Should Obese Patients be Denied Rehabilitation Resources for Chronic Disabling Occupational Musculoskeletal Disorders?
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In the United States, obesity is a rising concern because of its effect on both physical and mental health. More than one-third of Americans are obese, and approximately 1% (5 million people) suffer from clinically severe obesity (Kolotkin, Meter & Williams, 2001). Little research has been provided on the effect of obesity on functional restoration rehabilitation for work-related chronic musculoskeletal pain patients. The purpose of this study was to determine whether obese individuals are as successful after completing a functional restoration program as those that are of normal weight. Subjects included 3,341 chronic musculoskeletal patients from the Productive Rehabilitation Institute of Dallas for Ergonomics (PRIDE) who were separated in five BMI categories: Normal, Overweight, Obese I, Obese II, and Obese III. For the purposes of this study, the above weight categories were determined by using the body mass index formula: weight in kg/height in m.2 These subjects were evaluated on demographic, physical, psychosocial and one-year socioeconomic variables, with respect to the five BMI categories. The results showed some significant differences in terms of age, gender, and race. Injury related variables, however, were found to be nonsignificant. Significant difference was also found in the physical and psychosocial variables, in terms of disability level, physical functioning and pain intensity. Obese subjects were found to have a higher disability level, lower physical functioning, and higher pain intensity, pre- or post-treatment. In contrast, the results also suggest that the Obese III group improved pre- to post-treatment at the same rate as the other groups. Significant differences were also found in work return among the five groups; however, the linear trend analysis was found to be nonsignificant. This means that the Obese III group was not less likely to return to work than any of the other groups. Work retention, employment status, and hours worked per week did not result in any significant difference among the five groups. It can be concluded from this study that obese individuals are as successful as non obese individuals in returning to normal functioning after functional restoration rehabilitation.