Comprehensive assessment of physical functioning in bariatric surgery candidates compared with subjects without obesity

Background: Obesity appears to be associated with reduced physical performance, but comprehensive assessments of physical functioning are lacking in subjects with severe obesity, in particular in comparison with subjects without obesity. This precludes an objective assessment of the degree of impairment. Objective: To compare motor skills and cardiopulmonary fitness between subjects with severe obesity (OB) (i.e., candidates for bariatric surgery) and control subjects without obesity (non-OB). Setting: Cantonal Hospital, Switzerland. Methods: Flexibility, movement speed, balance, maximal isometric strength, and cardiopulmonary fitness were tested in 45 OB (body mass index: 42.6 +/-.9 kg/m(2); age: 35 +/- 1.7 years; 33 women) and 32 non-OB (body mass index: 23 +/- .4 kg/m(2); age: 38.5 +/- 2.1 years; 25 women) subjects. Results: In comparison with the non-OB group, the OB group showed reduced shoulder flexibility (P <.001) but comparable hamstrings flexibility (P =.3). Speed-related tasks (i e, timed up-and go test and timed lying-to-standing test) indicated that the OB group was slower than the non-OB group (all P <.007). Strength-related tasks indicated a greater absolute back muscle and knee extensor strength (all P <.002) in the OB group with no difference in knee-flexor strength (both P >.8). However, when related to weight, the OB group showed reduced maximal strength (all P <.002). Bicycle spiroergometry indicated that absolute oxygen consumption at peak exercise and at the anaerobic threshold did not differ between groups (both P >.06). Related to weight, however, values were lower in the OB than in the non-OB group (both P <.001). Conclusion: Data indicate a differential pattern of functional impairment in bariatric surgery candidates compared with subjects without obesity. These findings might help to establish tailored intervention protocols to improve physical performance in such subjects. (C) 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved.