Supplementary Material for: Resistance training following metabolic-bariatric surgery: motivators, barriers and preferences

Introduction. Metabolic and bariatric surgery (MBS) leads to substantial muscle mass loss. Resistance training (RT) is an effective strategy to maintain muscle mass. This study aimed to gain insight in the motivators, barriers and preferences that are correlated to RT uptake after MBS.
Methods. A digital survey assessing RT was sent to patients who had MBS 1 to 18 months prior. Patient characteristics were extracted from electronic health records. Motivators, barriers and preferences were assessed with a questionnaire and compared across three groups: patients currently (RT-group), previously (ex-RT) or never engaged in RT (non-RT).
Results. Among 1,609 participants (77% female, 47±11 years old, BMI 42±5 kg/m2) 68% was classified as RT-group, 11% as ex-RT and 21% as non-RT. The RT-group reported improving fitness (78% vs. 67%), mental health (65% vs. 43%) and overall health (63% vs. 41%) more often as motivators for RT than the ex-RT. RT barriers were comparable between ex-RT and non-RT, most frequently: lack of motivation (37% vs. 40%), time (33% vs. 28%), enjoyment (29% vs. 29%) and physical complaints (39% vs. 37%). Ex- and non-RT reported a preferred exercise frequency of 2 sessions/week with 30 minutes/session, in their home setting with a training schedule and guidance from a professional.
Conclusion. The majority of participants in our study engaged in RT. We identified improving overall fitness and limiting strength or muscle loss as motivators, lack of motivation, physical complaints, lack of time and enjoyment as barriers, and professional guidance and a training schedule for RT at home as facilitators, that were correlated to RT uptake after MBS.

引言：代谢减重手术（Metabolic and bariatric surgery, MBS）可导致显著的肌肉量丢失。抗阻训练（Resistance training, RT）是维持肌肉量的有效策略。本研究旨在深入探究代谢减重术后抗阻训练接受度相关的驱动因素、阻碍因素与偏好选择。
方法：本研究向术后1至18个月已接受代谢减重手术的患者发放了评估抗阻训练情况的电子问卷。从受试者的电子健康档案中提取其基线特征。通过问卷调查评估抗阻训练的驱动因素、阻碍因素与偏好选择，并将受试者分为当前参与抗阻训练组（RT组）、既往参与抗阻训练组（ex-RT组）及从未参与抗阻训练组（non-RT组）进行组间比较。
结果：本研究共纳入1609名受试者（77%为女性，年龄47±11岁，体质量指数42±5 kg/m²），其中68%被归入RT组，11%为ex-RT组，21%为non-RT组。与ex-RT组相比，RT组更常将改善体能（78% vs. 67%）、心理健康（65% vs. 43%）及整体健康状况（63% vs. 41%）作为参与抗阻训练的驱动因素。ex-RT组与non-RT组的抗阻训练阻碍因素较为相似，最常见的阻碍因素分别为：缺乏动力（37% vs. 40%）、时间不足（33% vs. 28%）、训练趣味性不足（29% vs. 29%）及躯体不适（39% vs. 37%）。ex-RT组与non-RT组均偏好每周进行2次、每次30分钟的居家抗阻训练，且希望获得训练计划与专业人员指导。
结论：本研究中大部分受试者均参与了抗阻训练。本研究明确了与代谢减重术后抗阻训练接受度相关的关键因素：改善整体体能与延缓肌力或肌肉量丢失为驱动因素，缺乏动力、躯体不适、时间不足及训练趣味性不足为阻碍因素，而居家抗阻训练的专业指导与标准化训练计划则为促进因素。