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Greater Adherence to Recommended Morning Physical Activity is Associated With Greater Total Intervention-Related Physical Activity Changes in Bariatric Surgery Patients.

ABSTRACT: BACKGROUND:This study examines whether performance of bout-related physical activity (PA) during morning hours is related to greater overall bout-related PA increases within a preoperative PA intervention for bariatric surgery (BS) patients. METHODS:Participants with severe obesity (n = 33; mean age = 45.6 ± 9.6 years; BMI = 45.7 ± 7.0 kg/m2) seeking BS were randomized to and completed 6 weeks of preoperative PA counseling (retention = 82.5%). Participants were encouraged to walk daily at a moderate intensity in bouts ? 10 minutes during morning hours to overcome time-related obstacles and establish a PA habit. Timing and amount of bout-related moderate-to-vigorous PA (MVPA) was assessed via objective monitor at pre- and postintervention. RESULTS:Greater proportion of bout-related MVPA performed during morning hours (4:00 AM-12:00 PM) at postintervention was associated with larger total increases in bout-related MVPA minutes/day (? = .40, P = .03). At postintervention, a greater proportion of participants whose longest MVPA bouts occurred during morning hours (n = 11) achieved the public health guideline (ie, ?150 bout-related MVPA minutes/week) versus those whose longest MVPA bouts occurred during nonmorning hours (n = 19; 63.6% vs. 26.3%, P = .04). CONCLUSIONS:Intervention-related increases in PA tended to be greatest when PA was performed in the morning. Morning exercise may be a viable strategy for promoting habitual PA in inactive BS patients.

SUBMITTER: Bond DS

PROVIDER: S-EPMC5786375 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Greater Adherence to Recommended Morning Physical Activity is Associated With Greater Total Intervention-Related Physical Activity Changes in Bariatric Surgery Patients.

Bond Dale S DS Raynor Hollie A HA Thomas J Graham JG Unick Jessica J Webster Jennifer J Ryder Beth B Vithiananthan Sivamainthan S

Journal of physical activity & health 20170302 6

<h4>Background</h4>This study examines whether performance of bout-related physical activity (PA) during morning hours is related to greater overall bout-related PA increases within a preoperative PA intervention for bariatric surgery (BS) patients.<h4>Methods</h4>Participants with severe obesity (n = 33; mean age = 45.6 ± 9.6 years; BMI = 45.7 ± 7.0 kg/m<sup>2</sup>) seeking BS were randomized to and completed 6 weeks of preoperative PA counseling (retention = 82.5%). Participants were encourag ...[more]

PMID: 28253045

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Project description:BackgroundDespite bariatric surgery showing significant weight loss trajectories for many patients, a substantial proportion regain weight after the first year following surgery. The addition of telemedicine to standard care could support patients with engaging in a more active lifestyle and thus improve clinical outcomes.ObjectiveOur aim was to evaluate a telemedicine intervention program dedicated to the promotion of physical activity including digital devices, teleconsultation, and telemonitoring the first 6 months following bariatric surgery.MethodsThis study employed a mixed methods design based on an open-label randomized controlled trial. Patients were included during the first week after bariatric surgery; then, they were randomized into 2 intervention groups: The TelePhys group received a monthly telemedicine consultation focusing on physical activity coaching, while the TeleDiet group received a monthly telemedicine consultation involving diet coaching. Data were collected using a watch pedometer and body weight scale, both of which were connected wirelessly. The primary outcome was the difference between the 2 groups in the mean numbers of steps at the first and sixth postoperative months. Weight change was also evaluated, and focus groups and interviews were conducted to enrich the results and capture perceptions of the telemedicine provided.ResultsAmong the 90 patients (mean age 40.6, SD 10.4 years; 73/90, 81% women; 62/90, 69% gastric bypass), 70 completed the study until the sixth month (n=38 TelePhys; n=32 TeleDiet), and 18 participants agreed to be interviewed (n=8 Telephys; n=10 TeleDiet). An increase in the mean number of steps between the first and sixth months was found in both groups, but this change was significant only in the TeleDiet group (P=.01). No difference was found when comparing both intervention groups. Interviewed participants reported having appreciated the teleconsultations, as the individualized tailored counseling helped them to make better choices about behaviors that could increase their likelihood of a daily life in better health. Weight loss followed by social factors (such as social support) were identified as the main facilitators to physical activity. Family responsibilities, professional constraints as well as poor urban policies promoting physical activity, and lack of accessibility to sport infrastructure were their major barriers to postoperative lifestyle adherence.ConclusionsOur study did not show any difference in mobility recovery after bariatric surgery related to a telemedicine intervention dedicated to physical activity. The early postoperative timing for our intervention may explain the null findings. eHealth interventions aiming to change behaviors and carried out by clinicians require support from structured public health policies that tackle patients' obesogenic environment in order to be efficient in their struggle against sedentary lifestyle-related pathologies. Further research will need to focus on long-term interventions.Trial registrationClinicalTrials.gov NCT02716480, https://clinicaltrials.gov/ct2/show/NCT02716480.

