The Application Of Exercise Rehabilitation Based On The Trans-theoretical Model In Patients After Bariatric Surgery

Objectives1.To construct an exercise rehabilitation regimen based on literature research and Delphi method,in order to help guide scientific and reasonable exercise prescriptions for obesity patients after bariatric surgery.2.To explore the effect of exercise rehabilitation based on the trans-theoretical model for patients undergoing bariatric surgery,in order to provide theoretical and empirical basis for the generalization and application of this kind of exercise rehabilitation form in patients and nursing staff.Methods1.The preliminary exercise rehabilitation strategies were established by systematically reviewed articles about exercise interventions after bariatric surgery in multi-databases.Appraisal of the selected literature was done using appropriate quality evaluation methods and the contents of literature was extracted.Then the two rounds of consultation using the Delphi-method were conducted on 16 experts to revise the exercise rehabilitation regimen.2.Totally 110 patients was conducted from January to September 2018 at the Department of Bariatric and Metabolic Surgery in the first Affiliated Hospital of Nanjing Medical University.Patients in the control group(n=55)received routine nursing care while patients in the experimental group(n=55)received exercise rehabilitation education based on the trans-theoretical model.Intervention effect was measured by exercise stages of change,exercise self-efficacy,exercise benefits and barriers,6-min walk test,one-week overall physical activity,exercise adherence and body composition at baseline and at 4 weeks and 12 weeks after bariatric surgery.Results1.The return rate of questionnaires was 88.89% and 100% in two rounds respectively,and the authority coefficient of experts was 0.90,Kendall coordination coefficients were 0.343 and 0.453 respectively,and P values were all less than 0.01.The final regimen included 3 primary indicators(screening and assessment,exercise prescription formulation,follow-up and education),10 secondary indicators and 48 tertiary indicators.2.The exercise stages of change,exercise self-efficacy,exercise benefits and barriers,one-week overall physical activity,6-min walk distance and exercise adherence of the experimental group were significantly higher than those of the control group at 4 weeks and 12 weeks after surgery(all P<0.05).3.There was no significant difference in body composition indexes between the experimental group and the control group at 4 weeks and 12 weeks after surgery(all P>0.05).Conclusions1.An exercise rehabilitation regimen conducted on the basis of literature research and Delphi-method is scientific and practical,thus may help guide the exercise rehabilitation of patients after bariatric surgery.2.Exercise rehabilitation interventions based on the tans-theoretical model can help patients produce positive intrinsic changes in establishing health behaviors,which can improve the level of exercise self-efficacy and perceived exercise benefits and barriers after bariatric surgery,improve patient's exercise capacity and the level of physical activity,so as to better promote post-bariatric surgery patients participation in regular exercise.