TABLE 1.
Characteristics of included controlled trials
| Reference | Study design Surgery type | Population | Intervention | Comparison | Outcomes | Follow‐up duration |
|---|---|---|---|---|---|---|
| Baillot et al.37 |
RCT Not reported |
Exercise group: N = 15 Age: 41.4 (38.3–54.3) years BMI: 44.8 (42.1–53.0) kg/m2 Female: 80% Control group: N = 14 Age: 43.3 (36.5–47.1) years BMI: 47.8 (40.3–54.0) kg/m2 Female: 79% |
Preoperative intervention ‐ Program duration: 3 months ‐ Aerobic + resistance training ‐ 3 sessions/week: 30 min of aerobic exercise (55–85% RHR) + 2–3 series of 12–15 rep on 9 resistance exercises ‐ Supervision: total (by PA specialists) |
Usual care |
‐ Body weight ‐ Body composition ‐ VO2peak ‐ Walking test (6MWT) ‐ Quality of life ‐ Blood pressure |
Postintervention |
| Baillot et al.38 |
RCT RYGB, SG |
‐‐ | Same intervention as Baillot et al.37 |
‐ Body weight ‐ Body composition ‐ VO2peak ‐ Walking test (6MWT) ‐ Accelerometer‐assessed PA ‐ Quality of life ‐ Blood pressure |
Long term | |
| Campanha‐Versiani et al.16 |
Non‐RCT RYGB |
Exercise group: N = 18 Age: 37.2 (9.3) years BMI: 42.5 (4.0) kg/m2 Female: 83% Control group: N = 19 Age: 37.0 (10.8) years BMI: 41.7 (4.6) kg/m2 Female: 83% |
Postoperative intervention ‐ Program duration: 9 months ‐ Start: 3 months after surgery ‐ Aerobic + resistance training ‐ 2 sessions/week: 1–3 series of 10–12 rep on 8 resistance exercises + 25 min of aerobic exercise (70–80% RHR) ‐ Supervision: total (staff not reported) |
Usual care |
‐ Body weight ‐ Body composition ‐ Bone mineral density ‐ Muscle strength |
Postintervention |
| Castello et al.36 |
RCT RYGB |
Exercise group: N = 21 Age: 38.0 (4.0) years BMI: 45.6 (1.5) kg/m2 Female: 100% Control group: N = 19 Age: 36.0 (4.0) years BMI: 44.5 (1.0) kg/m2 Female: 100% |
Postoperative intervention ‐ Program duration: 3 months ‐ Start: 1 month after surgery ‐ Aerobic training ‐ 3 sessions/week: 40 min of aerobic exercise (50–70% HRmax) ‐ Supervision: total (by physiotherapists) |
Usual care |
‐ Body weight ‐ Waist circumference ‐ Body composition ‐ Walking test (6MWT) |
Postintervention |
| Castello‐Simoes et al.39 | ‐‐ | ‐‐ | Same intervention as Castello et al.36 |
‐ BMI ‐ Lung function |
Postintervention | |
| Coen et al.26 |
RCT RYGB |
Exercise group: N = 66 Age: 41.3 (9.7) years BMI: 38.8 (6.1) kg/m2 Female: 89% Control group: N = 62 Age: 41.9 (10.3) years BMI: 38.3 (6.9) kg/m2 Female: 94% |
Postoperative intervention ‐ Program duration: 6 months ‐ Start: 1 month after surgery ‐ Aerobic training ‐ 3–5 sessions/week: 120 min of aerobic exercise (60–70% HRmax) per week ‐ Supervision: partial (by trained exercise physiologist) |
Usual care |
‐ Body weight ‐ Waist circumference ‐ Body composition ‐ VO2peak ‐ Glucose metabolism ‐ Lipid profile ‐ Blood pressure |
Postintervention |
| Coen et al.28 | ‐‐ | ‐‐ | Same intervention as Coen et al.26 | ‐ VO2peak | Postintervention | |
