Physiotherapy in Prehabilitation for Bariatric Surgery-Analysis of Its Impact on Functional Capacity and Original...

Background/Objectives: Prehabilitation is a multimodal intervention introduced in preparation for various surgical procedures. The most effective treatment for obesity is bariatric surgery. Physiotherapy during prehabilitation for bariatric surgery may be an effective method of functional capacity improvement. We aimed to evaluate the impact of an individual outpatient 12-week, exercise-based physiotherapy program featuring prehabilitation on functional status, exercise tolerance, everyday mobility, and fatigue among patients qualified for bariatric surgery. Methods: The completion of an individual outpatient 12-week, exercise-based physiotherapy program during prehabilitation was an inclusion criterion for the study group. Participants included in the study and control groups were assessed twice, after enrollment into the prehabilitation program (the first assessment) and after prehabilitation but before surgery (the second assessment). Both assessments involved functional tests (a six-minute walking test [6MWT], a timed up and go test [TUG], a chest mobility test, anthropometric measures, a mobility index [Barthel], and a modified Borg scale). The collected anthropometric data and values from the 6MWT were used to create original linear models. This study followed STROBE recommendations. Results: The study group and control group did not differ statistically in terms of their anthropometric data. Statistically significant results were obtained between the first and second assessments in both groups in terms of body weight and waist circumference. However, only the study group showed improved results in the TUG test (p = 0.0001) and distance in the 6MWT (p = 0.0005). The study group presented with the normalization of blood pressure (BP) after exertion in the second assessment (systolic BP p = 0.0204; diastolic BP p = 0.0377), and the 6MWT results were close to the norms. According to the original linear model used to predict performance in the 6MWT, the primary modifiable determinant of exercise tolerance was the participant's weight, while gender served as a non-modifiable determinant. Conclusions: Exercise-based physiotherapy in prehabilitation was associated with improved functional capacity in patients preparing for bariatric surgery, contributing to the improvement in 6MWT results in relation to the norms as well as exercise tolerance. Body weight may be an independent factor determining distance in the 6MWT for patients undergoing prehabilitation for bariatric surgery.