A efetividade da atividade física em pacientes pós-cirurgia bariátrica: uma revisão integrativa
Data
2024-07-05
Autores
Urbinatti, Gisele Okuda 
Orientadores
Aveiro, Mariana Chaves
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A cirurgia bariátrica tornou-se uma abordagem eficaz para a perda de peso e melhora das comorbidades associadas à obesidade. O exercício pode ajudar a manter a massa muscular, aumentar a tensão e a carga nos ossos, ativar o metabolismo, aumentar a produção de glóbulos vermelhos e o peristaltismo intestinal, melhorar a função cardiopulmonar e geral, aumentar a mineralização óssea e ajudar a manter a independência. A capacidade funcional (CF) tem diminuído nos adultos devido às mudanças tecnológicas, à falta de exercícios e à alimentação inadequada. Para ter uma vida plena e saudável, o exercício é fundamental, pois a prática regular de exercícios físicos tem sido usada para reduzir o impacto do envelhecimento sobre a capacidade funcional e a qualidade de vida. Objetivo: Este trabalho tem como objetivo sintetizar as evidências na literatura sobre a efetividade do exercício físico pós cirurgia bariátrica em adultos de 18 a 60 anos sobre a capacidade funcional e qualidade de vida. Método: O presente estudo é uma revisão integrativa da literatura que utilizou duas bases de dados (BVS/LILACS e PubMed), utilizando os descritores: cirurgia bariátrica; teste de caminhada de 6 minutos; exercício físico; capacidade funcional; qualidade de vida, nos idiomas português, inglês e espanhol sobre as evidências na literatura sobre a efetividade do exercício físico pós cirurgia bariátrica em adultos de 18 a 60 anos. A estratégia de busca final foi realizada com o auxílio de uma bibliotecária profissional da universidade e tem como desfecho primário analisar a capacidade funcional de pacientes pós bariátrica através do teste de caminhada de 6 minutos. E como desfecho secundário, a melhora da qualidade de vida. Foi utilizada a Escala PEDro, o objetivo dessa escala é assistir usuários da base de dados PEDro no que se refere à qualidade metodológica de Estudos Controlados Aleatorizados (ECA) nos quesitos validade interna (critérios de 2 a 9) e descrição estatística (10 e 11). Resultados: A base de dado foi incluída no software Rayyan para triagem e foram rastreados 469 artigos após a retirada dos duplicados, depois de eliminar 466 artigos pela divergência de objetivos, desfecho, temas e testes, sobraram apenas 3 artigos e por um deles ser um protocolo de ensaio clínico e o outro apresentar uma comparação com foco em avaliar a efetividade da cirurgia bariátrica e não do treinamento, restaram apenas 1 artigo incluído. Esse artigo apresentou a comparação intergrupos com mudanças expressivas, por exemplo, metros percorridos em seis minutos no TC6min (mudança de 30,45 ± 8,8 [p = 0,001] para a intervenção vs. mudança de 0,91 ± 0,2 [p = 0,92] para o controle). De acordo com os critérios de avaliação da Escala PEDro, o artigo incluído apresenta nota 5 considerada razoável. Conclusão: Nas duas bases de dados utilizadas, quando analisadas pelo desfecho do teste de caminhada de 6 minutos, faltam evidências para comprovar a efetividade do exercício físico pós cirurgia bariátrica em adultos de 18 a 60 anos, considerando a capacidade funcional e qualidade de vida. Podemos concluir que existe baixa evidência sobre a efetividade do exercício de intensidade moderada e vigorosa sobre a capacidade funcional, avaliada pelo teste de caminhada de 6 minutos, de pessoas pós-cirurgia bariátrica.