| Woodlief et al.29 | ‐‐ | ‐‐ | Same intervention as Coen et al.26 | ‐ Resting metabolic rate | Postintervention | |
| Carnero et al.30 | ‐‐ | ‐‐ | Same intervention as Coen et al.26 | ‐ Accelerometry‐assessed PA | Postintervention | |
| Nunez Lopez et al.31 | ‐‐ | ‐‐ | Same intervention as Coen et al.26 | ‐ Bone mass | Postintervention | |
| Coleman et al.15 |
RCT RYGB, SG, lap band |
Exercise group: N = 26 Age: 52.0 (10.9) years BMI: 45.0 (7.6) kg/m2 Female: 85% Control group: N = 25 Age: 46.6 (12.0) years BMI: 44.5 (5.5) kg/m2 Female: 100% |
Postoperative intervention ‐ Program duration: 6 months ‐ Start: 6–24 months after surgery ‐ Aerobic + resistance training ‐ 2 sessions/week: 60 min (details not reported) ‐ Supervision: partial (staff not reported) |
Usual care |
‐ Body weight ‐ Pedometer‐assessed PA ‐ Muscle strength ‐ Walking test (6MWT) |
Intermediate term |
| Daniels et al.48 |
RCT RYGB |
Exercise group: N = 8 Age: not reported BMI: not reported Female: 85% Control group: N = 8 Age: not reported BMI: not reported Female: 100% All participants Age: 44.9 (10.2) years |
Postoperative intervention ‐ Program duration: 3 months ‐ Start: 2 months after surgery ‐ Resistance training ‐ 3 sessions/week: 1–4 sets of 8–15 rep on 8–10 resistance exercises ‐ Supervision: not reported |
Usual care |
‐ Body weight ‐ Body composition ‐ Skeletal muscle mass ‐ Muscle strength |
Postintervention |
| Hassannejad et al.17 |
RCT RYGB, SG |
Exercise (aerobic) group: N = 20 Age: 33.3 (8.4) years BMI: 47.9 (6.7) kg/m2 Female: 75% Exercise (aerobic + resistance) group: N = 20 Age: 35.4 (8.1) years BMI: 42.9 (3.9) kg/m2 Female: 70% Control group: N = 20 Age: 36.7 (6.2) years BMI: 46.6 (6.0) kg/m2 Female: 80% |
Postoperative intervention ‐ Program duration: 3 months ‐ Start: immediately (aerobic) and 5‐week (aerobic + resistance) after surgery ‐ Aerobic training or aerobic + resistance training ‐ 3–5 sessions/week: 150–200 min of aerobic exercise (12–14 on Borg scale) per week + 20–30 min of resistance exercise (only in the aerobic + resistance group) ‐ Supervision: none |
Usual care |
‐ Body weight ‐ Body composition ‐ Skeletal muscle mass ‐ Muscle strength ‐ Walking test |
Postintervention |
| Herring et al.49 |
RCT RYGB, SG, GB |
Exercise group: N = 12 Age: 44.3 (7.9) years BMI: 38.2 (6.1) kg/m2 Female: 92% Control group: N = 12 Age: 52.4 (8.1) years BMI: 39.4 (4.3) kg/m2 Female: 92% |
Postoperative intervention ‐ Program duration: 3 months ‐ Start: 12–24 months after surgery ‐ Aerobic + resistance training ‐ 3 sessions/week: 45 min of aerobic exercise (64–77% HRmax) + 3 sets of 12 rep on 4 resistance exercises ‐ Supervision: total (by qualified gym instructors) |
Usual care |
‐ Body weight ‐ Waist circumference ‐ Body composition ‐ Accelerometry‐assessed PA ‐ Muscle strength ‐ Walking test ‐ Blood pressure |
Short term |
| Huck20 |
Non‐RCT RYGB, GB |
Exercise group: N = 7 Age: 53.6 (8.2) years BMI: 37.7 (6.3) kg/m2 Female: 86% Control group: N = 8 Age: 44.0 (9.7) years BMI: 32.7 (4.2) kg/m2 Female: 75% |
