To assess the clinical effectiveness of a hospital-based multidisciplinary rehabilitation program (MRP), in a selected population of morbidly obese subjects.
An observational study was undertaken in a population of 59 morbidly obese patients (18 M, 60±10 years, BMI 47±8) with disability and sleep disturbancies (Epworth scale score ≥6). Assessment and correction of OSAS, improvement of exercise tolerance, body weigth and associated psychological features were aims of this MRP. Calibrated dietary intake, twice daily sessions of moderate intensity exercising, twice weekly sessions of psychotherapy have been carried out over 1 month. Polisomnographic assessment and correction of apnea/hypopnea index (AHI) have been performed according to the current guidelines. Lung functions, AHI, 6-minute walked distance (6MWD), boby weight (BW), serum metabolic data (cholesterol, triglicerides, uric acid and glicate haemoglobin), and the quality of life by means of the Sat-P questionnaire have been recorded baseline (T0), at the end (T1) and 6 months after (T2) the MRP.
Overall, PaO2 improved over time (p<0.01), whereas AHI reduced at T1 and then remained stable at T2; in particular, the percentage of patients with AHI≥10 declined (from 65% at T0 to 20% at T1 and T2), despite 14 obese with AHI≥20 were prescribed to have nCPAP at T1. At T1, 6MWD and BW significantly improved (p<0.005) and then maintained at T2; a significant relationship (r= 0.379, p<0.01) has been found between changes of BW and 6MWD (recorded in between T0 and T2). Sat-P item scores dealing with sleep efficiency, problem solving, and social interactions improved (p<0.01) at T1 and then maintained at T2.
This conservative intervention provides useful short and long-term benefits in morbidly obese subjects with disability and sleep disturbancies.
Comprehensive and multidisciplinary rehabilitation could be a useful medical approach in the long-term management of severely disabled morbidly obese subjects.
Enrico Clini, None.