運動介入措施對減重術後身體組成之成效

減重手術是治療病態性肥胖患者的方式之一，可使體重減輕以及減少與肥胖相關併發症的罹病率。儘管減重手術在初期有良好的效果，但術後仍有許多病人維持不良生活作息且運動參與度低而降低手術的成效。由於目前國內相關的研究缺乏且無整合性的文獻，故本文目的即以系統性文獻回顧法，整合與評價運動介入措施對病態性肥胖減重術後身體組成之實證。搜尋2009年至2019年12月前發表之中、英文文獻，資料庫包括：PubMed、MEDLINE、Cochrane Library、CINAHL、ProQuest及華藝線上圖書館等，關鍵字分別為：病態性肥胖、減重手術、運動介入、身體組成、morbid obesity、bariatric surgery、exercise interventions、body composition。文獻選取符合條件為運動介入措施，對病態性肥胖減重術後身體組成之成效的隨機分派臨床試驗，並以modified Jadad scale作為文章品質節選工具，共納入八篇研究。八篇研究之研究品質介於4至6.5分，屬於中等品質實證研究。介入措施包含：有氧運動介入與阻力訓練等方式以改善術後身體組成之成效，但目前實證證據的品質與數量仍偏低，且運動介入頻率、強度、時間及種類皆有所不同，建議未來研究宜朝向更為嚴謹、盲化、大規模的隨機控制試驗，以持續更新此實證結果。

關鍵字

病態性肥胖；減重手術；身體組成；系統性文獻回顧

並列摘要

Bariatric surgery is one of the treatment modalities for morbid obesity which provides good weight loss and resolve related comorbidities in the early stages. Patients who have irregular lifestyles and inadequate exercise reduce surgical outcomes. There is limited research and systematic review in this field. The aim of the study was to perform a systematic review to summarize the effectiveness of exercise intervention on body composition after bariatric surgery. This review focused on studies published between 2009 and December 2019 searching the following databases: PubMed, MEDLINE, Cochrane Library, CINAHL, ProQuest, and Airiti Library. The search used the following key search terms both alone and in combination: morbid obesity, bariatric surgery, gastric bypass, gastric sleeve, exercise interventions, and body composition. The studies were thoroughly assessed under the guidelines of the modified Jadad scale for randomized controlled trials. Eight articles met the criteria and were presented in this review. The eight studies showed middle-quality levels of evidence rated 4-6.5 in modified Jadad scale. The exercise interventions included aerobic exercise and resistance training. However, the quality of existing evidence relating to exercise on body composition after bariatric surgery patients was low. Furthermore, the exercise frequency, intensity, duration and mode of intervention are not in consistency. More rigorous research designs, randomized controlled trials and larger sample are required in the future.

並列關鍵字

bariatric surgery ； body composition ； morbid obesity ； systematic review

參考文獻

Reid RE, Carver TE, Andersen KM, et al. Physical activity and sedentary behavior in bariatric patients long-term post-surgery. Obes Surg 2015;25:1073-77.

Toussi R, Fujioka K, Coleman, KJ. Pre‐and postsurgery behavioral compliance, patient health, and postbariatric surgical weight loss. Obesity 2009;17:996-1002.

King WC, Chen JY, Bond DS, et al. Objective assessment of changes in physical activity and sedentary behavior: Pre‐through 3 years post‐bariatric surgery. Obesity 2015;23:1143-50.

Kulick D, Hark L, Deen D. The bariatric surgery patient: A growing role for registered dietitians. J Am Diet Assoc 2010;110:593-9.

Verheggen RJ, Maessen MF, Green DJ, et al. A systematic review and meta‐analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue. Obes Rev 2016;17:664-90.

國際替代計量

運動介入措施對減重術後身體組成之成效

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