Investigation of the Effects of Whole Body Vibration Application on Muscle Functional Level, Physical Fitness and Respiratory Parameters After Bariatric Surgery

The aim of this study was to investigate the effects of whole body vibration on muscle functional level, physical fitness and respiratory parameters after bariatric surgery.

Hypotheses of the study:

H1: TVV after bariatric surgery has an effect on the functional level of the muscle.

H2: TVV after bariatric surgery has an effect on physical fitness. H3: TVV after bariatric surgery has an effect on respiratory parameters. H4: TVV after bariatric surgery has an effect on quality of life. H5: TVV after bariatric surgery has an effect on body composition. H6: TVV after bariatric surgery has an effect on biochemical parameters.

Patients will be divided into 3 randomized controlled groups. Whole body vibration application group, resistance exercise group and control group.

The whole body vibration group will exercise on the device 3 days a week. Resistance exercise group will exercise with resistance band 3 days a week. All exercises will last 6 weeks. The whole body vibration, resistance exercise and control groups will be recommended to walk 7 days a week.

Study Overview

• Status: Not yet recruiting
• Conditions: Morbid Obesity; Obesity & Overweight; Morbid Obesity Requiring Bariatric Surgery
• Intervention / Treatment: Other: Resistance Training; Other: Whole Body Vibration; Other: Control Group

Detailed Description

Sarcopenic obesity (SO) is the coexistence of obesity characterized by excess fat mass and sarcopenia and is a functional and clinical condition. Sarcopenia, defined as low mass and reduced function of skeletal muscle, has a multifactorial etiology and its prevalence increases with age The development of sarcopenia in obese individuals can occur at any age. Obesity can lead to both muscle mass and functional losses as it causes many conditions that negatively affect muscle mass such as inflammation, insulin resistance, oxidative stress, In addition, individuals with obesity have a high likelihood of non-communicable, chronic diseases that negatively affect muscle metabolism (catabolism and anabolism). Attempts to reduce high amounts of fat lead to losses in skeletal muscle mass. This is especially common after bariatric surgery and long-term unbalanced dietary regimens. However, fat accumulation in the abdominal and thoracic cavity and mediastinal area directly affects the mechanical properties of the lung and chest wall. Increased body fat deposition causes the diaphragm to remain in an upward position, thus limiting its downward movements, increasing pleural pressure, and decreasing functional residual capacity. However, fat accumulation in the abdominal and thoracic cavity and mediastinal area directly affects the mechanical properties of the lung and chest wall. Increased body fat deposition causes the diaphragm to remain in an upward position, thus limiting its downward movements, increasing pleural pressure and decreasing functional residual capacity. This reduction is 22% in obese people and 33% in severely obese people. The most important reason for the decrease in functional residual capacity in obese patients is the decrease in expiratory reserve volume. Expiratory residual volume decreases with increasing body mass index. Respiratory muscle weakness accompanies the picture due to both impaired length-tension relationship and decreased functional mobility of the diaphragm.

Bariatric surgery is a series of surgical methods for the treatment of morbid obesity. This procedure, which has recently gained popularity, is generally considered effective and safe. Bariatric surgery has significant health benefits, such as normalizing blood glucose levels, reducing hyperglycemia, lowering cholesterol and blood pressure, improving diabetes-related micro- and macrovascular complications and obstructive sleep apnea. However, like any other surgical procedure, this procedure has complications, some of which are life-threatening. However, like any other surgical procedure, this procedure has complications, some of which are life-threatening. Often after this surgery, people develop anemia and lose calcium and vitamins, which must be compensated by taking supplements for the rest of their lives. Some of the potentially serious complications of bariatric surgery include macro- and micronutrient deficiencies.

