Effectiveness of Multidisciplinary Inpatient and Outpatient Rehabilitation on Functional Outcomes in Obese Patients with Orthopedic Comorbidities

Abstract

Outpatient and inpatient rehabilitation programs are designed to minimize or abolish disability associated with obesity, which may be predominantly due to cardiorespiratory and musculoskeletal issues, and general deconditioning. This chapter discusses the efficacy of outpatient multidisciplinary rehabilitation in obese patients, and presents emerging evidence of the effects of inpatient rehabilitation on functional outcomes in obese patients with disabling orthopedic conditions. In inpatient setting, obesity and its related comorbidities may prolong or complicate hospital stays and reduce efficiency of functional gain. Because of the relative scarcity of data regarding inpatient rehabilitation programs, we performed a large prospective investigation on obese patients with orthopedic conditions (N = 464). Intensive rehabilitation administered to obese patients with orthopedic conditions and motor difficulties consisted of a 4-week multidisciplinary program covering nutritional, motor, and psychological aspects. Our data provide initial evidence that multidisciplinary intensive rehabilitation is effective in minimizing the obesity-related disability and enhancing functional capacities in obese patients with motor disability. Outpatient rehabilitation programs in obese patients focus on chronic musculoskeletal conditions resulting from obesity, specifically joint misalignment, balance and postural issues, and osteoarthritis. Common goals include decreasing body weight, reducing metabolic disease risk and musculoskeletal pain severity, and improving functional strength and mobility. The chapter discusses the randomized controlled trials which have previously examined the efficacy of a variety of outpatient exercise programs using variations of resistance and/or aerobic exercise modalities at achieving these goals.