{"title":"确定减肥手术后体育活动干预的有效设计成分：系统回顾和荟萃分析。","authors":"Kang Zhao, Yimeng Chen, Yinning Guo, Ting Wang, Hanfei Zhu, Ying Zhang, Chulei Tang, Weiying Li, Qin Xu","doi":"10.1111/obr.13951","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Poor physical activity (PA) conditions post-bariatric surgery can negatively affect patient prognosis. The long-term PA intervention effects are suboptimal, and lacking exploration regarding the dose–response relationship between intervention configurations and outcome. This study aims to explore the association between post-bariatric surgery PA intervention design components and actual PA improvements.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Seven electronic databases were searched. Included were randomized or quasi-randomized controlled trials post-bariatric surgery that implemented PA interventions and reported PA levels. Meta-analyses were conducted for changes in PA and BMI. Subgroup analysis and meta-regression were performed based on score of consensus on exercise reporting template (CERT), subjective and objective PA reports, intervention type, and intervention-related timing.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Out of 11,896 screened articles, 16 were included, totaling 1256 participants. Meta-analysis results showed significant improvements in PA status at the end of the intervention (<i>SMD =</i> 0.82, <i>95%CI</i> 0.25–1.40, <i>p</i> = 0.005), with no significant differences in PA changes at follow-up times or BMI changes (<i>p</i> > 0.05). Subgroup analysis indicated that subjective reporting, combined exercise type, starting intervention 1.5 months post-surgery, and a CERT score ≤7, as well as clear reporting of certain CERT items, enhanced intervention effects. Meta-regression demonstrated significant associations between CERT score and changes in PA (<i>β</i> = 0.415, <i>p</i> = 0.038) and BMI (<i>β</i> = −0.253, <i>p</i> = 0.022) at follow-up times.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>PA interventions should adopt a training program combining resistance training with aerobic exercise, clearly define training equipment and locations, and provide supervision, motivational strategies, replicable exercise guidance, and training compliance evaluations to enhance the long-term improvement of PA levels in post-bariatric surgery patients.</p>\n </section>\n </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"26 10","pages":""},"PeriodicalIF":7.4000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Identifying Effective Design Components in Physical Activity Interventions Post-Bariatric Surgery: A Systematic Review and Meta-Analysis\",\"authors\":\"Kang Zhao, Yimeng Chen, Yinning Guo, Ting Wang, Hanfei Zhu, Ying Zhang, Chulei Tang, Weiying Li, Qin Xu\",\"doi\":\"10.1111/obr.13951\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Poor physical activity (PA) conditions post-bariatric surgery can negatively affect patient prognosis. The long-term PA intervention effects are suboptimal, and lacking exploration regarding the dose–response relationship between intervention configurations and outcome. This study aims to explore the association between post-bariatric surgery PA intervention design components and actual PA improvements.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Seven electronic databases were searched. Included were randomized or quasi-randomized controlled trials post-bariatric surgery that implemented PA interventions and reported PA levels. Meta-analyses were conducted for changes in PA and BMI. Subgroup analysis and meta-regression were performed based on score of consensus on exercise reporting template (CERT), subjective and objective PA reports, intervention type, and intervention-related timing.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Out of 11,896 screened articles, 16 were included, totaling 1256 participants. Meta-analysis results showed significant improvements in PA status at the end of the intervention (<i>SMD =</i> 0.82, <i>95%CI</i> 0.25–1.40, <i>p</i> = 0.005), with no significant differences in PA changes at follow-up times or BMI changes (<i>p</i> > 0.05). Subgroup analysis indicated that subjective reporting, combined exercise type, starting intervention 1.5 months post-surgery, and a CERT score ≤7, as well as clear reporting of certain CERT items, enhanced intervention effects. Meta-regression demonstrated significant associations between CERT score and changes in PA (<i>β</i> = 0.415, <i>p</i> = 0.038) and BMI (<i>β</i> = −0.253, <i>p</i> = 0.022) at follow-up times.