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Obese patients recovered faster in a rehab facility
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Patients with a BMI of 30 or higher had a faster recovery at an acute rehabilitation hospital compared with patients classified as normal-weight or underweight.
Researchers examined associations of BMI with functional independence measure scores, which measure the ability of patients to mobilize and care for their basic needs after a severe injury or illness.
In the retrospective study, the researchers classified 1,077 inpatients as underweight (BMI ,18.5), normal-range (18.5-24.9), overweight (25-29.9), obese class 1 (30-34.9), obese class 2 (35-39.9) and obese class 3 (.40).
Patients classified as obese class 1 had the fastest recovery from admission to discharge, followed by obese class 2 patients. All obese patients progressed faster than those who were normal-weight or underweight. These findings persisted even after adjustments for age, sex and length of in-hospital stay. The researchers also examined whether the association between BMI and functional independence measure was different across motor and cognitive skill categories; most improvement was motor-related, not cognitive. – by Katie Kalvaitis
Am J Phys Med Rehabil. 2008;87:21-25.
It is an interesting study but one that is difficult to draw many relevant conclusions with regard to body weight and its relationship to functional independence measure. First, the population is heterogeneous and therefore it is difficult to draw significant conclusions about functional independence measure. There are many things that impact how a person will perform in a rehabilitation setting other than body weight; for example, resolution of the medical issues that originally led them to be deconditioned or presence of comorbid conditions such as diabetes and hypertension. A person with chronic kidney failure may not have the same ability to rehabilitate as someone that had suffered an acute injury. This report correctly indicates some of the limitations of the study, including no measurements on muscle mass strength or body fat and inability to control for the severity of underlying disease. These limitations are problematic and hinder the validity of the conclusion that obese individuals had better response to rehab than normal weight individuals. The more reliable conclusion was that all groups benefitted from rehabilitation.
– Dara P. Schuster, MD
Associate Professor, Internal Medicine, Ohio State University