119 Views)
Background. Obesity is considered a major global public health issue. Interestingly, physical exercise has a vital role in preventing, managing, and treating obesity. However, bariatric surgery has been reported as an effective treatment option.
Objectives. The present trial aimed to investigate the effectiveness of a 6-month, real-world, multi-component exercise intervention with bariatric surgery to improve anthropometric and physical function parameters in individuals with obesity.
Methods. Seventy-one individuals (73% female, mean age: 39.7±20.3 years) with obesity (mean body mass index: 38.4±3.0 kg/m2) were recruited, and 69 completed the study. Participants were divided into i) exercise group (EX, n=25; randomly assigned), ii) bariatric surgery group (BS, n=23; group-randomized), and iii) non-exercise and non-surgical control group (C, n=23; randomly assigned). Anthropometric parameters, handgrip strength, functional aerobic capacity, and flexibility were assessed at baseline and after six months.
Results. The EX and BS groups experienced beneficial changes in anthropometrics, functional aerobic capacity, and flexibility compared with C (p<0.001). BS demonstrated greater improvements in anthropometrics and functional aerobic capacity than C (p<0.05), while EX showed higher increases in handgrip strength than BS (p<0.05). Also, moderate negative and positive associations were found between anthropometrics and physical function changes in EX and BS, respectively.
Conclusion. A multi-component exercise programming approach could enhance physical capabilities. At the same time, bariatric surgery improved anthropometric characteristics, suggesting that surgical interventions may improve body composition but not muscular fitness in individuals living with obesity
Full-Text [PDF 587 kb]   (29 Downloads)    
  • Bariatric surgery shows a greater influence on anthropometrics than the multi-component exercise program in adults living with obesity.
  • A multi-component exercise program shows greater improvements in muscular fitness among individuals with obesity.
  • Clinicians and practitioners should promote multi-component exercise programs to their patients with obesity to achieve not only weight loss goals but also physical performance ones.

Type of Study: Original Article | Subject: Sport Physiology and its related branches
Received: 2024/01/3 | Accepted: 2024/03/23

1. 1. Bray GA, Heisel WE, Afshin A, Jensen MD, Dietz WH, Long M, et al. The Science of Obesity Management: An Endocrine Society Scientific Statement. Endocr Rev. 2018 Mar 6;39(2):79-132. [DOI:10.1210/er.2017-00253] [PMID] []
2. Sidenur B, Gowrishankar, Mupparapu S. Prevalence of Obesity and Overweight and Its Correlates among 20-40 Year Old Population in an Urban Area in Southern India. National Journal of Community Medicine. 2022 Feb 28;13(02):114-9. [DOI:10.55489/njcm1322022161]
3. Finucane MM, Stevens GA, Cowan M, Danaei G, Lin JK, Paciorek CJ, et al. National, regional, and global trends in body mass index since 1980: Systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011 Feb 12;377(9765):557-67. [DOI:10.1016/S0140-6736(10)62037-5] [PMID]
4. Kissler HJ, Settmacher U. Bariatric surgery to treat obesity. Semin Nephrol. 2013 Jan;33(1):75-89. [DOI:10.1016/j.semnephrol.2012.12.004] [PMID]
5. Benaiges D, Goday A, Pedro-Botet J, Más A, Chillarón JJ, Flores-Le Roux JA. Bariatric surgery: to whom and when? Minerva Endocrinol. 2015 Jun;40(2):119-28. [DOI:10.1093/ajh/hpw064] [PMID]
