• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Doctoral Thesis
DOI
https://doi.org/10.11606/T.5.2020.tde-09032020-163826
Document
Author
Full name
Gabriela Correia de Faria Santarém
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2019
Supervisor
Committee
Cleva, Roberto de (President)
Coelho, Fabricio Ferreira
Malheiros, Carlos Alberto
Pajecki, Denis
Title in Portuguese
Associação entre o índice de massa corporal, composição corporal com a capacidade de caminhar em obesos graves no pós-operatório tardio de cirurgia bariátrica
Keywords in Portuguese
Antropometria
Caminhada
Cirurgia bariátrica
Composição corporal
Movimento
Obesidade mórbida
Teste de esforço
Abstract in Portuguese
INTRODUÇÃO: A obesidade em seus diversos graus é um fator que diminuiu a capacidade de deslocamento motor, reduzindo a capacidade funcional. A utilização de índices de composição corporal total e segmentar no pós-operatório da cirurgia bariátrica poderá estimar com mais precisão, que o índice de massa corporal (IMC), a capacidade funcional durante deslocamento motor pelo teste de caminhada de seis minutos (TC6). Pacientes com menor redução da massa livre de gordura percentual (MLG %) no pós-operatório de cirurgia bariátrica apresentam melhor capacidade funcional. OBJETIVO: estudar a relação temporal entre a distância percorrida no TC6 (DTC6) e a redução do IMC, composição corporal total e segmentar no pós-operatório precoce (T1: 6 meses) e tardio (T2: 36 meses) de cirurgia bariátrica. MÉTODOS: A capacidade funcional foi avaliada em 77 pacientes que realizaram tratamento cirúrgico da obesidade por meio da DTC6 e a composição corporal através da bioimpedância elétrica (InBody 230®). Os pacientes foram classificados de acordo com a gravidade da obesidade no pré-operatório (T0): Grupo obeso mórbido (OM: IMC 40 a 49,9 kg/m2; n = 49) e Grupo superobeso (SO: IMC 50 a 59,9 kg/m2; n = 28) e de acordo com o percentual da perda do excesso de peso (%PEP >= 50%) no pós-operatório tardio de cirurgia bariátrica em: Grupo sucesso cirúrgico (GS: >= 50%; n = 35) e Grupo insucesso cirúrgico (GI: < 50%; n = 20). RESULTADOS: Foi encontrada diferença significativa (p < 0,001) na média da DTC6 entre os pacientes no T0/T1 e T0/T2 (T0: 518,6 ± 50,2 m; T1: 541,3 ± 55,6 m; T2: 559,8 ± 51,8 m). Houve aumento significativo (p < 0,05) na média da DTC6 entre T0/T1 e T0/T2 nos pacientes OM e SO, porém sem melhora significativa (p > 0,05) da DTC6 entre o T1/T2. Observou-se aumento significativo (p < 0,05) na média da DTC6 entre T0/T2 nos pacientes GS e GI. Não foi encontrada diferença significativa (p > 0,05) na DTC6 entre os pacientes OM/SO e GS/GI. Em todos os tempos (T0, T1 e T2) e grupos (OM, SO, GS, GI) a DTC6 apresentou correlação positiva forte a moderada (0,6 a 0,8; p < 0,05) com o valor percentual de massa livre de gordura de membros inferiores (MLGMI %) e não com o IMC. CONCLUSÕES: A massa livre de gordura corporal total e segmentar indicam melhor capacidade funcional. O IMC não é o melhor preditor de desempenho funcional no pós-operatório tardio da cirurgia bariátrica. A melhor capacidade funcional está associada a MLGMI %
Title in English
Association between body mass index, body composition with walking capacity in severe obesity in the late postoperative period of bariatric surgery
Keywords in English
Anthropometry
Bariatric surgery
Body composition
Exercise test
Movement
Obesity morbid
Walking
Abstract in English
BACKGROUND: Obesity in various degrees is a factor that decreases motor displacement capacity, reducing functional capacity. The use of total and segmental body composition in the postoperative period of bariatric surgery may more accurately estimate than the body mass index (BMI), functional capacity as assessed by the six-minute walk test (6MWT). Similarly, patients with lower fat-free mass percentage reduction (FFM %) in the postoperative period of bariatric surgery have better functional capacity. OBJECTIVE: To correlate the distance walked during the six-minute walk test (6MWD) with body mass index and total, and segmental body composition according to the obesity severity and success or failure surgical in the early postoperative period (T1: 6 months) and late postoperative period (T2: 36 months) of bariatric surgery. METHODS: Functional capacity was evaluated in 77 patients who underwent surgical treatment of obesity. Functional capacity was assessed with 6MWD and body composition by bioelectrical impedance analysis (InBody 230®). The patients were classified according to the preoperative severity of bariatric surgery (T0): Morbidly obese group (MO: BMI 40 to 49.9 kg/m2; n = 49) and super obese group (SO: BMI 50 to 59.9 kg/m2; n = 28) and according to the percentage of excess of loss weight (%PEP >= 50%) in the late postoperative period of bariatric surgery, patients were divided: surgical success group (SG: >= 50%; n = 35) and surgical failure group (FG: < 50%; n = 20). RESULTS: A significant difference (p < 0.001) was found in the 6MWD mean between patients T0/T1 and T0/T2 (T0: 518.6 ± 50.2 m; T1: 541.3 ± 55.6 m; T2: 559.8 ± 51.8 m). There was a significant increase (p < 0.05) in the average of the 6MWD between T0/T1 and T0/T2 in patients MO and SO, with no significant (p > 0.05) in the 6MWD between T1/T2. There was a significant increase (p < 0.05) in the average of the 6MWD between T0/T2 in patients SG and FG. No significant difference (p > 0.05) was found in the 6MWD between patients MO/SO and SG/FG. At all times (T0, T1 and T2) and groups (MO, SO, SG, FG), the 6MWD showed a strong to moderate positive correlation (0.6 to 0.8; p < 0.05) with the percentage of FFM of lower limbs (FFMLL %) but not with BMI. CONCLUSION: Total and segmental body fat free mass indicate better functional capacity. BMI is not the best predictor of postoperative functional capacity of bariatric surgery. The best functional capacity is pointed out by FFMLL %
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2020-03-09
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2021. All rights reserved.