Bariatric surgery also has some adverse effects on the musculoskeletal system. In addition to low-calorie nutrition and surgery-induced malabsorption after surgery, it also causes weight loss through other mechanisms. Bariatric surgery alters the production of bile acids, pancreatic secretions and some hormones. There is an increase in the production of anorexigenic hormones and a decrease in the production of orexigenic hormones. Ghrelin is considered an orexigenic hormone as well as a growth hormone secretagogue and promotes muscle protein anabolism. After bariatric surgery, there is a significant increase in the level of cortisol, which promotes muscle protein catabolism. This is attributed to the hypocaloric diet and post-surgical stress. Bariatric surgery has been proven to reduce not only fat mass but also muscle mass and strength (16-40%). Therefore, implementing tailored exercise programs for people after bariatric surgery may help this population to increase weight loss while maintaining lean mass, bone mass and muscle strength in the long term.

Evidence for various exercise approaches is presented in the literature. With the addition of exercise to the weight loss induced by surgery, adaptations develop in muscle insulin sensitivity that will form the basis for recovery. Capillary density increased angiogenesis, angiogenesis and adaptations that increase insulin and glucose delivery to muscle. Exercise also improves mitochondrial function in skeletal muscle, metabolic flexibility, fat oxidation, and reduces lipotoxic species thought to underlie insulin resistance. Although the physiological mechanism of vibration application has not been clearly explained, it occurs with the activation of the tonic vibration reflex. With whole body vibration (TVV) or local vibration application, the change in muscle length is perceived, increasing the activation of the golgi tendon organ and muscle spindle, which are responsible for transmitting this change to the central nervous system. Ia afferent fibers that form the primary terminations of the muscle spindle, which is sensitive to changes in muscle length, activate the alpha motor neuron through monosynaptic connections, and tonic reflexive contractions occur. Increasing alpha motor neuron activation of the muscle spindle, which becomes more sensitive to tension with vibration application; It has been observed to increase the number of cross bridges established, the amount of motor units, motor unit synchronization, and firing frequency.. The application of vibration is also perceived by the ruffini corpuscles, paccini corpuscles, skin and joint receptors, golgi tendon organ. TVV application can increase the efficiency of the proprioceptive feedback loop. During isometric contractions, proprioceptive pathways are used to generate force. A more efficient proprioceptive feedback loop caused by vibration application may lead to increases in force production. The proposed mechanisms for improvements in body composition (decrease in fat mass, increase in muscle mass) caused by TVV are the same as the proposed mechanisms for improvements after resistance exercise. The additional gravitational loading experienced by individuals when exposed to TVV has been shown to elicit an anabolic response. This is comparable to studies using resistance exercise. Both TVV application and resistance training cause an increase in testosterone and growth hormone levels. Studies have shown that repetitive muscle contractions and changes in the hormonal system caused by vibration application elicit some metabolic responses. This application increases the oxygen uptake of tissues and blood flow of skin and subcutaneous tissues. A decrease in arterial stiffness was observed after application. It also stimulates lipolysis by increasing lipolytic hormones.

The literature on TVV application shows that it significantly improves muscle strength and physical activity of participants performing unloaded exercise . It has also been found to be effective in alleviating conditions such as decreased muscle mass, muscle strength, and bone density, and has similar benefits to resistance training, especially in terms of increasing muscle performance ). Resistance exercises alone or in combination with aerobic exercises prevent the loss of muscle strength associated with bariatric surgery). In particular, resistance training has been shown to increase muscle strength and reduce muscle atrophy in obese individuals who adhere to calorie restriction for weight loss. In a study involving 12 weeks of resistance exercises with 19 participants, a decrease in body weight and waist circumference was observed. There was a significant increase in hand grip strength. Significant improvements were observed in lower and upper extremity muscle strength. People's moderate-to-vigorous physical activity levels increased significantly.