6. Tak YJ, Lee SY. Long-Term Efficacy and Safety of Anti-Obesity Treatment: Where Do We Stand? Curr Obes Rep. 2021;10:14-30. [DOI:10.1007/s13679-020-00422-w] [PMID] []
7. Kushner RF. Weight Loss Strategies for Treatment of Obesity: Lifestyle Management and Pharmacotherapy. Prog Cardiovasc Dis. 2018;61:246-252. [DOI:10.1016/j.pcad.2018.06.001] [PMID]
8. Butsch WS. Obesity medications: What does the future look like? Curr Opin Endocrinol Diabetes Obes. 2015;22:360-366. [DOI:10.1097/MED.0000000000000192] [PMID]
9. Coen PM, Tanner CJ, Helbling NL, Dubis GS, Hames KC, Xie H, et al. Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity. J Clin Invest. 2015 Jan 2;125(1):248-57. [DOI:10.1172/JCI78016] [PMID] []
10. Melton GB, Steele KE, Schweitzer MA, Lidor AO, Magnuson TH. Suboptimal Weight Loss after Gastric Bypass Surgery: Correlation of Demographics, Comorbidities, and Insurance Status with Outcomes. J Gastrointest Surg. 2008 Feb 1;12(2):250-5. [DOI:10.1007/s11605-007-0427-1] [PMID]
11. Pinto-bastos A, Conceição EM, Machado PP, P. Reoperative Bariatric Surgery: a Systematic Review of the Reasons for Surgery, Medical and Weight Loss Outcomes, Relevant Behavioral Factors. Obesity Surgery. 2017 Oct;27(10):2707-15. [DOI:10.1007/s11695-017-2855-7] [PMID]
12. Alfadda AA, Al-Naami MY, Masood A, Elawad R, Isnani A, Ahamed SS, et al. Long-Term Weight Outcomes after Bariatric Surgery: A Single Center Saudi Arabian Cohort Experience. Journal of Clinical Medicine. 2021 Jan;10(21):4922. [DOI:10.3390/jcm10214922] [PMID] []
13. Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean APH, MacLean LD. Surgery decreases long-term mortality, morbidity, and healthcare use in morbidly obese patients. Ann Surg. 2004;240:416-423; discussion 423-4. [DOI:10.1097/01.sla.0000137343.63376.19] [PMID] []
14. Salem L, Jensen CC, Flum DR. Are bariatric surgical outcomes worth their cost? A systematic review. J Am Coll Surg. 2005;200:270. [DOI:10.1016/j.jamcollsurg.2004.09.045] [PMID]
15. Jakicic JM, Tate DF, Lang W, Davis KK, Polzien K, Neiberg RH, et al. Objective Physical Activity and Weight Loss in Adults: The Step-Up Randomized Clinical Trial. Obesity (Silver Spring). 2014 Nov;22(11):2284-92. [DOI:10.1002/oby.20830] [PMID] []
16. El Ansari W, Elhag W. Weight Regain and Insufficient Weight Loss After Bariatric Surgery: Definitions, Prevalence, Mechanisms, Predictors, Prevention and Management Strategies, and Knowledge Gaps-a Scoping Review. Obes Surg. 2021;31(4):1755-66. [DOI:10.1007/s11695-020-05160-5] [PMID] []
17. Villa-González E, Barranco-Ruiz Y, Rodríguez-Pérez MA, Carretero-Ruiz A, García-Martínez JM, Hernández-Martínez A, et al. Supervised exercise following bariatric surgery in morbid obese adults: CERT-based exercise study protocol of the EFIBAR randomised controlled trial. BMC Surg. 2019 Sep 5;19:127. [DOI:10.1186/s12893-019-0566-9] [PMID] []
18. Jakicic JM, Davis KK. Obesity and physical activity. Psychiatr Clin North Am. 2011 Dec;34(4):829-40. [DOI:10.1016/j.psc.2011.08.009] [PMID]
19. Slentz CA, Tanner CJ, Bateman LA, Durheim MT, Huffman KM, Houmard JA, Kraus WE. Effects of exercise training intensity on pancreatic beta-cell function. Diabetes Care. 2009;32:1807-1811. [DOI:10.2337/dc09-0032] [PMID] []
20. Miller CT, Fraser SF, Levinger I, Straznicky NE, Dixon JB, Reynolds J, et al. The Effects of Exercise Training in Addition to Energy Restriction on Functional Capacities and Body Composition in Obese Adults during Weight Loss: A Systematic Review. PLoS One. 2013 Nov 25;8(11):e81692. [DOI:10.1371/journal.pone.0081692] [PMID] []
