Orthopaedics and Sports Medicine Institute (OSMI), PO Box 112727, Gainesville, FL 32607, USA.
Am J Phys Med Rehabil. 2012 Dec;91(12):1051-9. doi: 10.1097/PHM.0b013e31825f1b19.
This study examined whether differences existed in inpatient rehabilitation outcomes and therapy participation in nonobese and obese patients with orthopedic trauma.
This was a retrospective study of 294 consecutive patients admitted to an inpatient rehabilitation hospital. Main outcomes included participation in therapy sessions, Functional Independence Measure (FIM) ratings, walking distance and stair climb, length of stay, FIM efficiency (FIM score gain/length of stay), and discharge to home. Data were stratified by patient body mass index values (nonobese, <30 kg/m; or obese, ≥30 kg/m).
There were no differences in therapy participation or length of stay between groups. Both total and motor FIM ratings at discharge were lower in obese patients compared with nonobese patients (P < 0.05). FIM efficiency was significantly lower in the obese than in the nonobese group (2.6 ± 1.5 vs. 3.1 ± 1.5 points gained per day; P = 0.05). Walking distance and stair climb ability were similar between groups by discharge. Even morbidly obese patients attained some improvement with independence in walking.
Obese patients make significant functional improvement during rehabilitation, but at a lesser magnitude and rate as their nonobese counterparts. Even with morbid obesity, small but important functional gains can occur during rehabilitation for orthopedic trauma.
本研究旨在探讨骨科创伤患者中，非肥胖者和肥胖者在住院康复结局和治疗参与方面是否存在差异。
这是一项对 294 例连续住院康复医院患者的回顾性研究。主要结局包括治疗参与次数、功能独立性测量（FIM）评分、步行距离和爬楼梯能力、住院时间、FIM 效率（FIM 评分增加/住院时间）以及出院回家情况。数据按患者体重指数值（非肥胖，<30kg/m；或肥胖，≥30kg/m）分层。
两组患者在治疗参与和住院时间方面无差异。与非肥胖患者相比，肥胖患者在出院时的总 FIM 和运动 FIM 评分均较低（P<0.05）。肥胖组的 FIM 效率明显低于非肥胖组（2.6±1.5 与 3.1±1.5 分/天；P=0.05）。出院时两组患者的步行距离和爬楼梯能力相似。即使是病态肥胖患者，在行走方面也能获得一定程度的独立。
肥胖患者在康复过程中会有显著的功能改善，但程度和速度低于非肥胖患者。即使患有病态肥胖，在骨科创伤的康复过程中也能获得微小但重要的功能改善。
