Role of the exercise professional in metabolic and bariatric surgery.
Role of the exercise professional in metabolic and bariatric surgery.
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运动专业人员在代谢和减肥手术中的作用。
DOI：
10.1101/2023.04.20.23288698
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发表时间：
2023
期刊：
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作者：
Stults-Kolehmainen,MatthewA;Bond,DaleS;Richardson,LauraA;Herring,LouisaY;Mulone,Bethany;Garber,CarolEwing;Morton,John;Ghiassi,Saber;Duffy,AndrewJ;Balk,Ethan;Abolt,CharlesJ;Howard,MattC;Ash,GarrettI;Williamson,Susannah;
背景身体活动（PA）对于接受代谢和减肥手术（MBS）的患者的长期健康和体重管理非常重要。然而，运动专业人员在临床 MBS 环境中的作用尚未系统确定。目的调查：（1）谁是在 MBS 临床环境中实施 PA 规划的专业人员； (2) 他们执行哪些以患者为中心的任务？设置全球临床和学术锻炼环境。方法这是一项多方法研究。对所有减肥 PA 项目进行了系统的文献综述。有关工作任务的数据被提取、缩减并提供给由 10 名专家组成的小组进行分类。利用聚类分析来查找任务的层次结构。使用德尔菲流程就最终模型达成一致，然后将文献重新编码为更高阶的工作任务类别。结果大多数 PA 专业人员是美国的运动生理学家和其他地方的物理治疗师或其他类型的运动专业人员。确定了 43 项任务，报告最多的是：运动监督、体能测试和运动处方。高阶类别包括：与运动相关的健康评估、身体成分和身体健康评估、生活方式身体活动和久坐行为评估、教育、指导和处方、运动监测、行为咨询和社会心理支持以及饮食支持。文献中报道的最常见的技能是：运动监督、体能测试、运动处方、心率监测和身体活动咨询。以下陈述的平均评分为 9.0，表明所有受访者都表示“势在必行”：1)“需要为减肥手术患者提供术前和术后 PA/运动指南”，2)“减肥手术计划需要将 PA/运动作为多学科护理的一部分”。结论我们的减肥运动专业人员、联合临床医生和科学家组成的专家组就运动专业人员的 7 个主要工作任务分类达成了共识。对于世界各地的管理医学协会来说，正式认可经验丰富的运动专业人士在减肥手术患者的持续、多学科护理中发挥着关键作用非常重要。这些发现为如何在更大的医疗保健背景下巩固这些立场提供了循证指导。亮点MBS 环境中的大多数运动专业人员都是运动生理学家。结果确定了 43 项以患者为中心的任务，分为 7 个主要类别。最常见的任务是运动处方、监督和体能测试。执行的任务因运动专业人员的类型而略有不同。专家组认为将运动纳入 MBS 患者护理中是“势在必行”。
BackgroundPhysical 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 clinical MBS settings have not been systematically determined.ObjectivesTo investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform?SettingClinical and academic exercise settings worldwide.MethodsThis is a multimethod study. A systematic literature review of all bariatric PA programs was conducted. Data about job tasks were extracted, reduced and provided to a panel of 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, and then the literature was recoded for higher order job task categories.ResultsThe 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. Higher-order categories were: Exercise-related health assessment, Body composition and physical fitness assessment, Lifestyle physical activity and sedentary behavior assessment, Education, instruction, and prescription, Exercise monitoring, Behavioral counseling and psychosocial support, and Dietary support. The most common skills reported in the literature were: supervision of exercise, fitness testing, exercise prescription, heart rate monitoring, and physical activity counseling. The following statements were rated an average of 9.0, signifying “imperative” was indicated by all respondents: 1) “Pre- and post-operative PA/exercise guidelines for bariatric surgery patients are needed”, 2) “Bariatric surgery programs need to include PA/exercise as part of multidisciplinary care”.ConclusionsOur expert group of bariatric exercise professionals, allied clinicians, and scientists 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 bariatric surgery patients. These findings provide evidence-based guidance on how to solidify these positions within the greater context of healthcare.HighlightsMost exercise professionals in MBS settings are exercise physiologists.Results identified 43 patient-centered tasks, which divided into 7 major categories.The most common tasks were exercise prescription, supervision, and fitness testing.Tasks performed varied marginally by the type of exercise professional.Including exercise in MBS patient care was deemed “imperative” by the Expert Group.