People who have undergone bariatric surgery are recommended to exercise, but the recommended guidelines are not specific to people who have undergone surgery. The American College of Sports Medicine recommends the same amount of physical activity for both individuals who have undergone bariatric surgery and those with obesity. Initiation of exercise interventions after bariatric surgery ranges from 1 to 3 months, depending on the type of exercise. It is observed that resistance exercises are started at the 6th week after surThe aim of this study was to demonstrate the feasibility of whole body vibration application after bariatric surgery.gery and the duration is prolonged in different studies.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: büşra terim, PT, MSc; Phone Number: +90 5462131307; Email: fztbusraterim@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Having undergone bariatric surgery, At least 6 weeks have passed since bariatric surgery, Being between the ages of 18-65, Being diagnosed with obesity and having a BMI>35, There is no obstacle that restricts exercise

Exclusion Criteria:

• Acute hernia, Thromboembolism, Steroid use, Cardiovascular, neurological, orthopedic disease, Presence of knee or hip prosthesis, History of non-traumatic fracture, Presence of pacemaker, Malignancy, Presence of kidney, liver or thyroid disease, Presence of arrhythmia, Pregnancy status, Presence of kidney stones, Presence of epilepsy, Presence of migraine, Presence of organ failure, Presence of acute infection, History of smoking, Presence of respiratory system disease