Postoperative intervention ‐ Program duration: 3 months ‐ Start: 4 months after surgery ‐ Resistance training ‐ 2–3 sessions/week: 1–3 sets of 8–12 rep on 8–10 resistance exercises ‐ Supervision: total (by certified strength and conditioning specialist) |
Usual care |
‐ Body weight ‐ Waist circumference ‐ Body composition ‐ VO2peak ‐ Muscle strength |
Postintervention |
| Marchesi et al.40 |
Non‐RCT RYGB |
Exercise group: N = 10 Age: 43.1 (37–48) years BMI: 29.6 (23.9–33.6) kg/m2 Female: 100% Control group: N = 10 Age: 39.1 (31–46) years BMI: 30.1 (25.9–39.3) kg/m2 Female: 100% |
Postoperative intervention ‐ Program duration: 10 months ‐ Start: 1–3 years after surgery ‐ Aerobic training ‐ 3 sessions/week: 60 min of aerobic exercise (55–65% HRmax with some sessions at 65–85% HRmax) ‐ Supervision: total (by personal trainers) |
Usual care |
‐ Body weight ‐ Waist circumference ‐ Body composition ‐ VO2peak ‐ Quality of life ‐ Glucose metabolism ‐ Lipid profile |
Postintervention |
| Marc‐Hernandez et al.41 (p) |
Non‐RCT Not reported |
Exercise group: N = 10 Age: 42.5 (5.1) years BMI: 47.5 (7.1) kg/m2 Female: 70% Exercise group: N = 8 Age: 37.5 (10.3) years BMI: 41.5 (2.7) kg/m2 Female: 100% |
Preoperative intervention ‐ Program duration: 3 months ‐ Aerobic (including HIIT) + resistance training ‐ 2–4 sessions/week: 35–50 min of aerobic exercise (60–70% HRmax) or 20 min HIIT (60–80% HRmax) + 1–4 sets of 15–20 rep on 4–7 resistance exercises ‐ Supervision: total (staff not reported) |
Usual care |
‐ Body weight ‐ Body composition ‐ VO2peak ‐ Muscle strength ‐ Lipid profile ‐ Quality of life |
Postintervention |
| Marcon et al.47 |
RCT Not reported |
Exercise group: N = 22 Age: 43.4 (2.3) years BMI: 50.8 (9.6) kg/m2 Female: 82% Exercise + counseling group: N = 17 Age: 50.1 (2.8) years BMI: 45 (4.1) kg/m2 Female: 100% Control group: N = 18 Age: 42.5 (2.7) years BMI: 47.1 (7.6) Female: 89% |
Preoperative intervention ‐ Program duration: 4 months ‐ Aerobic training or aerobic training + cognitive‐behavioral therapy ‐ 2 sessions/week: 25 min of aerobic exercise (intensity not reported) ‐ Supervision: total (by personal trainers) |
Usual care |
‐ Body weight ‐ Walking test (6MWT) ‐ Estimated VO2peak ‐ Glucose metabolism ‐ Blood pressure ‐ Lipid profile |
Postintervention |
| Mundbjerg et al.27 |
RCT RYGB |
Exercise group: N = 32 Age: 42.3 (9.4) years BMI: 43.1 (6.7) kg/m2 Female: 66% Control group: N = 28 Age: 42.4 (9.0) years BMI: 42.8 (5.5) kg/m2 Female: 75% |
Postoperative intervention ‐ Program duration: 6 months ‐ Start: 6 months after surgery ‐ Aerobic + resistance training ‐ 2 sessions/week: 30 min of aerobic exercise (15–17 on the Borg scale) + 10 min of resistance exercise
|
Usual care |
‐ Body weight ‐ Waist circumference ‐ Abdominal fat volume ‐ Blood pressure ‐ Resting heart rate ‐ Glucose metabolism ‐ Lipid profile |
Long term |
