Obesity Surgery

, Volume 23, Issue 11, pp 1835–1841 | Cite as

Improvement of Exercise Capacity and Peripheral Metaboreflex After Bariatric Surgery

  • Roberto P. da Silva
  • Denis Martinez
  • Christiane C. Faria
  • Luiz A. de Carli
  • Winston I. B. P. de Souza
  • Nelson G. Meinhardt
  • Katia E. P. Souto
  • Manoel R. M. Trindade
  • Jorge P. Ribeiro
Original Contributions



Bariatric surgery is the only predictable method to obtain weight loss in severe obesity. Poor physical performance of obese individuals may be mediated by the peripheral metaboreflex, which controls blood flow redistribution to exercising muscles. Weight reduction improves exercise capacity through several possible mechanisms that are insufficiently understood. We hypothesized that the metaboreflex is one among the causes of improvement in exercise capacity after weight loss. This study thus aimed to examine the effect of bariatric surgery on exercise performance and metaboreflex.


Severely obese patients were assessed before and 3 months after bariatric surgery. Metaboreflex was evaluated by the technique of selective induction by post-exercise circulatory occlusion (PECO+) after isometric handgrip exercise at 30 % of maximum voluntary contraction. The exercise capacity was assessed by 6-min walking test.


Seventeen patients completed the protocol. Body mass index decreased from 46.4 ± 2 to 36.6 ± 2 kg/m2 (P < 0.001). The distance walked in 6 min increased from 489 ± 14 to 536 ± 14 m (P < 0.001). The peripheral metaboreflex activity, expressed by the area under the curve of vascular resistance, was lower after than before bariatric surgery (42 ± 5 to 20 ± 4 units, P = 0.003). Heart rate, blood pressure, and vascular resistance were also significantly decreased. The correlation between change in distance walked in 6 min and change in peripheral metaboreflex activity was not significant.


Weight loss after bariatric surgery increases exercise capacity and reduces peripheral metaboreflex, heart rate, and blood pressure. Further investigation on the role of metaboreflex regarding mechanisms of exercise capacity of individuals with obesity is warranted.


Exercise Sympathetic activity Obesity 



The authors acknowledge the contribution of colleagues from Interdisciplinary Sleep Research Laboratory—LIPES and Exercise Pathophysiology Research Laboratory—LAFIEX (Cardiology Division, HCPA, UFRGS, Porto Alegre, Brazil) for their support. The authors are indebted to the staff at the Obesity Treatment Center of the Hospital Santa Casa de Misericordia de Porto Alegre and to the staff of the bariatric surgery department of Hospital Nossa Senhora da Conceição. Mr. Silva and Ms. Faria received grants from the Brazilian government through CAPES and CNPq. The main support was offered by the Research Incentive Fund, HCPA.


The authors have reported no financial conflicts of interest regarding this article. This is not an industry-supported study.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Roberto P. da Silva
    • 1
    • 2
  • Denis Martinez
    • 1
    • 2
    • 3
  • Christiane C. Faria
    • 1
    • 2
  • Luiz A. de Carli
    • 5
  • Winston I. B. P. de Souza
    • 6
  • Nelson G. Meinhardt
    • 6
  • Katia E. P. Souto
    • 6
  • Manoel R. M. Trindade
    • 4
  • Jorge P. Ribeiro
    • 1
    • 2
    • 3
  1. 1.Graduate Program in Cardiology and Cardiological Sciences, Faculty of MedicineFederal University of Rio Grande do Sul (UFRGS)Porto AlegreBrazil
  2. 2.Exercise Pathophysiology Research LaboratoryUFRGSPorto AlegreBrazil
  3. 3.Cardiology Division, Hospital de Clinicas de Porto Alegre (HCPA)UFRGSPorto AlegreBrazil
  4. 4.Graduate Program in Surgery, Faculty of MedicineUFRGSPorto AlegreBrazil
  5. 5.Department of SurgeryGrupo Hospitalar Santa Casa de MisericordiaPorto AlegreBrazil
  6. 6.Class III Obesity Care CenterHospital Nossa Senhora ConceiçãoPorto AlegreBrazil

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