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: intervention group- resistance exercise; The resistance exercise training group will be given resistance exercise with theraband for 6 weeks in addition to the conventional physiotherapy program. The exercise protocol will be performed 3 days a week, 1 time a day, 1 day supervised. The evaluation sessions of the individuals will be face to face. Sessions will start with a 5-minute warm-up exercise, resistance exercise protocol will be applied, and will end with a 5-minute cool-down exercise. Rest periods of 2-3 minutes will be given between sets. Before and after each exercise, heart rate, blood pressure, SpO2, dyspnea and fatigue values will be measured according to the Modified Borg Scale. They will be asked to be between 4-6 (moderate) according to the scale during the exercise. After finding 1 RM of the individuals, 50% of this value will be taken for exercise loads between 0-2 weeks. According to the corresponding value of this value in the elastic resistance band, the appropriate band color will be selected and the per	Other: Resistance Training; The resistance exercise training group will be given resistance exercise with theraband for 6 weeks in addition to the conventional physiotherapy program. The exercise protocol will be performed 3 days a week, 1 time a day, 1 day supervised. The evaluation sessions of the individuals will be face to face. Sessions will start with a 5-minute warm-up exercise, resistance exercise protocol will be applied, and will end with a 5-minute cool-down exercise.
Experimental: intervention group- whole body vibration; The WBV training group will be given exercises on the WBV device in addition to the conventional physiotherapy program. The exercise protocol will be performed face to face, 3 days a week, 1 time a day for 6 weeks. Individuals will be evaluated and exercise sessions will be conducted face to face. Exercise sessions will be performed under the control of a physiotherapist and each patient's heart rate, fatigue perception, dyspnea perception and saturation will be monitored. Individuals will be asked to report any negative experiences during or after the application. Exercises will be practiced before the application on the device. Before and after each exercise, heart rate, blood pressure, SpO2, dyspnea and fatigue values will be measured according to the Modified Borg Scale. They will be asked to be between 4-6 (moderate level) according to the scale during the exercise. At the end of the 2nd and 4th week, if dyspnea and fatigue do not develop in the person and the measured values are	Other: Whole Body Vibration; The WBV training group will be given exercises on the WBV device in addition to the conventional physiotherapy program. The exercise protocol will be performed face to face, 3 days a week, 1 time a day for 6 weeks. Individuals will be evaluated and exercise sessions will be conducted face to face. Exercise sessions will be performed under the control of a physiotherapist and each patient's heart rate, fatigue perception, dyspnea perception and saturation will be monitored. Individuals will be asked to report any negative experiences during or after the application.
Active Comparator: control group; Individuals will be informed about what they should do after bariatric surgery, what they should do during the treatment process and physical activity, they will be advised to walk regularly for 30 minutes a day, 7 days a week and they will be informed about the things to pay attention during walking. Patients in the control group will be asked to keep a diary, write down their vital signs and the extent to which they perform the exercise recommendation of 30 minutes a day, 7 days a week on a weekly basis. Patients in this group will be called regularly on a weekly basis and the information they keep in the diary will be requested and recorded.	Other: Control Group; Individuals will be informed about what they should do after bariatric surgery, what they should do during the treatment process and physical activity, they will be advised to walk regularly for 30 minutes a day, 7 days a week and they will be informed about the things to pay attention during walking.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle Ultrasound	Measurements will be made using a 5-12 MHz probe. Muscle fascicle lengths, muscle thickness and pennate angles are measured. Sarcopenia mainly affects the lower extremity muscles more. Quadriceps muscle is one of the basic muscles that enable us to perform daily life activities such as walking and standing. The functionality of the quadriceps muscle allows us to have information about the quality of life of individuals. The gastrocnemius muscle is also one of the methods used to determine sarcopenic obesity by ultrasound (Deniz et al., 2020; Minetto et al., 2016; Perkisas et al., 2021). In a study conducted by Li et al. in 2020 with 179 geriatric individuals, the biceps brachii muscles of the participants were measured by ultrasound. In the study, it was observed that the cross-sectional area of the biceps brachii muscle was significantly reduced in sarcopenic elderly compared to non-sarcopenic elderly (Li et al., 2020).	6 weeks
Muscle Strength Measurement	Peripheral muscle strength of shoulder abductor and adductor, shoulder flexor, extensor, elbow flexor and extensor, hip flexor, extensor, abductor and adductor, knee flexor and extensor muscles will be measured with a portable myometer (Model 01165, Lafayette, IN, USA). Hand grip strength will be measured with a hand dynamometer (Jamar, Nottinghamshire, England) in a sitting position, elbow flexed 90 degrees, wrist neutral. The measurements will be repeated three times for the right and left side and the best of the values obtained will be recorded in Newton (N) (Hébert et al., 2011).	6 weeks
Elasticity Evaluation of Muscle	The tonus of quadriceps, gastrocnemius and biceps brachii muscles will be measured with MyotonPro™ device (Myoton AS, Talin, Estonia). The most bulging part of the muscle will be marked with a skin marker pen and the device will be placed perpendicular to the muscle. During the test, a 0.4N impulse is applied from the device to the skin with a force of 0.18N and a duration of 15 msec. Elasticity values (ms) of the muscle will be recorded on the screen of the device (Aird et al., 2012). The assessment point and position of the muscles will be measured according to the positions and criteria recommended on the Myoton®PRO official website (https://www.myoton.com/applications).	6 weeks