| Mundbjerg et al.32 | ‐‐ | ‐‐ | Same intervention as Mundbjerg et al.27 |
‐ VO2peak ‐ Muscle strength |
Long‐term | |
| Stolberg et al.34 | ‐‐ | ‐‐ | Same intervention as Mundbjerg et al.27 |
‐ Inflammation ‐ Endothelial function |
Long‐term | |
| Stolberg et al.33 | ‐‐ | ‐‐ | Same intervention as Mundbjerg et al.27 |
‐ Accelerometer‐assessed PA ‐ Quality of life |
Long‐term | |
| Stolberg et al.35 | ‐‐ | ‐‐ | Same intervention as Mundbjerg et al.27 | ‐ Markers of coagulation | Long‐term | |
| Murai et al.44 |
RCT RYGB |
Exercise group: N = 31 Age: 40.0 (7.8) years BMI: 49.8 (7.0) kg/m2 Female: 100% Control group: N = 32 Age: 42.1 (8.2) years BMI: 48.5 (8.1) kg/m2 Female: 100% |
Postoperative intervention ‐ Program duration: 6 months ‐ Start: 3 months after surgery ‐ Aerobic + resistance training ‐ 2 sessions/week: 30–60 min of moderate‐intensity aerobic exercise + 3 sets of 8–12 rep on 7 resistance exercises ‐ Supervision: total (staff not reported) |
Usual care | ‐ Bone mineral density | Postintervention |
| Muschitz et al.50 |
RCT RYGB, SG |
Exercise group: N = 110 Age: 41.0 (34;0; 45.0) years BMI: 44.3 (41.1; 47.9) kg/m2 Female: 60% Control group: N = 110 Age: 40.0 (35.0; 45.8) years BMI: 44.2 (40.7; 47.7) kg/m2 Female: 56% |
Post‐operative intervention ‐ Program duration: 24 months Start: 2 weeks after surgery ‐ Aerobic + resistance training + protein, calcium and vit. D supplementation ‐ 5 sessions/week of aerobic training (45 min, intensity not reported) + 2 sessions/week of resistance training (30 min, intensity not reported) ‐ Supervision: none |
Usual care |
‐ Body weight ‐ Body composition ‐ Bone mineral density ‐ Quality of life |
Postintervention |
| Onofre et al.18 |
Non‐RCT RYGB, SG |
Exercise group: N = 6 Age: 40.3 (10.7) years BMI: 46.1 (7.0) kg/m2 Female: 100% Control group: N = 6 Age: 39.5 (7.2) years BMI: 44.9 (9.0) kg/m2 Female: 100% |
Postoperative intervention ‐ Program duration: 3 months ‐ Start: 3 months after surgery ‐ Aerobic + resistance training ‐ 3 sessions/week: 30 min of aerobic exercise (40–60% RHR with high‐intensity periods at 85–90% RHR) + 20 min of resistance exercise ‐ Supervision: total (by physiotherapists) |
Usual care |
‐ Body weight ‐ Waist circumference ‐ VO2peak |
Postintervention |
| Oppert et al.45 |
RCT RYGB |
Exercise + protein supplementation group: N = 23 Age: 40.9 (10.8) years BMI: 45.2 (5.2) kg/m2 Female: 100% Protein supplementation group: N = 31 Age: 42.5 (8.7) years BMI: 43.3 (6.0) kg/m2 Female: 100% Control group: N = 22 Age: 43.9 (10.7) years BMI: 43.6 (6.2) kg/m2 Female: 100% |
Postoperative intervention ‐ Program duration: 6 months ‐ Start: 1.5 months after surgery ‐ Resistance training ‐ 3 sessions/week: 4 sets of 8–12 rep on 6 resistance exercises ‐ Supervision: total (by trained PA instructors) |
Usual care |
‐ Body weight ‐ Body composition ‐ Accelerometry‐assessed PA ‐ VO2peak ‐ Muscle strength ‐ Quality of life ‐ Dietary (protein) intake |
Postintervention |
