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Thèse de Doctorat
DOI
https://doi.org/10.11606/T.5.2022.tde-18042022-105145
Document
Auteur
Nom complet
Alexandre Vieira Gadducci
Adresse Mail
Unité de l'USP
Domain de Connaissance
Date de Soutenance
Editeur
São Paulo, 2021
Directeur
Jury
Cleva, Roberto de (Président)
Cazzo, Everton
Oliveira, Daniel Riccioppo Cerqueira Ferreira de
Santo, Marco Aurelio
Titre en portugais
Força muscular dos membros inferiores como preditora de sucesso no pós-operatório de cirurgia bariátrica
Mots-clés en portugais
Cirurgia bariátrica
Força muscular
Obesidade mórbida
Resumé en portugais
INTRODUÇÃO: A cirurgia bariátrica promove melhora nos parâmetros metabólicos, antropométricos, funcionais, posturais e ortopédicos. Entretanto, após a cirurgia há diminuição da força muscular absoluta e melhora inicial na força muscular relativa após 6 meses, não se mantém no seguimento de longo prazo. OBJETIVO: Avaliar a força muscular de membros inferiores como preditora de sucesso cirúrgico tardio (36 meses). Métodos: Os pacientes foram submetidos a avaliação antropométrica e dinamométrica antes (T0: n = 123), seis meses (T1: n = 123) e 36 meses (T2: n = 79) após o bypass gástrico em Y de Roux (RYGB). Os torques máximos de contração voluntária dos membros inferiores foram medidos por meio de um dinamômetro isocinético. O grupo sucesso cirúrgico (GS) foi definido como 50% da perda do excesso de peso (PEP) 36 meses após a cirurgia. PEP inferior a 50% foi considerado insucesso cirúrgico (GI). RESULTADOS: Dos 79 pacientes avaliados 36 meses após a cirurgia, não houve diferença significativa entre a força muscular relativa Ext e Flex em T1 e T2. Não houve diferença significativa entre a força muscular relativa Ext e Flex em T1 e T2 entre os pacientes com SS e FS. No entanto, na força muscular relativa houve diferença significativa entre os pacientes GS e GI em T2. CONCLUSÕES: Nossos resultados demonstram que a força muscular de membros inferiores em 6 meses pode predizer aproximadamente 76% de chances de sucesso em 36 meses. A redução de peso aliada ao aumento da força muscular podem predizer o SS
Titre en anglais
Lower Limbs Muscle Strength as a predictor of postoperative success in bariatric surgery
Mots-clés en anglais
Bariatric surgery
Morbid Obesity
Muscle strength
Resumé en anglais
INTRODUCTION: Bariatric surgery promove improvement in metabolic, anthropometric, functional, postural and orthopedic parameters. However after surgery there is a decrease of absolute muscle strength and observed the initial improvement in a relative muscle strength 6 months but was not maintained on long term follow up. OBJECTIVE: To assess muscle strength of lower limbs as a predictor of late surgical success (36 months). Methods: Patients were subject to anthropometric measurements and dynamometry evaluation before (T0: n=123), six months (T1: n=123) and 36 months (T2: n=79) after Roux-in-y gastric bypass (RYGB) maximum voluntary contraction torques of the lower limbs were measured using an isokinetic dynamometer. Surgical success (SS) was defined as 50% excess weight loss (EWL) 36 months after surgery. EWL of less than 50% was considered surgical failure (FS). RESULTS: Of 79 patients evaluated 36 months after surgery, there was no significant difference between relative muscle strength Ext and Flex in T1 and T2. There was also no significant difference between relative muscle strength Ext and Flex in T1 and T2 between patients with SS and FS. But when showing the relative muscle strength, there was a significant difference between patients SS and FS in T2. CONCLUSIONS: Our findings demonstrate that muscle strength of lower limbs at 6 months can predict approximately 76% of the chances of success in 36 months. There are factors combined within weight reduction and the increase in muscle strength that can predict the SS. To determine goals for the surgical post process is necessary to preserve functionality and benefits long term
 
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Date de Publication
2022-04-18
 
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