Walking capacity of bariatric surgery candidates

• Published in: Surgery for obesity and related diseases Vol. 8; no. 1; pp. 48 - 59
• Main Authors: King, Wendy C., Engel, Scott G., Elder, Katherine A., Chapman, William H., Eid, George M., Wolfe, Bruce M., Belle, Steven H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2012
• Subjects: Adolescent; Adult; Age Factors; Aged; Bariatric Surgery; Body composition; Body Mass Index; Comorbidity; Female; Functional limitation; Gastroenterology and Hepatology; Heart Rate - physiology; Humans; Longitudinal Studies; Male; Middle Aged; Mobility disability; Mobility Limitation; Obesity, Morbid - physiopathology; Obesity, Morbid - surgery; Risk Factors; Severe obesity; Sex Factors; Smoking - adverse effects; Surgery; United States; Walking - physiology; Walking capacity; United States; Functional limitation; Walking capacity; Mobility disability; Severe obesity; Body composition; Bariatric surgery
• ISSN: 1550-7289; 1878-7533; 1878-7533
• DOI: 10.1016/j.soard.2011.07.003

This study characterizes the walking limitations of bariatric surgery candidates by age and body mass index (BMI) and determines factors independently associated with walking capacity. The setting was multi-institutional at research university hospitals in the United States. Participants of the Longitudinal Assessment of Bariatric Surgery study (n=2458; age 18–78 yr, BMI 33–94 kg/m 2) attended a preoperative research visit. Their walking capacity was measured by self-report and the 400 m Long Distance Corridor Walk (LDCW). Almost two thirds (64%) of subjects reported limitations with walking several blocks, 48% had an objectively defined mobility deficit, and 16% reported at least some walking aid use. In multivariate analysis, BMI, older age, lower income, and greater bodily pain were independently associated ( P < .05) with walking aid use, physical discomfort during the LDCW, an inability to complete the LDCW, and a slower time to complete the LDCW. Female gender, Hispanic ethnicity (but not race), greater heart rate at rest, a history of smoking, several co-morbidities (history of stroke, ischemic heart disease, diabetes, asthma, sleep apnea, venous edema with ulcerations), and depressive symptoms were also independently related ( P < .05) to at least one measure of reduced walking capacity. Walking limitations are common in bariatric surgery candidates, even among the least severely obese and youngest patients. Physical activity counseling must be tailored to individuals' abilities. Although several factors identified in the present study (eg, BMI, age, pain, co-morbidities) should be considered, directly assessing the patient's walking capacity will facilitate appropriate goal setting.