Eur J Phys Rehabil Med. 2026 Aug;62(4):432-440. doi: 10.23736/S1973-9087.26.09267-1.
ABSTRACT
BACKGROUND: A recent definition of clinical obesity emphasises the presence of age-adjusted limitations in activities of daily living (ADLs). Early identification of ADL limitations and factors negatively influencing the development of disability is needed to enhance the effectiveness of rehabilitation programs.
AIM: To investigate the relationship between functional limitations in ADLs, body composition parameters, and comorbid conditions in a large cohort of adults with different degrees of obesity.
DESIGN: Retrospective observational cross-sectional study.
SETTING: Hospital-based rehabilitation setting.
POPULATION: Adult inpatients with different degree of obesity, from mild to severe obesity.
METHODS: Patients were enrolled at hospital admission. Collected data included demographic/anthropometric measures, functional status (by modified Katz ADL Index), comorbidities, body composition, and muscle strength.
RESULTS: Out of 3229 enrolled patients, 193 (6.0%) resulted fully dependent, while 2115 (65.5%) were fully independent. The most frequently observed disabilities were in urine/fecal continence (24.7%) and toileting (15.5%). ADL impairments were significantly associated with older age, higher BMI, higher waist circumference, excess of fat mass, reduced fat-free mass and lower values of HGS. The logistic model identified 5 variables statistically associated with the probability to be a fully dependent patient: age, weight and waist circumference increased this probability, while Muscle Mass and Hand Grip strength lowered it. Osteoarthritis was present in 52% of patient with severe limitations.
CONCLUSIONS: The severity in ADLs is influenced by both body composition and comorbid conditions.
CLINICAL REHABILITATION IMPACT: Rehabilitation should focus on functional limitations and presence of comorbidities and risk factors in patients with obesity, and particularly on preventing muscle mass loss during weight management.
PMID:42517169 | DOI:10.23736/S1973-9087.26.09267-1