| Pico‐Sirvent et al.42 |
Non‐RCT Not reported |
Exercise group: N = 3 Age: 39.7 (10.2) years BMI: 38.0 (1.2) kg/m2 Female: 67% Control group: N = 3 Age: 36.7 (0.6) years BMI: 29.5 (0.6) kg/m2 Female: 100% |
Preoperative intervention ‐ Program duration: 6 months ‐ Aerobic (including HIIT) + resistance training ‐ 2 sessions/week of 50 min of aerobic exercise (60–85% HRmax) + 2 sessions/week of HIIT (30″/30″ at 95% HRmax) + 1–4 series of 10–20 rep on 5 resistance exercises ‐ Supervision: total (staff not reported) |
Usual care |
‐ Body weight ‐ Body composition ‐ VO2peak ‐ Muscle strength |
Postintervention |
| Rojhani‐Shirazi et al.46 |
RCT SG |
Exercise group: N = 16 Age: 36.1 (6.7) years BMI: 40.5 (5.4) kg/m2 Female: 100% Control group: N = 16 Age: 36.6 (7.8) years BMI: 44.0 (7.2) kg/m2 Female: 100% |
Postoperative intervention ‐ Program duration: 1 month ‐ Start: 5 days after surgery ‐ Balance training ‐ 4 sessions/week of 30–45 min ‐ Supervision: Not reported |
Usual care |
‐ Body weight ‐ Waist circumference ‐ Balance control |
Postintervention |
| Shah et al.19 |
RCT RYGB, GB |
Exercise group: N = 21 Age: 47.3 (10.0) years BMI: 42.4 (6.9) kg/m2 Female: 90% Control group: N = 12 Age: 53.9 (8.8) years BMI: 41.0 (3.7) kg/m2 Female: 92% |
Postoperative intervention ‐ Program duration: 3 months ‐ Start: 3–42 months after surgery ‐ Aerobic training ‐ 5 sessions/week: aerobic exercise (60–70% VO2max) resulting in an energy expenditure ≥ 2000 kcal/week ‐ Supervision: total (by a study investigator) |
Usual care |
‐ Body weight ‐ Waist circumference ‐ Body composition ‐ Pedometer‐assessed PA ‐ VO2max ‐ Glucose metabolism ‐ Lipid profile ‐ Quality of life |
Postintervention |
| Stegen et al.43 |
Non‐RCT RYGB |
Exercise group: N = 8 Age: 39.9 (9.9) years BMI: 45.3 (2.7) kg/m2 Female: 88% Control group: N = 7 Age: 43.1 (5.6) years BMI: 40.4 (8.1) kg/m2 Female: 57% |
Postoperative intervention ‐ Program duration: 3 months ‐ Start: 1 month after surgery ‐ Aerobic + resistance training ‐ 3 sessions/week: 25 min of resistance exercise (1–3 sets of 10 rep) + 30 min of aerobic exercise (60% HRmax) ‐ Supervision: total (by sports science students) |
Usual care |
‐ Body weight ‐ Waist circumference ‐ Body composition ‐ VO2peak ‐ Muscle strength ‐ Walking test (6MWT) |
Postintervention |
Note: Articles are presented in alphabetical order, and articles reporting results from the same trial are presented together. Assessment performed immediately after the intervention, less than 6 months after the intervention, 6–12 months after the intervention, or more than 12 months after the intervention was referred to as postintervention, short term, intermediate term, and long term, respectively.
Abbreviations: GB, gastric banding; HR, heart rate; non‐RCT, nonrandomized controlled trial; PA, physical activity; RCT, randomized controlled trial; RHR, reserve heart rate; RYGB, Roux‐en‐Y gastric bypass; SG, sleeve gastrectomy; 6MWT, 6‐min walk test.