21. Skrypnik D, Bogdański P, Mądry E, Karolkiewicz J, Ratajczak M, Kryściak J, et al. Effects of Endurance and Endurance Strength Training on Body Composition and Physical Capacity in Women with Abdominal Obesity. Obes Facts. 2015 Jun;8(3):175-87. [DOI:10.1159/000431002] [PMID] []
22. Jakicic JM, Rogers RJ, Church TS. Physical activity in the new era of antiobesity medications. Obesity (Silver Spring). 2024 Feb;32(2):234-6. [DOI:10.1002/oby.23930] [PMID]
23. Vanhees L, Geladas N, Hansen D, Kouidi E, Niebauer J, Reiner Ž, Cornelissen V, Adamopoulos S, Prescott E, Börjesson M; on behalf of the writing group. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (Part II). Eur J Prev Cardiol. 2012;19:1005-1033. [DOI:10.1177/2047487312437059]
24. Ren Y, Li L, Peng T, Tan Y, Sun Y, Cheng G, Zhang G, Li J. The effect of milrinone on mortality in adult patients who underwent CABG surgery: A systematic review of randomized clinical trials with a meta-analysis and trial sequential analysis. BMC Cardiovasc Disord. 2020;20:328. [DOI:10.1186/s12872-020-01598-8] [PMID] []
25. Baillot A, St-Pierre M, Bernard P, Burkhardt L, Chorfi W, Oppert JM, Bellicha A, Brunet J. Exercise and bariatric surgery: A systematic review and meta-analysis of the feasibility and acceptability of exercise and controlled trial methods. Obes Rev. 2022;23:e13480. [DOI:10.1111/obr.13480] [PMID]
26. Stults-Kolehmainen MA, Bond DS, Richardson LA, Herring LY, Mulone B, Garber CE, Morton J, Ghiassi S, Duffy AJ, Balk E, et al. Role of the exercise professional in metabolic and bariatric surgery. Surg Obes Relat Dis. 2023;20:98-108. [DOI:10.1016/j.soard.2023.09.026] [PMID]
27. Fonseca-Junior SJ, Sá CG, Rodrigues PA, Oliveira AJ, Fernandes-Filho J. Physical exercise and morbid obesity: a systematic review. Arq Bras Cir Dig. 2013;26:67-73. [DOI:10.1590/S0102-67202013000600015] [PMID]
28. Thompson PD. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease. Arterioscler Thromb Vasc Biol. 2003;23:1319-21. [DOI:10.1161/01.ATV.0000087143.33998.F2] [PMID]
29. Gilyana M, Batrakoulis A, Zisi V. Physical Activity, Body Image, and Emotional Intelligence Differences in Adults with Overweight and Obesity. Diseases. 2023;11:71. [DOI:10.3390/diseases11020071] [PMID] []
30. Kercher VM, Kercher K, Levy P, Bennion T, Alexander C, Amaral PC, Batrakoulis A, Chávez LFJG, Cortés-Almanzar P, Haro JL, et al. 2023 Fitness Trends from Around the Globe. ACSMs Health Fit J. 2023;27:19-30. [DOI:10.1249/FIT.0000000000000836]
31. Batrakoulis A, Jamurtas AZ, Fatouros IG. Exercise and type II diabetes mellitus: A brief guide for exercise professionals. Strength Cond J. 2022;44:64-72. [DOI:10.1519/SSC.0000000000000731]
32. Batrakoulis A, Fatouros IG. Psychological adaptations to high-intensity interval training in overweight and obese adults: A topical review. Sports. 2022;10:64. [DOI:10.3390/sports10050064] [PMID] []
33. Batrakoulis A. Psychophysiological Adaptations to Pilates Training in Overweight and Obese Individuals: A Topical Review. Diseases. 2022;10:71. [DOI:10.3390/diseases10040071]
34. Batrakoulis A. Psychophysiological Adaptations to Yoga Practice in Overweight and Obese Individuals: A Topical Review. Diseases. 2022;10:107. [DOI:10.3390/diseases10040071] [PMID] []
35. Batrakoulis A. Role of Mind-Body Fitness in Obesity. Diseases. 2023;11:1. [DOI:10.3390/diseases11010001] [PMID] []
36. Batrakoulis A, Jamurtas AZ, Fatouros IG. High-Intensity Interval Training in Metabolic Diseases: Physiological Adaptations. ACSMs Health Fit J. 2021;25:54-59. [DOI:10.1249/FIT.0000000000000703]
