Background: Severe obesity is associated to sarcopenic-like features, including a reduced muscle quality, as well as decreased muscle strength and physical performance. After bariatric surgery, which is currently the most effective treatment for severe obesity, a decrease in muscle strength is observed. Few studies have investigated the evolution of endurance and muscle fatigue following bariatric surgery, particularly in the context of a postoperative exercise training program. The aim of this study was to evaluate the effect of a 12-week supervised exercise program on muscle endurance and fatigue following bariatric surgery
METHODS AND RESULTS: Sixty participants who underwent bariatric surgery were randomly assigned to either: 1) the exercise group (aerobic and resistance training, three times weekly) or, 2) the control group (two meetings with a kinesiologist). Anthropometric measurements (bioelectrical impedance), lower-limb muscle endurance and fatigue measures (BIODEX dynamometer) were obtained before surgery, and at 3, 6, and 12 months post-surgery. Fifty participants (73% women, age 42±12 years, baseline values before surgery BMI 46.0±5.9 kg/m²) were included in the analysis, with 34 individuals in the exercise group and 16 persons in the control group (2:1 randomization). No significant differences were observed between the groups at baseline for all clinical characteristics. Bariatric surgery resulted in significant reductions in anthropometric measurements (BMI, fat mass, and lean mass) at 3, 6, and 12 months (p < 0.001), with no significant differences between groups (p>0.05). At 6 months, absolute muscle endurance (p=0.20) and muscle endurance relative to lean body mass (p=0.25) remained stable in both the control group and exercise groups (p=0.20 and p=0.25, respectively), while muscle endurance relative to body weight significantly improved in both groups (14.4±15.5% vs. 22.0±13.0%; p=0.08). Muscle fatigue remained stable in the control group, while it decreased in the exercise group at 6 months (-0.4±15.6% vs. -8.8±14.7%; p=0.05).
Conclusion: A 12-week supervised exercise program after bariatric surgery did not show superior efficacy compared to standard medical care in enhancing muscle endurance or preventing muscle fatigue. These findings highlight the need to further explore alternative exercise strategies in individuals with severe obesity aimed at maintaining muscle quality and function, as well as overall post-operative fitness outcomes.
