The Impact of Abdominal Body Contouring Surgery on Physical Function After Massive Weight Loss: A Pilot Prospective Matched Comparison.

BACKGROUND: Many individuals develop excess skin (ES) following massive weight loss (MWL). Patient-reported outcomes demonstrate that abdominal ES negatively impacts perceived physical function which is improved by abdominal body contouring surgery (ABCS). However, the effect of ABCS on objective measures of physical function is unknown. OBJECTIVES: The aim of this study was to examine the impact of ABCS on objective measures of physical function in individuals who have undergone MWL. METHODS: Patients who have undergone MWL with abdominal ES (grade, ≥2) underwent the following physical function assessments: 9-item modified physical performance test (mPPT), chair stand, star excursion balance test (SEBT), timed up and go (TUG), modified agility T test, and 6-minute walk test (6-MWT). Perception of physical exertion and BODY-Q questionnaire scales were also collected. Nonsurgical controls (n = 21) and those who had undergone ABCS (n = 6) after the first visit performed a second physical function assessment 8 to 12 weeks later to allow for postoperative healing. RESULTS: No ceiling or floor effect was detected for any physical function measure. The intraclass correlation coefficient was 0.78 (95% CI, 0.44, 0.91) for the mPPT and >0.80 for all other measures. The effect sizes were 0.74 (75% CI, 0.19, 1.28) for the mPPT, 0.54 (75% CI, 0.00, 1.08) for the SEBT, -0.63 (75% CI, -1.17, -0.09) for the modified agility T test, and 0.79 (75% CI, 0.24, 0.13) for the 6-MWT. CONCLUSIONS: The mPPT and tests involving dynamic balance, agility, and walking were reliable and showed medium to large effect sizes, suggesting that these tests may be sensitive to change following ABCS.

Higher- and lower-load resistance exercise training induce load-specific local muscle endurance changes in young women: a randomised trial.

The effect of resistance training with higher- and lower-loads on muscle mass and strength has been extensively studied, while changes in muscle endurance have received less attention. This trial aimed to assess the effect of training load on absolute muscle endurance (AME) and relative muscle endurance (RME). Sixteen untrained women (22.7 ± 3.3 yr: mean ± SD) had one arm and leg randomly assigned to train with higher loads (HL; 80-90% 1RM), and the contralateral limbs trained with lower loads (LL; 30-50% 1RM) thrice weekly to volitional fatigue for 10 weeks. Heavy and light load AME and RME, strength, and muscle mass were assessed pre- and post-training. Strength increased more in the HL compared to LL leg (P < 0.01), but similar increases in strength were observed between upper body conditions (P = 0.46). Lower body heavy and light load AME improved in both conditions, but HL training induced a larger improvement in heavy load AME (HL: 9.3 ± 4.3 vs. LL: 7.5 ± 7.1 repetitions, time × limb P < 0.01) and LL training induced a larger improvement in light load AME (LL: 24.7 ± 22.2 vs. HL: 15.2 ± 16.7 repetitions, time × limb P = 0.04). In the upper body, HL and LL training induced similar increases in both heavy (time × limb P = 0.99), and light load (time × limb P = 0.16) AME. Dual-energy X-ray absorptiometry showed no change in leg fat-and-bone-free mass (FBFM) for either condition, and an increase in only LL arm FBFM. AME improved in a manner specific to the training loads used. ClinicalTrials.gov (NCT04547972).