Introduction: Bariatric surgery has become an effective approach for weight loss and improving comorbidities associated with obesity. Exercise can help maintain muscle mass, increase tension and load on bones, activate metabolism, increase red blood cell production and intestinal peristalsis, improve cardiopulmonary and general function, increase bone mineralization, and help maintain independence. Functional capacity (FC) has decreased in adults due to technological changes, lack of exercise and inadequate nutrition. To have a full and healthy life, exercise is essential, as regular physical exercise has been used to reduce the impact of aging on functional capacity and quality of life. Objective: This work aims to synthesize the evidence in the literature on the effectiveness of physical exercise after bariatric surgery in adults aged 18 to 60 years on functional capacity and quality of life. Method: The present study is an integrative review of the literature that used two databases (BVS/LILACS and PubMed), using the descriptors: bariatric surgery; 6-minute walk test; physical exercise; functional capacity; quality of life, in Portuguese, English and Spanish on the evidence in the literature on the effectiveness of physical exercise after bariatric surgery in adults aged 18 to 60 years. The final search strategy was carried out with the help of a professional librarian from the university and its primary outcome is to analyze the functional capacity of post-bariatric patients using the 6-minute walk test. And as a secondary outcome, improved quality of life. The PEDro Scale was used, the objective of this scale is to assist users of the PEDro database with regard to the methodological quality of Randomized Controlled Studies (RCTs) in terms of internal validity (criteria 2 to 9) and statistical description (10 and 11 ). Results: The database was included in the Rayyan software for screening and 469 articles were tracked after removing duplicates, after eliminating 466 articles due to divergence in objectives, outcome, themes and tests, only 3 articles remained and because one of them was a clinical trial protocol and the other presents a comparison focused on evaluating the effectiveness of bariatric surgery and not training, only 1 article remained included. This article presented an intergroup comparison with significant changes, for example, meters covered in six minutes in the 6MWT (change of 30.45 ± 8.8 [p = 0.001] for the intervention vs. change of 0.91 ± 0.2 [ p = 0.92] for control). According to the PEDro Scale evaluation criteria, the included article presents a score of 5 considered reasonable. Conclusion: In the two databases used, when analyzed by the outcome of the 6-minute walk test, there is a lack of evidence to prove the effectiveness of physical exercise after bariatric surgery in adults aged 18 to 60 years, considering functional capacity and quality of life. We can conclude that there is little evidence on the effectiveness of moderate and vigorous intensity exercise on functional capacity, assessed by the 6-minute walk test, in people after bariatric surgery.
Introduction: Bariatric surgery has become an effective approach for weight loss and improving comorbidities associated with obesity. Exercise can help maintain muscle mass, increase tension and load on bones, activate metabolism, increase red blood cell production and intestinal peristalsis, improve cardiopulmonary and general function, increase bone mineralization, and help maintain independence. Functional capacity (FC) has decreased in adults due to technological changes, lack of exercise and inadequate nutrition. To have a full and healthy life, exercise is essential, as regular physical exercise has been used to reduce the impact of aging on functional capacity and quality of life. Objective: This work aims to synthesize the evidence in the literature on the effectiveness of physical exercise after bariatric surgery in adults aged 18 to 60 years on functional capacity and quality of life. Method: The present study is an integrative review of the literature that used two databases (BVS/LILACS and PubMed), using the descriptors: bariatric surgery; 6-minute walk test; physical exercise; functional capacity; quality of life, in Portuguese, English and Spanish on the evidence in the literature on the effectiveness of physical exercise after bariatric surgery in adults aged 18 to 60 years. The final search strategy was carried out with the help of a professional librarian from the university and its primary outcome is to analyze the functional capacity of post-bariatric patients using the 6-minute walk test. And as a secondary outcome, improved quality of life. The PEDro Scale was used, the objective of this scale is to assist users of the PEDro database with regard to the methodological quality of Randomized Controlled Studies (RCTs) in terms of internal validity (criteria 2 to 9) and statistical description (10 and 11 ). Results: The database was included in the Rayyan software for screening and 469 articles were tracked after removing duplicates, after eliminating 466 articles due to divergence in objectives, outcome, themes and tests, only 3 articles remained and because one of them was a clinical trial protocol and the other presents a comparison focused on evaluating the effectiveness of bariatric surgery and not training, only 1 article remained included. This article presented an intergroup comparison with significant changes, for example, meters covered in six minutes in the 6MWT (change of 30.45 ± 8.8 [p = 0.001] for the intervention vs. change of 0.91 ± 0.2 [ p = 0.92] for control). According to the PEDro Scale evaluation criteria, the included article presents a score of 5 considered reasonable. Conclusion: In the two databases used, when analyzed by the outcome of the 6-minute walk test, there is a lack of evidence to prove the effectiveness of physical exercise after bariatric surgery in adults aged 18 to 60 years, considering functional capacity and quality of life. We can conclude that there is little evidence on the effectiveness of moderate and vigorous intensity exercise on functional capacity, assessed by the 6-minute walk test, in people after bariatric surgery.
Descrição
Citação
URBINATTI, Gisele Okuda. A efetividade da atividade física em pacientes pós-cirurgia bariátrica: uma revisão integrativa. 2024. 24 f. Trabalho de conclusão de curso (Graduação em Fisioterapia) - Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Santos, 2024.