37. Batrakoulis A, Jamurtas AZ, Metsios GS, Perivoliotis K, Liguori G, Feito K, Riebe D, Thompson WR, Angelopoulos TJ, Krustrup P, et al. Comparative efficacy of five exercise types on cardiometabolic health in overweight and obese adults: A systematic review and network meta-analysis of randomized controlled trials. Circ Cardiovasc Qual Outcomes. 2022;15:e008243. [DOI:10.1161/CIRCOUTCOMES.121.008243] [PMID]
38. Egberts K, Brown WA, Brennan L, O'Brien PE. Does Exercise Improve Weight Loss after Bariatric Surgery? A Systematic Review. Obes Surg. 2012;22:335-341. [DOI:10.1007/s11695-011-0544-5] [PMID]
39. Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, Ko CY, Gibbons MM. Exercise Following Bariatric Surgery: Systematic Review. Obes Surg. 2010;20:657-665. [DOI:10.1007/s11695-010-0096-0] [PMID] []
40. Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, Hróbjartsson A, Mann H, Dickersin K, Berlin JA, et al. SPIRIT 2013 Statement: Defining Standard Protocol Items for Clinical Trials. Ann Intern Med. 2013;158:200. [DOI:10.7326/0003-4819-158-3-201302050-00583] [PMID] []
41. Murray DM, Varnell SP, Blitstein JL. Design and analysis of group-randomized trials: A review of recent methodological developments. Am J Public Health. 2004;94:423 -432. [DOI:10.2105/AJPH.94.3.423] [PMID] []
42. Batrakoulis A, Fatouros IG, Chatzinikolaou A, Draganidis D, Georgakouli K, Papanikolaou K, Deli CK, Tsimeas P, Avloniti A, Syrou N, Jamurtas AZ. Dose-response effects of high-intensity interval neuromuscular exercise training on weight loss, performance, health and quality of life in inactive obese adults: Study rationale, design and methods of the DoIT trial. Contemp Clin Trials Commun. 2019;15:100386. [DOI:10.1016/j.conctc.2019.100386] [PMID] []
43. Batrakoulis A, Jamurtas AZ, Georgakouli K, Draganidis D, Deli CK, Papanikolaou K, Avloniti A, Chatzinikolaou A, Leontsini D, Tsimeas P, et al. High intensity, circuit-type integrated neuromuscular training alters energy balance and reduces body mass and fat in obese women: A 10-month training-detraining randomized controlled trial. PLoS One. 2018;13:e0202390. [DOI:10.1371/journal.pone.0202390] [PMID] []
44. Borg E, Kaijser L. A comparison between three rating scales for perceived exertion and two different work tests. Scand J Med Sci Sports. 2006;16:57-69. [DOI:10.1111/j.1600-0838.2005.00448.x] [PMID]
45. American College of Sports Medicine, Liguori G, Feito Y, Fountaine C, Roy BA. ACSM's Guidelines for Exercise Testing and Prescription, 11th ed. Wolters Kluwer Health: Philadelphia, PA, USA, 2021; pp. 296-299.
46. World Health Organization. Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation, World Health Organization: Geneva, Switzerland, 2008.
47. Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, Sayer AA. A review of the measurement of grip strength in clinical and epidemiological studies: Towards a standardised approach, Age Ageing. 2011;40:423-429. [DOI:10.1093/ageing/afr051] [PMID]
48. Enright PL. The Six-Minute Walk Test. Respir Care. 2003;48:783-785.
49. Mayorga-Vega D, Merino-Marban R, Viciana J. Criterion-Related Validity of Sit-and-Reach Tests for Estimating Hamstring and Lumbar Extensibility: A Meta-Analysis. J Sports Sci Med. 2014;13:1-14. [DOI:10.4100/jhse.2014.91.18]
50. Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Front Psychol. 2013;4:863. [DOI:10.3389/fpsyg.2013.00863] [PMID] []
51. Eisenberg D, Shikora SA, Aarts E, Aminian A, Angrisani L, Cohen RV, et al. 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity andMetabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery. Obes Surg. 2023;33(1):3-14. [DOI:10.1007/s11695-022-06332-1] []
