Quelles interventions en activité physique devrait-on proposer aux personnes en attente ou ayant réalisé une chirurgie bariatrique ? XXe Journées d’Études Francophones en Activités Physiques Adaptées.
A Baillot, C Voyer, R Reid, M-F Langlois, E Riesco, P Blackburn, E Doucet, A Tchernof. (2021)
Summary
Background: Despite the well-known health and fitness benefits of physical activity(PA) in pre- and post-bariatric surgery, more than 70% of people waiting for bariatric surgery are physically inactive and remain inactive after surgery. In order to improve initiation, adherence to, and retention in PA procedures among bariatric surgery patients, a better understanding and integration of their preferences is needed. Therefore, the objectives of this study were to document the preferences for physical activity interventions for bariatric surgery patients, as well as to determine whether there were differences in preferences between people waiting or having performed bariatric surgery.
Method: Five groups of Quebec participants (41.6±1.6 years, 95% women, 68% who had a vertical gastrectomy) [before (n = 30), 0-1 years (n = 48), 1-2 years (n = 23) and >3 years (n = 30) after surgery] completed an online questionnaire assessing their preferences for physical activity interventions (pattern, type, timing, location, supervision, modalities), their socio-economic status and stage of change.
Results: No statistical differences between the bariatric surgery groups were found in socioeconomic status, stage of change (58% at the action-maintenance stage) and physical activity intervention preferences, except for participants included in the intervention group (see below). Weight loss and improved quality of life were ranked, respectively, 37% and 15% as their preferred reason for physical activity by participants. The type of physical activity intervention preferred by participants was the combination of several modalities, namely supervised physical training with physical activity counselling sessions and training plans (40%). Participants said they preferred the physical activity intervention to take place either when they were on the waiting list (27%), before (29%) or 3 to 12 months after bariatric surgery (31%), but few people chose more than one, two or three years after bariatric surgery. More than a third of participants preferred to receive a face-to-face intervention (42%) and supervised by a physical activity specialist (73%). The location of the intervention most often chosen was in a sports centre (34%), but 26% of participants said they had no preference. For 42% of participants, both an individual and group intervention was preferred. In contrast, 46% of patients in bariatric presurgery up to one year after surgery said they preferred to receive their intervention in a group with bariatric surgery patients, while half of the participants more than a year after surgery expressed no preference. Walking (82%) and swimming (69%) were the most popular physical activities. Free (72%) and supervision (77%) were identified by participants as the two main components that would help them maintain their motivation to participate in a physical activity intervention.
Conclusion: These results can be used in the development of physical activity interventions with bariatric surgery patients to try to improve their initiation, adherence, compliance, satisfaction and perseverance. However, other elements, such as available resources, scientific evidence and the views of health professionals and managers, should also be considered in order to propose feasible and effective physical activity interventions. In addition, research will then be needed to determine the effectiveness of interventions based on the preferences of this population.