The Effect of Body Mass Index on Pulmonary Related Debility Rehabilitation.

BACKGROUND: Obesity is a known factor for the development of abnormal respiratory physiology. However, several studies have found that obesity does not hinder functional recovery in patients hospitalized for postacute care following a stroke or cardiovascular event. This study was designed to determine the effect of overweight and obesity on patients with acute pulmonary disease, hospitalized in an inpatient rehabilitation facility (IRF). OBJECTIVE: To investigate the impact of body mass index (BMI) on indices of function, specifically, the functional independence measure (FIM) among patients with pulmonary related debility admitted to a rehabilitation hospital. DESIGN: Retrospective cohort study. SETTING: Pulmonary unit in an acute freestanding rehabilitation hospital. PATIENTS: All patients admitted to an IRF with a diagnosis of pulmonary related debility over a 6-year period. METHODS: The data used in the study included the patient height and weight (measured on admission) and FIM (scored on admission and discharge). MAIN OUTCOME MEASURES: The primary study outcome measure was the change in FIM per day by the patients' BMI category. RESULTS: For the 381 patients admitted during the observation period, BMI was compared with FIM score changes per day (FIM efficiency). After adjusting for age and sex, the FIM efficiency only slightly differed by BMI, failing to reach statistical significance. However, age did significantly influence the outcome (P = .05). CONCLUSION: This study demonstrates that among a large group of patients with a pulmonary related debility, there was no statistically significant correlation between BMI and FIM efficiency. The overweight patients were similar in progression to those who were underweight, normal weight, and obese. However, this study found that increased age adversely affected the outcome of rehabilitation. LEVEL OF EVIDENCE: III.

The Effect of Body Mass Index on the Functional Prognosis of Traumatic Brain Injury Patients.

BACKGROUND: Although many studies have demonstrated that obesity is correlated with an increased risk of chronic disease, some have reported a paradox by which those in the higher weight categories actually recover better during hospitalization. This study was designed to determine whether this obesity paradox is also reflected in the recovery of patients with traumatic brain injury (TBI) undergoing care in a rehabilitation hospital. OBJECTIVE: To investigate the association between body mass index (BMI) and the functional progress of patients with TBI, admitted to a rehabilitation hospital. DESIGN: Retrospective cohort study. METHODS: The study included all patients admitted to the brain injury unit of a rehabilitation hospital over a 6-year period. The data used for this study included patient height and weight (measured on admission) and functional independence measurements (scored on admission and discharge). MAIN OUTCOME MEASURES: Functional independence measure (FIM) change per day, BMI category. RESULTS: For the 444 patients admitted, the overall FIM efficiency did not differ significantly by BMI (P = .93). After adjusting for age and gender, overweight and obese patients had the lowest FIM efficiency (1.04 for both groups), followed by the underweight and normal weight groups (1.11 and 1.26, respectively). CONCLUSION: This study demonstrated that higher BMI was not significantly correlated with the rate of functional recovery among patients admitted to a rehabilitation hospital for TBI. LEVEL OF EVIDENCE: III.

The Effect of Body Mass Index on Functional Outcome of Patients With Knee Replacement.

OBJECTIVE: To investigate the effects of body mass index (BMI) on the rehabilitation process in patients with a recent knee replacement. DESIGN: This retrospective cohort study included all patients admitted to a rehabilitation hospital, with a recent diagnosis of knee replacement and available hospital admission data including height and weight, between 2014 and 2017. SETTING: Rehabilitation hospital. PARTICIPANTS: Study participants included patients who had undergone knee replacement surgery (N=742), with available BMI data. INTERVENTIONS: None. MAIN OUTCOME MEASURES: FIM scores, including FIM change per day (FIM efficiency) by BMI category. RESULTS: The chart review identified 742 patients who had undergone knee replacement surgery, with available BMI data. The identified patients ranged in age from 58 to 85 years, with a mean age of 70 years. Of the patients included in the study, 24 were male, 49 were female, 73 were within the normal weight class, 180 in the overweight class, 189 in the obese class I, 143 in the obese class II, and 157 patients were classified as obese class III. The mean FIM efficiency was highest in the obese class II category (3.96). In a multivariate analysis after controlling for age, obese classes II and III had significantly better FIM efficiency. CONCLUSION: This study did not demonstrate that obesity adversely affects the rate of recovery during hospitalization after knee replacement surgery.

Effect of body mass index on stroke rehabilitation.

OBJECTIVE: To investigate the association between body mass index (BMI) and the functional progress of patients with stroke, admitted to a rehabilitation hospital. DESIGN: A retrospective cohort study. SETTING: A freestanding university rehabilitation hospital stroke unit. PARTICIPANTS: All patients (N=819) admitted to the stroke unit of a rehabilitation hospital during the study. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The primary study outcome measure was the FIM efficiency of patients by BMI category. RESULTS: For the 819 patients admitted during the observation period, BMI was compared with FIM score changes per day (FIM efficiency). After adjusting for age and sex, the FIM efficiency differed by BMI. The underweight group had the lowest FIM efficiency, followed by the obese and normal-weight subgroups. The overweight group had the highest FIM efficiency (P=.05) when compared with the obese subgroup. CONCLUSIONS: Among patients admitted to an acute rehabilitation hospital for stroke rehabilitation, overweight patients had better functional progress than did patients in the other weight categories.