Authors (including presenting author) :
Lee S(1), Wong KT(1), Shum YS(1)
Affiliation :
(1)Physiotherapy Department, Prince of Wales Hospital
Introduction :
Metabolic and Bariatric surgery is an evidence-based practice for morbidly obese patients (1), with long-term weight loss of approximately 20-30% of initial weight of patients (2,3). In 2018, a Working Group of Development of Metabolic Surgery is formed in order to establish guideline and service model for a better management for this group of patients among Hospital Authority. This structured model is supported by a multi-disciplinary team including bariatric surgeon, anesthesiologist, nurse specialist coordinator, dietitian, endocrinologist, psychiatrist, psychologist, pharmacist and physiotherapist. First line treatment of pre-operative weight loss relies much on dietary and behavioral modification as well as exercise habit. Physiotherapist plays an important role in strengthening peri-operative support for patients in the areas of clinical assessment, education, pre-habilitation, and exercise. Moreover, continuity of lifestyle modification and exercise is crucial in determining long-term success for patients after surgery.
The aims of peri-operative management in physical aspect are weight reduction before surgery and weight reduction and restoration of patients’ physical capacity after surgery.
Objectives :
To compare the physical function and weight reduction of patients before and after surgery.
Methodology :
Patients on waiting list of metabolic and bariatric surgery were referred to physiotherapy Department of Prince of Wales Hospital for this program. The whole program consisted of one session of education class and exercise classes for peri-operative training. Assessment was conduct on the first physiotherapy appointment and at post-op 1 month and 3 months. Outcome measures were anthropometric measurement by (1) BMI (2) waist circumference (3) percentage body fat and physical outcomes by (4) 1-minute sit-up (5) sit and reach (6) 30 second chair-stand test. The results were analyzed with one-way repeated ANOVA analysis using paired t-test as post-hoc test.
Result & Outcome :
This study included a total of 19 participants in analysis. The results showed a significant reduction in BMI (p<0.001) and waist circumference (p<0.001) comparing pre-operation and post-operation for both 1- and 3-month follow up. A statistically significant increase in sit-and-reach distance (p=0.010) was demonstrated at 3-month follow up. The increase in means of 1-min sit-up test was found to have no statistical significance (p=0.409). No significant change in 30-second chair-stand test was showed comparing pre-operation and post-operation.
