Role of the exercise professional in metabolic and bariatric surgery.

Metabolic and bariatric surgery exercise prescription implementation mixed methods physical activity qualitative

Journal

medRxiv : the preprint server for health sciences
Titre abrégé: medRxiv
Pays: United States
ID NLM: 101767986

Informations de publication

Date de publication:
18 Aug 2023
Historique:
pubmed: 30 8 2023
medline: 30 8 2023
entrez: 30 8 2023
Statut: epublish

Résumé

Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined. To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform? Clinical and academic exercise settings worldwide. This multimethod study included a scoping review of PA programs in MBS described in the research literature. Data about job tasks were extracted and provided to 10 experts to sort into categories. Cluster analysis was utilized to find the hierarchical structure of tasks. A Delphi process was used to agree on a final model. The majority of PA professionals were exercise physiologists in the USA and physiotherapists or other types of exercise professionals elsewhere. Forty-three tasks were identified, the most reported being: supervision of exercise, fitness testing, and exercise prescription. Seven higher-order categories were determined: (1) Exercise-related health assessment, (2) Body composition and physical fitness assessment, (3) Lifestyle physical activity and sedentary behavior assessment, (4) Education, instruction, and prescription, (5) Exercise monitoring, (6) Behavioral counseling and psychosocial support, and (7) Dietary support. The following statements were rated an average of 9.0, classifying them as "imperative": 1) "Pre- and post-operative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care". The expert group reached a consensus on 7 major classifications of job tasks for the exercise professional. It is important for governing medical associations across the world to formally recognize experienced exercise professionals as playing pivotal roles in continuing, multidisciplinary care for MBS patients. These findings also provide evidence-based information in the effort to solidify these positions within the greater context of healthcare.

Sections du résumé

Background UNASSIGNED
Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined.
Objectives UNASSIGNED
To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform?
Setting UNASSIGNED
Clinical and academic exercise settings worldwide.
Methods UNASSIGNED
This multimethod study included a scoping review of PA programs in MBS described in the research literature. Data about job tasks were extracted and provided to 10 experts to sort into categories. Cluster analysis was utilized to find the hierarchical structure of tasks. A Delphi process was used to agree on a final model.
Results UNASSIGNED
The majority of PA professionals were exercise physiologists in the USA and physiotherapists or other types of exercise professionals elsewhere. Forty-three tasks were identified, the most reported being: supervision of exercise, fitness testing, and exercise prescription. Seven higher-order categories were determined: (1) Exercise-related health assessment, (2) Body composition and physical fitness assessment, (3) Lifestyle physical activity and sedentary behavior assessment, (4) Education, instruction, and prescription, (5) Exercise monitoring, (6) Behavioral counseling and psychosocial support, and (7) Dietary support. The following statements were rated an average of 9.0, classifying them as "imperative": 1) "Pre- and post-operative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care".
Conclusions UNASSIGNED
The expert group reached a consensus on 7 major classifications of job tasks for the exercise professional. It is important for governing medical associations across the world to formally recognize experienced exercise professionals as playing pivotal roles in continuing, multidisciplinary care for MBS patients. These findings also provide evidence-based information in the effort to solidify these positions within the greater context of healthcare.

Identifiants

pubmed: 37645986
doi: 10.1101/2023.04.20.23288698
pmc: PMC10462198
pii:
doi:

Types de publication

Preprint

Langues

eng

Subventions

Organisme : NIDDK NIH HHS
ID : K01 DK129441
Pays : United States

Déclaration de conflit d'intérêts

COMPETING INTERESTS None

Auteurs

Matthew A Stults-Kolehmainen (MA)

Center for Weight Management, Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States.
Department of Biobehavioral Sciences, Teachers College - Columbia University, New York, NY, United States.

Dale S Bond (DS)

Departments of Surgery and Research, Hartford Hospital/HealthCare, Hartford, CT, United States.

Laura A Richardson (LA)

School of Kinesiology, University of Michigan, Ann Arbor, MI, United States.

Louisa Y Herring (LY)

University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, England, United Kingdom.
NIHR Leicester Biomedical Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, England, United Kingdom.

Bethany Mulone (B)

Center for Weight Management, Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States.

Carol Ewing Garber (CE)

Department of Biobehavioral Sciences, Teachers College - Columbia University, New York, NY, United States.

John Morton (J)

Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States.

Saber Ghiassi (S)

Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States.

Andrew J Duffy (AJ)

Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States.

Ethan Balk (E)

Center for Weight Management, Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States.
Department of Nutrition and Food Studies, New York University, New York, NY, United States.

Charles J Abolt (CJ)

Earth and Environmental Sciences Division, Los Alamos National Laboratory, Los Alamos, NM, United States.

Matt C Howard (MC)

Department of Marketing & Quantitative Methods, University of South Alabama, Mobile, AL, United States.

Garrett I Ash (GI)

Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States.
Center for Pain, Research, Informatics, Medical Comorbidities and Education Center (PRIME), VA Connecticut Healthcare System, West Haven, CT, United States.

Susannah Williamson (S)

Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, United States.
Army Educational Outreach Program, Rochester Institute of Technology, United States.

Emilian Rejane Marcon (ER)

Department of Bariatric Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.

Melissa De Los Santos (M)

Department of Biobehavioral Sciences, Teachers College - Columbia University, New York, NY, United States.

Samantha Bond (S)

College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States.

Janet Huehls (J)

UMass Memorial Weight Center, UMASS Memorial Medical Center, Worchester, MA, United States.

Osama Alowaish (O)

Department of Biobehavioral Sciences, Teachers College - Columbia University, New York, NY, United States.

Nina Brojan Heyman (NB)

Department of Biobehavioral Sciences, Teachers College - Columbia University, New York, NY, United States.

Bruno Gualano (B)

Applied Physiology & Nutrition Research Group, School of Medicine, University of São Paulo, São Paulo, Brazil.

Classifications MeSH