Project description:BackgroundHabitual physical activity (PA) may help to optimize bariatric surgery outcomes; however, objective PA measures show that most patients have low PA preoperatively and make only modest PA changes postoperatively. Patients require additional support to adopt habitual PA. The objective of this study was to test the efficacy of a preoperative PA intervention (PAI) versus standard presurgical care (SC) for increasing daily moderate-to-vigorous PA (MVPA) in bariatric surgery patients.MethodsOutcomes analysis included 75 participants (86.7% women; 46.0±8.9 years; body mass index [BMI]=45.0±6.5 kg/m2) who were randomly assigned preoperatively to 6 weeks of PAI (n=40) or SC (n=35). PAI received weekly individual face-to-face sessions with tailored instruction in behavioral strategies (e.g., self-monitoring, goal-setting) to increase home-based walking exercise. The primary outcome, pre- to postintervention change in daily bout-related (≥10 min bouts) and total (≥1 min bouts) MVPA minutes, was assessed objectively via a multisensor monitor worn for 7 days at baseline- and postintervention.ResultsRetention was 84% at the postintervention primary endpoint. In intent-to-treat analyses with baseline value carried forward for missing data and adjusted for baseline MVPA, PAI achieved a mean increase of 16.6±20.6 min/d in bout-related MVPA (baseline: 4.4±5.5 to postintervention: 21.0±21.4 min/d) compared to no change (-0.3±12.7 min/d; baseline: 7.9±16.6 to postintervention: 7.6±11.5 min/d) for SC (P=.001). Similarly, PAI achieved a mean increase of 21.0±26.9 min/d in total MVPA (baseline: 30.9±21.2 to postintervention: 51.9±30.0 min/d), whereas SC demonstrated no change (-0.1±16.3 min/d; baseline: 33.7±33.2 to postintervention: 33.6±28.5 minutes/d) (P=.001).ConclusionWith behavioral intervention, patients can significantly increase MVPA before bariatric surgery compared to SC. Future studies should determine whether preoperative increases in PA can be maintained postoperatively and contribute to improved surgical outcomes.

Project description:BackgroundPhysical activity levels after bariatric surgery are usually low, despite the significant protective health benefits of physical activity in this population. Positive psychological well-being is associated with improved adherence to health behaviors, but bariatric surgery patients often have negative associations with physical activity that prevent sustained engagement.ObjectiveThe Gaining Optimism After weight Loss Surgery (GOALS) pilot randomized controlled trial is aimed at testing a novel intervention to increase physical activity after bariatric surgery, which incorporates positive psychological skill-building with motivational interviewing and goal-setting.MethodsThe GOALS trial is a 2-arm, 24-week pilot randomized controlled trial that aims to enroll 58 adults who report less than 200 minutes per week of moderate to vigorous physical activity and a desire to become more active 6-12 months after bariatric surgery. GOALS is testing the feasibility, acceptability, and preliminary efficacy of a positive psychology-motivational interviewing telephone intervention targeting to increase physical activity and associated positive affect. Intervention components include positive psychology, goal-setting, self-monitoring via provided Fitbits, and motivational interviewing to overcome barriers and increase motivation. The intervention is compared to a physical activity education control that includes mailings with psychoeducation around physical activity and provision of a Fitbit. The primary outcomes of the pilot trial are feasibility and acceptability, measured as session completion rates and participant ratings of ease and helpfulness of each session. The main secondary outcome is change in accelerometer-measured moderate to vigorous physical activity post intervention and at 24-week follow-up. Additional outcomes include changes in attitudes related to physical activity, psychological well-being, and physical health measures.ResultsThis multiphase project was funded in 2020 and institutional review board approval was obtained for the proposed trial in 2021. Recruitment for the randomized controlled trial began in July 2022. Upon completion of the pilot trial, we will examine the feasibility, acceptability, and preliminary efficacy of the intervention.ConclusionsAlthough bariatric surgery is the most effective treatment available for severe obesity, weight regain occurs, often in the context of low psychological well-being. Many individuals would benefit from learning strategies to increase positive psychological well-being after bariatric surgery, which could help them maintain lifestyle changes. Positive psychology is a novel approach to improve adherence by increasing positive associations with health behaviors including physical activity. The GOALS pilot trial will determine whether this type of intervention is feasible and acceptable to this population and will provide a foundation for a future full-scale randomized controlled efficacy trial.Trial registrationClinicalTrials.gov NCT04868032; https://clinicaltrials.gov/ct2/show/NCT04868032.International registered report identifier (irrid)PRR1-10.2196/39856.

Project description:Purpose Physical activity is critical for weight loss maintenance and cardiometabolic disease prevention after metabolic/bariatric surgery (MBS), but few patients meet recommended levels. While difficulties meeting physical activity recommendations are common in the general population, those who have undergone MBS may have unique psychological barriers to activity that impede success, including negative associations with physical activity that are related to a long history with obesity, weight stigma, and physical limitations. This qualitative study aimed to better understand the positive and negative emotional experiences of post-MBS patients with regard to physical activity to inform the development of an emotion-focused intervention to increase physical activity after MBS. Methods Adults who had MBS in the past 2 years completed semi-structured interviews and psychological/behavioral questionnaires. After transcription, a codebook was developed using inductive and deductive methods. Coded data were analyzed using content analysis. Results Participants were 23 adults (78% female). Contexts that contributed to positive emotions during physical activity included an enjoyable type of exercise, social interaction, mindfulness during exercise, and mastery. Contexts that contributed to negative affect were more unique to the MBS population, including all-or-nothing thinking about exercise, using distraction, depression, negative body image, exercising only for weight loss, and the COVID-19 pandemic. Conclusion For most participants, emotional factors were relevant in the decision to be physically active and in their ability to maintain their habits. An intervention that encourages factors that lead to positive affect and addresses factors that lead to negative affect could be effective in increasing physical activity following MBS. Graphical abstract Supplementary Information The online version contains supplementary material available at 10.1007/s11695-021-05807-x.

Dataset Information

Greater Adherence to Recommended Morning Physical Activity is Associated With Greater Total Intervention-Related Physical Activity Changes in Bariatric Surgery Patients.

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Greater Adherence to Recommended Morning Physical Activity is Associated With Greater Total Intervention-Related Physical Activity Changes in Bariatric Surgery Patients.

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