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>PA interventions should adopt a training program combining resistance training with aerobic exercise, clearly define training equipment and locations, and provide supervision, motivational strategies, replicable exercise guidance, and training compliance evaluations to enhance the long-term improvement of PA levels in post-bariatric surgery patients.</p>\\n </section>\\n </div>\",\"PeriodicalId\":216,\"journal\":{\"name\":\"Obesity Reviews\",\"volume\":\"26 10\",\"pages\":\"\"},\"PeriodicalIF\":7.4000,\"publicationDate\":\"2025-05-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Obesity Reviews\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/obr.13951\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obesity Reviews","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/obr.13951","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
导言：减肥手术后不良的身体活动（PA）状况会对患者预后产生负面影响。长期PA干预效果不理想，缺乏对干预配置与结果之间剂量-反应关系的探索。本研究旨在探讨减肥手术后PA干预设计成分与实际PA改善之间的关系。方法：检索7个电子数据库。纳入了在减肥手术后实施PA干预并报告PA水平的随机或准随机对照试验。对PA和BMI的变化进行meta分析。根据运动报告模板（CERT）的共识评分、主观和客观PA报告、干预类型和干预相关时间进行亚组分析和元回归。结果：在11896篇筛选文章中，纳入16篇，共计1256名受试者。meta分析结果显示干预结束时PA状态有显著改善（SMD = 0.82, 95%CI 0.25-1.40, p = 0.005），随访时PA变化或BMI变化无显著差异（p < 0.05）。亚组分析表明，主观报告、联合运动方式、术后1.5个月开始干预、CERT评分≤7分以及明确报告某些CERT项目可增强干预效果。meta回归显示，CERT评分与随访时PA （β = 0.415, p = 0.038）和BMI （β = -0.253, p = 0.022）的变化有显著相关性。结论：PA干预应采用阻力训练与有氧运动相结合的训练方案，明确训练设备和地点，并提供监督、激励策略、可复制的运动指导和训练依从性评估，以促进减肥手术后患者PA水平的长期改善。
Identifying Effective Design Components in Physical Activity Interventions Post-Bariatric Surgery: A Systematic Review and Meta-Analysis
Introduction
Poor physical activity (PA) conditions post-bariatric surgery can negatively affect patient prognosis. The long-term PA intervention effects are suboptimal, and lacking exploration regarding the dose–response relationship between intervention configurations and outcome. This study aims to explore the association between post-bariatric surgery PA intervention design components and actual PA improvements.
Methods
Seven electronic databases were searched. Included were randomized or quasi-randomized controlled trials post-bariatric surgery that implemented PA interventions and reported PA levels. Meta-analyses were conducted for changes in PA and BMI. Subgroup analysis and meta-regression were performed based on score of consensus on exercise reporting template (CERT), subjective and objective PA reports, intervention type, and intervention-related timing.
Results
Out of 11,896 screened articles, 16 were included, totaling 1256 participants. Meta-analysis results showed significant improvements in PA status at the end of the intervention (SMD = 0.82, 95%CI 0.25–1.40, p = 0.005), with no significant differences in PA changes at follow-up times or BMI changes (p > 0.05). Subgroup analysis indicated that subjective reporting, combined exercise type, starting intervention 1.5 months post-surgery, and a CERT score ≤7, as well as clear reporting of certain CERT items, enhanced intervention effects. Meta-regression demonstrated significant associations between CERT score and changes in PA (β = 0.415, p = 0.038) and BMI (β = −0.253, p = 0.022) at follow-up times.
Conclusions
PA interventions should adopt a training program combining resistance training with aerobic exercise, clearly define training equipment and locations, and provide supervision, motivational strategies, replicable exercise guidance, and training compliance evaluations to enhance the long-term improvement of PA levels in post-bariatric surgery patients.
期刊介绍：
Obesity Reviews is a monthly journal publishing reviews on all disciplines related to obesity and its comorbidities. This includes basic and behavioral sciences, clinical treatment and outcomes, epidemiology, prevention and public health. The journal should, therefore, appeal to all professionals with an interest in obesity and its comorbidities.
Review types may include systematic narrative reviews, quantitative meta-analyses and narrative reviews but all must offer new insights, critical or novel perspectives that will enhance the state of knowledge in the field.
The editorial policy is to publish high quality peer-reviewed manuscripts that provide needed new insight into all aspects of obesity and its related comorbidities while minimizing the period between submission and publication.
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