[ { "page": 1, "items": [ { "page": 1, "type": "TEXT", "location": { "l": 154.7688, "t": 750.72, "r": 460.4672, "b": 737.04 }, "text": "Homerton bariatric service: physiotherapy essential advice", "reading_order": 0 }, { "page": 1, "type": "TITLE", "location": { "l": 53.7492, "t": 719.76, "r": 387.2819, "b": 706.08 }, "text": "Why is exercise important before and after bariatric surgery?", "reading_order": 1, "level": 2 }, { "page": 1, "type": "TEXT", "location": { "l": 53.9891, "t": 689.28, "r": 542.0507, "b": 633.6 }, "text": "Physical activity plays a vital role in your bariatric surgery journey – from preparing your body for surgery to helping ensure a safe recovery, and supporting long-term weight management. Below we have outlined the advised recommendations for a safe and successful surgery outcome. If you are struggling to meet these guidelines, it is important you discuss this with a member of the Bariatric team to establish if any further support is required.", "reading_order": 2 }, { "page": 1, "type": "TITLE", "location": { "l": 61.4276, "t": 604.08, "r": 268.5059, "b": 589.44 }, "text": "Before Surgery – Get Your Body Ready", "reading_order": 3, "level": 2 }, { "page": 1, "type": "TITLE", "location": { "l": 313.6168, "t": 604.08, "r": 537.4917, "b": 588.96 }, "text": "After Surgery – Keep Moving, Stay Strong", "reading_order": 4, "level": 2 }, { "page": 1, "type": "TITLE", "location": { "l": 61.6676, "t": 573.6, "r": 95.7407, "b": 561.12 }, "text": "Goals:", "reading_order": 5, "level": 2 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 60.7078, "t": 558.48, "r": 289.8616, "b": 531.84 }, "text": "Improve fitness for surgery (reduces anaesthetic risks and surgical complications)", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 6 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 61.1877, "t": 529.68, "r": 281.7032, "b": 502.08 }, "text": "Build muscle strength and stamina to improve post-op recovery", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 7 }, { "page": 1, "type": "TITLE", "location": { "l": 314.5766, "t": 573.36, "r": 348.4098, "b": 560.88 }, "text": "Goals:", "reading_order": 8, "level": 2 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 314.3366, "t": 558.48, "r": 471.505, "b": 545.52 }, "text": "Enhance weight loss outcomes", "marker": "•", "list_id": "L2", "level": 0, "reading_order": 9 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 314.5766, "t": 543.6, "r": 513.0166, "b": 530.64 }, "text": "Preserve muscle mass during weight loss", "marker": "•", "list_id": "L2", "level": 0, "reading_order": 10 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 314.8165, "t": 528.48, "r": 481.103, "b": 515.52 }, "text": "Help reduce risk of weight re-gain", "marker": "•", "list_id": "L2", "level": 0, "reading_order": 11 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 315.0565, "t": 514.08, "r": 512.7766, "b": 486.96 }, "text": "Improve blood pressure, blood sugar and cholesterol", "marker": "•", "list_id": "L2", "level": 0, "reading_order": 12 }, { "page": 1, "type": "TITLE", "location": { "l": 61.6676, "t": 487.68, "r": 183.0831, "b": 474.48 }, "text": "Recommended Activities:", "reading_order": 13, "level": 2 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 60.9477, "t": 471.36, "r": 292.501, "b": 418.08 }, "text": "Aim for at least 150 minutes of moderate-intensity exercise per week (e.g., brisk walking, cycling). This can be broken down into 10-minute bouts.", "marker": "•", "list_id": "L3", "level": 0, "reading_order": 14 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 60.7078, "t": 415.44, "r": 280.0236, "b": 374.4 }, "text": "Include strength-building activities at least 2 days a week (e.g., bodyweight exercises, resistance bands)", "marker": "•", "list_id": "L3", "level": 0, "reading_order": 15 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 60.9477, "t": 372, "r": 277.624, "b": 345.6 }, "text": "Reduce sitting time – stand or move regularly throughout the day", "marker": "•", "list_id": "L3", "level": 0, "reading_order": 16 }, { "page": 1, "type": "TEXT", "location": { "l": 60.7078, "t": 343.68, "r": 293.7008, "b": 317.52 }, "text": "Start gradually if you are not active. Every movement counts!", "reading_order": 17 }, { "page": 1, "type": "TITLE", "location": { "l": 314.5766, "t": 471.84, "r": 442.9507, "b": 458.64 }, "text": "Early Recovery (0–6 weeks):", "reading_order": 18, "level": 2 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 313.8567, "t": 456.96, "r": 512.0568, "b": 429.84 }, "text": "Start gentle walking as soon as advised – usually within 24 