52. Sjöström CD, Lissner L, Wedel H, Sjöström L. Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: The SOS Intervention Study. Obes Res. 1999;7:477-484. [DOI:10.1002/j.1550-8528.1999.tb00436.x] [PMID]
53. Ionut V, Burch M, Youdim A, Bergman RN. Gastrointestinal Hormones and Bariatric Surgery-induced Weight Loss. Obesity (Silver Spring). 2013;21:1093-1103. [DOI:10.1002/oby.20364] [PMID] []
54. Sánchez-Alcoholado L, Gutiérrez-Repiso C, Gómez-Pérez AM, García-Fuentes E, Tinahones FJ, Moreno-Indias I. Gut microbiota adaptation after weight loss by Roux-en-Y gastric bypass or sleeve gastrectomy bariatric surgeries. Surg Obes Relat Dis. 2019;15:1888-1895. [DOI:10.1016/j.soard.2019.08.551] [PMID]
55. De Luca M, Angrisani L, Himpens J, Busetto L, Scopinaro N, Weiner R, Sartori A, Stier C, Lakdawala M, Bhasker AG, et al. Indications for Surgery for Obesity and Weight-Related Diseases: Position Statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Obes Surg. 2016;26:1659-1696. [DOI:10.1007/s11695-016-2271-4] [PMID] []
56. Ross R. Reduction in Obesity and Related Comorbid Conditions after Diet-Induced Weight Loss or Exercise-Induced Weight Loss in Men: A Randomized, Controlled Trial. Ann Intern Med. 2000;133:92. [DOI:10.7326/0003-4819-133-2-200007180-00008] [PMID]
57. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Impact of Physical Inactivity on the World's Major Non-Communicable Diseases. Lancet. 2012;380:219-229. [DOI:10.1016/S0140-6736(12)61873-X] [PMID]
58. Courcoulas AP, Christian NJ, Belle SH, Berk PD, Flum DR, Garcia L, Horlick M, Kalarchian MA, King WC, Mitchell JE, et al. Weight Change and Health Outcomes at Three Years After Bariatric Surgery Among Patients with Severe Obesity. JAMA. 2013;310:2416-2425. [DOI:10.1001/jama.2013.280928]
59. Swift DL, Johannsen NM, Lavie CJ, Earnest CP, Church TS. The Role of Exercise and Physical Activity in Weight Loss and Maintenance. Prog Cardiovasc Dis. 2014;56:441-447. [DOI:10.1016/j.pcad.2013.09.012] [PMID] []
60. Rothwell L, Kow L, Toouli J. Effect of a Post-operative Structured Exercise Programme on Short-Term Weight Loss After Obesity Surgery Using Adjustable Gastric Bands. Obes Surg. 2015;25:126-128. [DOI:10.1007/s11695-014-1323-x] [PMID]
61. Murai IH, Roschel H, Dantas WS, Gil S, Merege-Filho C, de Cleva R, de Sá-Pinto AL, Lima F, Santo MA, Benatti FB, et al. Exercise Mitigates Bone Loss in Women With Severe Obesity After Roux-en-Y Gastric Bypass: A Randomized Controlled Trial. J Clin Endocrinol Metab. 2019;104:4639-4650. [DOI:10.1210/jc.2019-00074] [PMID]
62. Ross, R.; Goodpaster, B.H.; Koch, L.G.; Sarzynski, M.A.; Kohrt, W.M.; Johannsen, N.M.; Skinner, J.S.; Castro, A.; Irving, B.A.; Noland, R.C.; et al. Precision exercise medicine: Un-derstanding exercise response variability. Br. J. Sports Med. 2019, 53, 1141-1153. [DOI:10.1136/bjsports-2018-100328] [PMID] []
63. Hassannejad A, Khalaj A, Mansournia MA, Rajabian Tabesh M, Alizadeh Z. The Effect of Aerobic or Aerobic-Strength Exercise on Body Composition and Functional Capacity in Patients with BMI ≥35 after Bariatric Surgery: a Randomized Control Trial. Obes Surg. 2017;27:2792-2801. [DOI:10.1007/s11695-017-2717-3] [PMID]
64. Dereppe H, Forton K, Pauwen NY, Faoro V. Impact of Bariatric Surgery on Women Aerobic Exercise Capacity. Obes Surg. 2019;29:3316-3323. [DOI:10.1007/s11695-019-03996-0] [PMID]