Respiratory Muscle Strength Assessment	In the respiratory muscle strength assessment, the maximum inspiratory intraoral pressure (IMP) and maximum expiratory intraoral pressure (MEP) of the patients will be measured using a portable, electronic oral pressure measuring device, and the values will be recorded in cmH2O. MIP is the intraoral pressure measured during maximum inspiration against a valve closing the airway. For measurement, the subject is made to expire maximally and at the end of this, the airway is closed with a valve and the subject is asked to inspire maximally and maintain this for '1-3' seconds. MEP is the intraoral pressure measured during maximal expiration against a valve closing the airway. In MEP measurement, after the person performs maximal inspiration, the person is asked to perform maximal expiration for '1-3' seconds against the closed airway. The best of the three measurements will be selected. It will be expressed as a percentage of normal reference values calculated according to age and gender.	6 weeks
Respiratory Muscle Endurance	In the dynamic method, peak inspiratory flow rate (PIF) and respiratory muscle strength index (S-index) will be assessed using the portable POWERbreathe K5 device (PowerBreathe K5, HaB International Ltd, Warwickshire, UK). Patients will perform at least 10 consecutive speed-dependent maneuvers (4.5 seconds between inspirations) in two different phases of the assessment sequence. Respiratory muscle endurance will be assessed using the POWERbreathe Classic respiratory muscle training device (PowerBreathe International Ltd, Warwickshire, UK) with an increasing workload test. The test will start with 30% of the MIP and the patient will be asked to breathe deeply with this workload for 2 minutes. For patients who have completed 2 minutes, the workload will be increased by 10% per minute. The final workload sustained for at least 1 minute will be recorded (Woszezenki et al., 2017, Silva et al., 2018).	6 weeks
Pulmonary Function Test	In the pulmonary function test, patients' forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), the ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC), peak flow rate (PEF) will be measured with a portable spirometer. Pulmonary function test parameters will be expressed in liters and as a percentage of the expected value. Pulmonary function test will be performed with a spirometer (Cosmed Pony FX, Italy) according to ATS/ ERS criteria. Against the risk of infection, appropriate sterilization method recommended by the guideline, disposable, personalized mouthpieces and filters will be used (Ucok et al., 2010).	6 weeks
Cardiopulmonary Exercise Test	In our study, CPET will be performed with a treadmill. Modified Bruce protocol will be applied. All participants will be informed about the device before starting the test. Situations that may require people to terminate the test will be explained. During the test, people will breathe in and out with a mask with a gas analyzer attached at the end so that the amount of oxygen they take in and carbon dioxide they exhale can be measured. Ventilation parameters will be obtained by analyzing and measuring the gases collected by gas analyzers and flow meters in each breath. Heart rate and ECG will be monitored during KPET. The test will be terminated if the person states that he/she cannot continue the exercise for any reason or if there are indications to terminate the exercise. During the test, VO2max, RER, HR, VO2/HR, maximum time, VE/VO2, VE/VCO2, VD/VT, VE, BF, BR, paCO2, VO2/kg, values will be recorded.	6 weeks
Stiffness of Muscle	Description: The tonus of quadriceps, gastrocnemius and biceps brachii muscles will be measured with MyotonPro™ device (Myoton AS, Talin, Estonia). The most bulging part of the muscle will be marked with a skin marker pen and the device will be placed perpendicular to the muscle. During the test, a 0.4N impulse is applied from the device to the skin with a force of 0.18N and a duration of 15 msec. Stiffness (N/m) value of the muscle will be recorded on the screen of the device (Aird et al., 2012). The assessment point and position of the muscles will be measured according to the positions and criteria recommended on the Myoton®PRO official website (https://www.myoton.com/applications). Time Frame: 6 weeks	6 weeks
Tonus Evaluation of Muscle	Description: The tonus of quadriceps, gastrocnemius and biceps brachii muscles will be measured with MyotonPro™ device (Myoton AS, Talin, Estonia). The most bulging part of the muscle will be marked with a skin marker pen and the device will be placed perpendicular to the muscle. During the test, a 0.4N impulse is applied from the device to the skin with a force of 0.18N and a duration of 15 msec. Tonus (Hz) value of the muscle will be recorded on the screen of the device (Aird et al., 2012). The assessment point and position of the muscles will be measured according to the positions and criteria recommended on the Myoton®PRO official website (https://www.myoton.com/applications). Time Frame: 6 weeks	6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Biochemical Analyses	Blood will be collected in gel biochemistry tubes in Istinye University laboratories before and after 6 weeks of exercise training and serum samples will be obtained after centrifugation for 10 minutes. Serum samples will be kept frozen at -80 degrees Celsius until the day of the experiment. The concentrations of TNF-alpha, interleukin 6, interleukin 4, interleukin 12, CK-MM, CK-MB parameters in serum samples will be measured by commercially available ELISA-based kits.	6 weeks
Body Composition Analysis	Participants' body weights, body fat percentages and torso summer percentages will be measured with Tanita-BC 418 device. Situations that may affect the measurement will be specified and people will come to the measurement by following the instructions. Before the application, people are asked to stand on the device platform by selecting their age, height and body type.	6 weeks
Assessment of Quality of Life	The Impact of Weight on Quality of Life (IWQOL) scale was developed by Kolotkin in 1995. In 2001, the short version of the scale, IWQOL-Lite, was created. The short form of the scale consists of 5 groups and 31 items: self-confidence (7 items), bodily functions (11 items), work (4 items), sexual life (4 items), social pressure (5 items). A maximum score of 100 and a minimum score of 0 is obtained from the scale. A high score indicates a high quality of life and a low score indicates a low quality of life. Çömlekçi et al. The questionnaire, whose Turkish validity and reliability was performed by Çömlekçi et al. consists of 29 items. Work 3 and Work 4 items were removed (Necmiye, 2010). In our study, this test will be used to measure the quality of life of individuals	6 weeks

