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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.

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.

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.

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