65. Zhou N, Scoubeau C, Forton K, Loi P, Closset J, Deboeck G, Moraine JJ, Klass M, Faoro V. Lean Mass Loss and Altered Muscular Aerobic Capacity after Bariatric Surgery. Obes Facts. 2022;15:248-256. [DOI:10.1159/000521242] [PMID] []
66. Jiang Y, Tan S, Wang Z, Guo Z, Li Q, Wang J. Aerobic exercise training at maximal fat oxidation intensity improves body composition, glycemic control, and physical capacity in older people with type 2 diabetes. J Exerc Sci Fit. 2020;18:7-13. [DOI:10.1016/j.jesf.2019.08.003] [PMID] []
67. Pearl RL, Wadden TA, Tronieri JS, Berkowitz RI, Chao AM, Alamuddin N, Leonard SM, Carvajal R, Bakizada ZM, Pinkasavage E, et al. Short- and Long-Term Changes in Health-Related Quality of Life with Weight Loss: Results from a Randomized Controlled Trial. Obesity (Silver Spring). 2018;26:985-991. [DOI:10.1002/oby.22187] [PMID] []
68. Vaurs C, Diméglio C, Charras L, Anduze Y, Chalret du Rieu M, Ritz P. Determinants of changes in muscle mass after bariatric surgery. Diabetes Metab. 2015;41:416-421. [DOI:10.1016/j.diabet.2015.04.003] [PMID]
69. Nuijten MAH, Eijsvogels TMH, Monpellier VM, Janssen IMC, Hazebroek EJ, Hopman MTE. The magnitude and progress of lean body mass, fat-free mass, and skeletal muscle mass loss following bariatric surgery: A systematic review and meta-analysis. Obes Rev. 2022;23:e13370. [DOI:10.1111/obr.13370] [PMID] []
70. Martínez MC, Meli EF, Candia FP, Filippi F, Vilallonga R, Cordero E, Hernández I, Eguinoa AZ, Burgos R, Vila A, Simó R, Ciudin A. The Impact of Bariatric Surgery on the Muscle Mass in Patients with Obesity: 2-Year Follow-up. Obes Surg. 2022;32:625-633. [DOI:10.1007/s11695-021-05815-x] [PMID] []
71. Gil S, Kirwan JP, Murai IH, Dantas WS, Merege-Filho CAA, Ghosh S, Shinjo SK, Pereira RMR, Teodoro WR, Felau SM, et al. A randomized clinical trial on the effects of exercise on muscle remodelling following bariatric surgery. J Cachexia Sarcopenia Muscle. 2021;12:1440-1455. [DOI:10.1002/jcsm.12815] [PMID] []
72. Coral RV, Bigolin AV, Machry MC, Menguer RK, Pereira-Lima JC, Contin I, Stock PV. Improvement in Muscle Strength and Metabolic Parameters Despite Muscle Mass Loss in the Initial Six Months After Bariatric Surgery. Obes Surg. 2021;31:4485-4491. [DOI:10.1007/s11695-021-05634-0] [PMID]
73. Rolland Y, Lauwers-Cances V, Cristini C, Abellan van Kan G, Janssen I, Morley JE, Vellas B. Difficulties with physical function associated with obesity, sarcopenia, and sarcopenic-obesity in community-dwelling elderly women: The EPIDOS (EPIDemiologie de l'OSteoporose) Study. Am J Clin Nutr. 2009;89:1895-1900. [DOI:10.3945/ajcn.2008.26950] [PMID]
74. Oppert J-M, Bellicha A, Roda C, Bouillot J-L, Torcivia A, Clement K, Poitou C, Ciangura C. Resistance Training and Protein Supplementation Increase Strength After Bariatric Surgery: A Randomized Controlled Trial. Obesity (Silver Spring). 2018;26:1709-1720. Available from: [DOI:10.1002/oby.22317] [PMID]
75. Otto M, Kautt S, Kremer M, Kienle P, Post S, Hasenberg T. Handgrip Strength as a Predictor for Post Bariatric Body Composition. Obes Surg. 2014;24:2082-2088. [DOI:10.1007/s11695-014-1299-6] [PMID]
76. Herring LY, Stevinson C, Davies MJ, Biddle SJ, Sutton C, Bowrey D, Carter P. Changes in physical activity behaviour and physical function after bariatric surgery: A systematic review and meta-analysis. Obes Rev. 2016;17:250-261. [DOI:10.1111/obr.12361] [PMID]
77. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111-117. [DOI:10.1164/ajrccm.166.1.at1102] [PMID]
78. Du H, Wonggom P, Tongpeth J, Clark R. Six-Minute Walk Test for Assessing Physical Functional Capacity in Chronic Heart Failure. Curr Heart Fail Rep. 2017;14:158-166. [DOI:10.1007/s11897-017-0330-3] [PMID]