Collaborators and Investigators

• Sponsor: Kirsehir Ahi Evran Universitesi
• Collaborators: Istinye University

Publications and helpful links

General Publications

• Aird L, Samuel D, Stokes M. Quadriceps muscle tone, elasticity and stiffness in older males: reliability and symmetry using the MyotonPRO. Arch Gerontol Geriatr. 2012 Sep-Oct;55(2):e31-9. doi: 10.1016/j.archger.2012.03.005. Epub 2012 Apr 13.
• Keller C, Steensberg A, Pilegaard H, Osada T, Saltin B, Pedersen BK, Neufer PD. Transcriptional activation of the IL-6 gene in human contracting skeletal muscle: influence of muscle glycogen content. FASEB J. 2001 Dec;15(14):2748-50. doi: 10.1096/fj.01-0507fje. Epub 2001 Oct 29.
• Necking LE, Lundstrom R, Lundborg G, Thornell LE, Friden J. Skeletal muscle changes after short term vibration. Scand J Plast Reconstr Surg Hand Surg. 1996 Jun;30(2):99-103. doi: 10.3109/02844319609056390.
• Roelants M, Delecluse C, Goris M, Verschueren S. Effects of 24 weeks of whole body vibration training on body composition and muscle strength in untrained females. Int J Sports Med. 2004 Jan;25(1):1-5. doi: 10.1055/s-2003-45238.
• Sheng B, Truong K, Spitler H, Zhang L, Tong X, Chen L. The Long-Term Effects of Bariatric Surgery on Type 2 Diabetes Remission, Microvascular and Macrovascular Complications, and Mortality: a Systematic Review and Meta-Analysis. Obes Surg. 2017 Oct;27(10):2724-2732. doi: 10.1007/s11695-017-2866-4.
• Vissers D, Verrijken A, Mertens I, Van Gils C, Van de Sompel A, Truijen S, Van Gaal L. Effect of long-term whole body vibration training on visceral adipose tissue: a preliminary report. Obes Facts. 2010;3(2):93-100. doi: 10.1159/000301785. Epub 2010 Apr 7.
• Zaki ME. Effects of whole body vibration and resistance training on bone mineral density and anthropometry in obese postmenopausal women. J Osteoporos. 2014;2014:702589. doi: 10.1155/2014/702589. Epub 2014 Jun 18.
• Huck CJ. Effects of supervised resistance training on fitness and functional strength in patients succeeding bariatric surgery. J Strength Cond Res. 2015 Mar;29(3):589-95. doi: 10.1519/JSC.0000000000000667.
• Hong SH, Choi KM. Sarcopenic Obesity, Insulin Resistance, and Their Implications in Cardiovascular and Metabolic Consequences. Int J Mol Sci. 2020 Jan 13;21(2):494. doi: 10.3390/ijms21020494.
• Guazzi M, Arena R, Halle M, Piepoli MF, Myers J, Lavie CJ. 2016 focused update: clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. Eur Heart J. 2018 Apr 7;39(14):1144-1161. doi: 10.1093/eurheartj/ehw180.
• Goto K, Takamatsu K. Hormone and lipolytic responses to whole body vibration in young men. Jpn J Physiol. 2005 Oct;55(5):279-84. doi: 10.2170/jjphysiol.RP000305. Epub 2005 Nov 8.
• Gloeckl R, Heinzelmann I, Baeuerle S, Damm E, Schwedhelm AL, Diril M, Buhrow D, Jerrentrup A, Kenn K. Effects of whole body vibration in patients with chronic obstructive pulmonary disease--a randomized controlled trial. Respir Med. 2012 Jan;106(1):75-83. doi: 10.1016/j.rmed.2011.10.021. Epub 2011 Nov 21.
• Feland JB, Stevenson DL, Hunter I, Hopkins JT, Cochrane DJ. Acute effect of whole-body vibration on electromechanical delay and vertical jump performance. J Musculoskelet Neuronal Interact. 2021 Sep 1;21(3):373-378.
