Role of the exercise professional in metabolic and bariatric surgery

Matthew A. Stults-Kolehmainen, Division of Digestive Health, Center for Weight Management, Yale New Haven Hospital, New Haven, Connecticut; Department of Biobehavioral Sciences, Teachers College - Columbia University, New York, New York. Electronic address: matthew_stults@yahoo.com.
Dale S. Bond, Departments of Surgery and Research, Hartford Hospital/HealthCare, Hartford, Connecticut.
Laura A. Richardson, School of Kinesiology, University of Michigan, Ann Arbor, Michigan.
Louisa Y. Herring, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, England, UK; NIHR Leicester Biomedical Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, England, UK.
Bethany Mulone, Division of Digestive Health, Center for Weight Management, Yale New Haven Hospital, New Haven, Connecticut.
Carol Ewing Garber, Department of Biobehavioral Sciences, Teachers College - Columbia University, New York, New York.
John Morton, Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.Follow
Saber Ghiassi, Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.Follow
Andrew J. Duffy, Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.Follow
Ethan Balk, Division of Digestive Health, Center for Weight Management, Yale New Haven Hospital, New Haven, Connecticut; Department of Nutrition and Food Studies, New York University, New York, New York.
Charles J. Abolt, Earth and Environmental Sciences Division, Los Alamos National Laboratory, Los Alamos, New Mexico.
Matt C. Howard, Department of Marketing & Quantitative Methods, University of South Alabama, Mobile, Alabama.
Garrett I. Ash, Center for Medical Informatics, Yale School of Medicine, New Haven, Connecticut; Center for Pain, Research, Informatics, Medical Comorbidities and Education Center (PRIME), VA Connecticut Healthcare System, West Haven, Connecticut.
Susannah Williamson, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research (WRAIR), Silver Spring, Maryland; Army Educational Outreach Program, Rochester Institute of Technology, Rochester, New York.
Emilian Rejane Marcon, Department of Bariatric Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Melissa De Los Santos, Department of Biobehavioral Sciences, Teachers College - Columbia University, New York, New York.
Samantha Bond, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois.
Janet Huehls, UMass Memorial Weight Center, UMass Memorial Medical Center, Worchester, Massachusetts.
Osama Alowaish, Department of Biobehavioral Sciences, Teachers College - Columbia University, New York, New York.
Nina Brojan Heyman, Department of Biobehavioral Sciences, Teachers College - Columbia University, New York, New York.
Bruno Gualano, Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.

Document Type

Article

Publication Title

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Abstract

BACKGROUND: 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: To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform? SETTING: Clinical and academic exercise settings worldwide. METHODS: 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: 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 postoperative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care". CONCLUSIONS: 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.

First Page

98

Last Page

108

DOI

10.1016/j.soard.2023.09.026

Publication Date

1-1-2024

Identifier

38238107 (pubmed); NIHMS2008743 (mid); PMC11311246 (pmc); 10.1016/j.soard.2023.09.026 (doi); S1550-7289(23)00714-1 (pii)

This document is currently not available here.

Share

COinS