79. Wang Y, Li F, Blaha O, Meng C, Esserman D. Design and analysis of partially randomized preference trials with propensity score stratification. Stat Methods Med Res. 2022;31:1515-1537. [DOI:10.1177/09622802221095673] [PMID] []
80. Al-Mhanna SB, Rocha-Rodriguesc S, Mohamed M, Batrakoulis A, Aldhahi MI, Afolabi HA, Yagin FH, Alhussain MH, Gülü M, Abubakar BD, et al. Effects of combined aerobic exercise and diet on cardiometabolic health in patients with obesity and type 2 diabetes: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil. 2023;15:165. [DOI:10.1186/s13102-023-00766-5] [PMID] []
81. Batrakoulis A, Jamurtas AZ, Draganidis D, Georgakouli K, Tsimeas P, Poulios A, Syrou N, Deli CK, Papanikolaou K, Tournis S, Fatouros IG. Hybrid Neuromuscular Training Improves Cardiometabolic Health and Alters Redox Status in Inactive Overweight and Obese Women: A Randomized Controlled Trial. Antioxidants (Basel). 2021;10:1061. [DOI:10.3390/antiox10101601] [PMID] []
82. Batrakoulis A, Jamurtas AZ, Tsimeas P, Poulios A, Perivoliotis K, Syrou N, Papanikolaou K, Draganidis D, Deli CK, Metsios GS, Angelopoulos TJ, Feito Y, Fatouros IG. Hybrid-type, multicomponent interval training upregulates musculoskeletal fitness of adults with overweight and obesity in a volume-dependent manner: A 1-year dose-response randomized controlled trial. Eur J Sport Sci. 2023;23:432-443. [DOI:10.1080/17461391.2021.2025434] [PMID]
83. Batrakoulis A, Loules G, Georgakouli K, Tsimeas P, Draganidis D, Chatzinikolaou A, Papanikolaou K, Deli CK, Syrou N, Comoutos N, Theodorakis Y, Jamurtas AZ, Fatouros IG. High-intensity interval neuromuscular training promotes exercise behavioral regulation, adherence and weight loss in inactive obese women. Eur J Sport Sci. 2020;20:783-792. [DOI:10.1080/17461391.2019.1663270] [PMID]
84. Batrakoulis A, Tsimeas P, Deli CK, Vlachopoulos D, Ubago-Guisado E, Poulios A, Chatzinikolaou A, Draganidis D, Papanikolaou K, Georgakouli K, Batsilas D, Gracia-Marco L, Jamurtas AZ, Fatouros I. Hybrid neuromuscular training promotes musculoskeletal adaptations in inactive overweight and obese women: A training-detraining randomized controlled trial. J Sports Sci. 2021;39:503-512. [DOI:10.1080/02640414.2020.1830543] [PMID]
85. Meli EF, Candia FP, Filippi F, Vilallonga R, Cordero E, Hernández I, Eguinoa AZ, Burgos R, Vila A, et al. The Impact of Bariatric Surgery on the Muscle Mass in Patients with Obesity: 2-Year Follow-up. Obes Surg. 2022;32:625-633. [DOI:10.1007/s11695-021-05815-x] [PMID] []
86. Al-Mhanna SB, Wan Ghazali WS, Batrakoulis A, Alkhamees NH, Drenowatz C, Mohamed M, Gülü M, Afolabi HA, Badicu G. Impact of Various Types of Exercise on Lipid Metabolism in Patients with Type 2 Diabetes and Concurrent Overweight/Obesity: A Narrative Review. Ann Appl Sport Sci. (InPress):e1324.
87. Al-Mhanna SB, Leão C, Wan Ghazali WS, Mohamed M, Batrakoulis A, Afolabi HA, Abubakar BD, Aldhahi MI, Gülü M, Yagin FA, Nikolaidis PT. Impact of Exercise on High-Density Lipoprotein Cholesterol in Adults with Overweight and Obesity: A Narrative Review. Ann Appl Sport Sci. (InPress):e1300.
88. Newsome AM, Reed R, Sansone J, Batrakoulis A, McAvoy C, Parrott MW. 2024 ACSM Worldwide Fitness Trends: Future Directions of the Health and Fitness Industry. ACSMs Health Fit J. 2024;28:14-26. [DOI:10.1249/FIT.0000000000000933]

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Annals of Applied Sport Science

Designed & Developed by : Yektaweb