hours", "marker": "•", "list_id": "L4", "level": 0, "reading_order": 19 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 314.8165, "t": 428.16, "r": 522.3747, "b": 414.48 }, "text": "Increase walking time daily (little and often)", "marker": "•", "list_id": "L4", "level": 0, "reading_order": 20 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 314.8165, "t": 413.28, "r": 509.6573, "b": 399.6 }, "text": "Avoid lifting heavy objects for 4–6 weeks", "marker": "•", "list_id": "L4", "level": 0, "reading_order": 21 }, { "page": 1, "type": "TITLE", "location": { "l": 314.5766, "t": 384.96, "r": 414.8764, "b": 372.48 }, "text": "6 Weeks and Beyond:", "reading_order": 22, "level": 2 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 313.8567, "t": 370.08, "r": 533.8924, "b": 342.96 }, "text": "Gradually return to 150–300 minutes/week of moderate-intensity aerobic activity", "marker": "•", "list_id": "L5", "level": 0, "reading_order": 23 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 314.0967, "t": 341.28, "r": 524.2943, "b": 312.48 }, "text": "Add muscle-strengthening exercises (e.g., resistance training) at least 2 days/week", "marker": "•", "list_id": "L5", "level": 0, "reading_order": 24 }, { "page": 1, "type": "TITLE", "location": { "l": 56.6286, "t": 288.48, "r": 164.1269, "b": 276.96 }, "text": "Risks of Not Exercising", "reading_order": 25, "level": 3 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 53.9891, "t": 273.84, "r": 477.7437, "b": 261.6 }, "text": "Higher risk of post-surgical complications (e.g., respiratory problems, slower wound healing)", "marker": "•", "list_id": "L6", "level": 0, "reading_order": 26 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 53.7492, "t": 259.2, "r": 276.4243, "b": 247.44 }, "text": "Slower recovery and return to daily activities", "marker": "•", "list_id": "L6", "level": 0, "reading_order": 27 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 53.7492, "t": 244.32, "r": 336.4122, "b": 232.32 }, "text": "Reduced weight loss and higher chance of regaining weight", "marker": "•", "list_id": "L6", "level": 0, "reading_order": 28 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 53.9891, "t": 229.44, "r": 264.4267, "b": 217.68 }, "text": "Loss of muscle mass and physical function", "marker": "•", "list_id": "L6", "level": 0, "reading_order": 29 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 53.9891, "t": 214.8, "r": 427.5938, "b": 202.8 }, "text": "Increased risk of long-term health problems (e.g., type 2 diabetes, heart disease)", "marker": "•", "list_id": "L6", "level": 0, "reading_order": 30 }, { "page": 1, "type": "TITLE", "location": { "l": 54.469, "t": 169.2, "r": 149.7298, "b": 158.16 }, "text": "Further information:", "reading_order": 31, "level": 3 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 53.9891, "t": 155.04, "r": 526.6938, "b": 114 }, "text": "Please refer to the Homerton Bariatric Surgery Service Website (www.homerton.nhs.uk/obesity-surgery-bariatrics/). Under the ‘patient resources’ section, review the physiotherapy resources for further essential education videos, exercise videos and patient testimonials.", "marker": "•", "links": [ { "uri": "http://www.homerton.nhs.uk/obesity-surgery-bariatrics/", "dest": null, "action_type": "/URI", "bbox": [ 344.98, 141.28, 561.55, 156.08 ] }, { "uri": "http://www.homerton.nhs.uk/obesity-surgery-bariatrics/", "dest": null, "action_type": "/URI", "bbox": [ 54.45, 127.14, 120.99, 141.28 ] } ], "list_id": "L7", "level": 0, "reading_order": 32 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 54.2291, "t": 111.84, "r": 550.449, "b": 85.44 }, "text": "Seek out resources in your local borough, for example ask your GP to refer you to your local 'Physical Activity on Referral' programme if available.", "marker": "•", "list_id": "L7", "level": 0, "reading_order": 33 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 53.9891, "t": 82.8, "r": 525.974, "b": 57.12 }, "text": "Search for resources online to exercise at home, such as the NHS fitness studio videos (www.nhs.uk/live-well/exercise/about-our-videos/).", "marker": "•", "links": [ { "uri": "http://www.nhs.uk/live-well/exercise/about-our-videos/", "dest": null, "action_type": "/URI", "bbox": [ 446.75, 69.249, 561.55, 84.053 ] }, { "uri": "http://www.nhs.uk/live-well/exercise/about-our-videos/", "dest": null, "action_type": "/URI", "bbox": [ 54.45, 55.109, 212.96, 69.249 ] } ], "list_id": "L7", "level": 0, "reading_order": 34 }, { "page": 1, "type": "FIGURE", "location": { "l": 95.2608, "t": 50.64, "r": 516.8558, "b": 11.76 }, "text": "", "reading_order": 35 } ] } ]