Measuring changes after multidisciplinary rehabilitation of obese individuals

Background: In 2009, the Italian Society of Obesity developed the short-form questionnaire for Obesity-related Disabilities (TSD-OC). Aims: To stage the degree of disability in obese patients using TSD-OC; to verify its sensitivity to change after rehabilitation. Subjects: Three hundred and fifty-five adult obese individuals [body mass index (BMI) >30 kg/m2] undergoing rehabilitation. Exclusion criteria were severe cardiovascular or respiratory diseases, neurological and psychological conditions. Sensitivity to change of TSD-OC was evaluated in 194 patients out of the initial sample. Methods: To define the disability levels according to TSD-OC, the method of interquartile range was applied to the initial sample. The 194 in-patients were assessed with Roland-Morris Disability Questionnaire, Functional Independence Measure (FIM), Functional Visual Analogue Scale, and TSD-OC before (S0) and after 4 weeks (S1) of intensive (3 h daily) rehabilitation multidisciplinary program. Individuals were grouped according to age (1: age 30–59 yr; 2: age over 60 yr) and degree of obesity (BMI: A, 30–40 kg/m2; B, 40–50 kg/m2). Results: At S1, BMI and all the clinical scores improved significantly in the whole study sample. The younger individuals with higher level of obesity showed a higher functional improvement (−51.3%). In the older subjects, improvement was not statistically different when varying BMI (A2–13.7% vs B2–14.6%). In the whole group, the TSD-OC improvement was statistically greater than the physical FIM gain (−25.9% vs +5.4%, p<0.05). Conclusions: Our data evidenced that the TSD-OC is a sensitive measure of short-term changes in disability status of obese individuals after rehabilitation.