Outpatient rehabilitation outcomes in obese patients with orthopedic conditions

Obesity is related to the development of functional and mobility impairment, musculoskeletal pain and orthopedic problems. Irrespective of age, obese children and adults have impaired walking capacity and body transfer ability, and difficulties navigating obstacle courses or community spaces. Obesity is related to relative strength deficits, musculoskeletal pain, kinesiophobia, low self-efficacy and a decline in quality of life.

This review provides an update of the available evidence for the efficacy of outpatient rehabilitation programs for the treatment of disabling obesity.

Outpatient rehabilitation programs can effectively improve muscle strength, self-confidence and physical function. Key rehabilitation components should include aerobic exercise (AX), resistance exercise (RX) and cognitive strategies to cope with the unique challenges posed by obesity. Available high quality evidence indicates that 3-18 month rehabilitation programs that included aerobic and strengthening exercise (2-3 days per week) with caloric restriction (typically 500-750 kcal deficit/ day), elicited the best changes in functional performance measures compared with exercise or diet alone.

Comprehensive outpatient rehabilitation interventions coupled with diet can catalyze lifestyle patterns that improve and preserve physical function over the life span.