• Di Giminiani R, Rucci N, Capuano L, Ponzetti M, Aielli F, Tihanyi J. Individualized Whole-Body Vibration: Neuromuscular, Biochemical, Muscle Damage and Inflammatory Acute Responses. Dose Response. 2020 Jun 29;18(2):1559325820931262. doi: 10.1177/1559325820931262. eCollection 2020 Apr-Jun.
• Deniz O, Cruz-Jentoft A, Sengul Aycicek G, Unsal P, Esme M, Ucar Y, Burkuk S, Sendur A, Yavuz BB, Cankurtaran M, Halil M. Role of Ultrasonography in Estimating Muscle Mass in Sarcopenic Obesity. JPEN J Parenter Enteral Nutr. 2020 Nov;44(8):1398-1406. doi: 10.1002/jpen.1830. Epub 2020 Apr 28.
• Daniels P, Burns RD, Brusseau TA, Hall MS, Davidson L, Adams TD, Eisenman P. Effect of a randomised 12-week resistance training programme on muscular strength, cross-sectional area and muscle quality in women having undergone Roux-en-Y gastric bypass. J Sports Sci. 2018 Mar;36(5):529-535. doi: 10.1080/02640414.2017.1322217. Epub 2017 May 3.
• https://www.researchgate.net/publication/367638746_THE_EFFECT_OF_6-WEEKS_WHOLE_BODY_VIBRATION_ON_MUSCULAR_PERFORMANCE_ON_YOUNG_NON-COMPETITIVE_FEMALE_ARTISTIC_GYMNASTS
• Blanks AM, Rodriguez-Miguelez P, Looney J, Tucker MA, Jeong J, Thomas J, Blackburn M, Stepp DW, Weintraub NJ, Harris RA. Whole body vibration elicits differential immune and metabolic responses in obese and normal weight individuals. Brain Behav Immun Health. 2019 Nov 14;1:100011. doi: 10.1016/j.bbih.2019.100011. eCollection 2020 Jan.
• Barazzoni R, Bischoff S, Boirie Y, Busetto L, Cederholm T, Dicker D, Toplak H, Van Gossum A, Yumuk V, Vettor R. Sarcopenic Obesity: Time to Meet the Challenge. Obes Facts. 2018;11(4):294-305. doi: 10.1159/000490361. Epub 2018 Jul 18.

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Estimated): May 30, 2026
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): September 1, 2026

Study Registration Dates

• First Submitted: June 16, 2025
• First Submitted That Met QC Criteria: May 16, 2026
• First Posted (Actual): May 22, 2026

Study Record Updates

• Last Update Posted (Actual): May 22, 2026
• Last Update Submitted That Met QC Criteria: May 16, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: bariatric surgery; resistance exercise; whole body vibration; respiration; physical fitness; functional level of muscle
• Additional Relevant MeSH Terms: Pathologic Processes; Nutrition Disorders; Overnutrition; Body Weight; Respiratory Tract Diseases; Respiration Disorders; Pathological Conditions, Signs and Symptoms; Nutritional and Metabolic Diseases; Signs and Symptoms; Overweight; Obesity; Respiratory Aspiration; Obesity, Morbid; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Investigative Techniques; Epidemiologic Research Design; Epidemiologic Methods; Research Design; Methods; Therapeutics; Physical Therapy Modalities; Patient Care; Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Physical Conditioning, Human; Exercise; Control Groups; Resistance Training
• Other Study ID Numbers: IstinyeU

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No