ABSTRACT
This paper provides a new management about the treatment of obesity, that have a growing incidence worldwide. A management centered on the patients' needs during the bariatric surgery is necessary. In this context, patient monitoring and follow-up by a case manager, who guides the provision of specialized care focused on patient's adaptation to the new reality, can prove to be essential to achieve better outcomes. This study, guided by the Design Science Research Methodology (DSRM), will have as main objective to design a new intervention (Case-managing program) aimed at patients undergoing bariatric surgery. As secondary objectives, we intend to analyze the influence of the new intervention in the perioperative period and impact on several clinical and humanistic endpoints. In the evaluation phase, an experimental, controlled, and randomized study (RCT) will be developed, with an intervention group (IG) and a control group (CG). The CG will receive the usual care and the IG, will receive the intervention for an expected period of one year. This project aims to be the first study to investigate the effect of a long-term specialized case-management intervention (face-to-face and e-health) in patients who are candidates for bariatric surgery during all the perioperative periods. This method presents: ⢠The results will be reported the patients related outcomes measures for bariatric surgery ⢠The results are expected to provide an overview of the most effective case management interventions for long-term better results on bariatric surgery ⢠Allowing researchers to design and propose a new case management for bariatric surgery.
ABSTRACT
Severe obesity is a chronic disease and bariatric surgery is the treatment with more proven efficacy in reducing weight. After surgery, the weight loss is greatly associated with a significant reduction of skeletal muscle and bone mineral mass, with an increased risk of sarcopenia for these patients. Prophylactic programs that prevent sarcopenia in bariatric surgery patients seems to be one of the crucial points for the long-term surgical success of bariatric and metabolic surgery. This article aims to describe a protocol using supervised exercise applied after bariatric surgery on skeletal muscle mass index, body composition and strength to determinate sarcopenia in bariatric patients. A RCT will be conducted with 46 patients. Baseline measures will be compared with measures after de exercise program, in five different chronologic times. Participants will be randomly allocated to: 1) combined exercise group or 2) control group. The intervention will be 16 weeks for a combined exercise, started 1 month after surgery. The present study is expected to generate significant information about the role of exercise in patients undergoing bariatric surgery.
ABSTRACT
Bariatric surgery is the treatment for severe obesity, with proven efficacy in reducing weight. Weight loss associated with bariatric surgery is greatly associated with a significant reduction of skeletal muscle and bone mineral mass, which leads us to induce that after bariatric surgery, patients incur an increased risk of sarcopenia. Prophylactic programs that prevent sarcopenia in bariatric surgery patients seems to be one of the crucial points for the long-term surgical success of bariatric and metabolic surgery. This article presents a initial data set of skeletal muscle mass index, body composition and strength to determinate sarcopenia in bariatric patients. The data were collected in a Central Hospital and in the University. In total, is necessary to recruit 46 patients waiting for bariatric surgery, between 18 and 60 years, men, and woman, without contradiction for exercise. The patients are randomized in two groups, for exercise group and control group. The evaluation is made on five points of timeline, before the surgery, after the surgery, after de exercise program, six months, and twelve months after the exercise program.
