ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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JMBS 2022, 7(2): 202–208
https://doi.org/10.26693/jmbs07.02.202
Physical Therapy and Ergotherapy

Determination of the State of Basic Activities of Daily Life in Patients with Morbid Obesity as an Aspect of the Efficiency of the Physical Therapy Program

Aravitska M. G.
Abstract

The main reasons for the restriction of activities of daily life in individuals with morbid obesity are limited mobility due to deterioration in flexibility and strength, deterioration in balance, and concomitant pathology of the musculoskeletal system. The data available in the current literature predominantly highlight disorders of activities of daily life in obese elderly people. At the same time, there are almost no studies highlighting the limitations of activities of daily life in morbid obesity, as well as the gender characteristics of these limitations. The purpose of the study was to determine the nature of daily life activity disturbances in men and women with morbid obesity and the effectiveness of their correction by means of physical therapy against the background of different levels of therapeutic alliance. Materials and methods. 74 adults of the second adult age (39.6 ± 1.4 years) were examined with a morbid obesity established by body mass index (more than 40) (43 women and 21 men). According to the results of determining the therapeutic alliance, they were divided into two groups. The comparison group consisted of individuals with a low level of therapeutic alliance who refused to actively participate in the program of weight loss. The main group consisted of patients with a high level of therapeutic alliance, they underwent a correction program using dietary and lifestyle modifications, therapeutic exercises, massage, acupuncture, psychocorrection lasting one year. The main principle of the program was an individual approach taking into account the physical capabilities, comorbidities, psycho-emotional state of the patient with constant monitoring of body functions against the background of maintaining a high level of therapeutic alliance. The performance of daily life activities was characterized by the dynamics of the Barthel index parameters. Results and discussion. In patients with morbid obesity, a deterioration in the performance of daily life activities (according to the Barthel index) was revealed. The use of kinesitherapy against the background of a decrease in body weight as a part of a physical therapy program allowed the patients to restore their independence when performing activities of daily life (according to the Barthel index). The low level of therapeutic alliance led to poor implementation or non-implementation of the recommendations provided (aimed at reducing body weight, increasing physical activity), which was associated with a lack of improvement in the performance of daily life activities. Conclusion. As a result of one-year implementation of the developed program of physical therapy, a statistically significant (p<0.05) improvement in the studied indicators of daily life activities in patients with morbid obesity and restoration of functional independence in this indicator was determined compared to the initial result

Keywords: rehabilitation, adipose tissue, medical compliance, Barthel index

Full text: PDF (Ukr) 283K

References
  1. Clinical Guidelines on the identification, evaluation and treatment of overweight and obesity in adults. The Evidence Report. National Heart, Lung and Blood Institute, NIH; 1998.
  2. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation (WHO Technical Report Series 894). Available from: http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/
  3. Keaver L, Xu B, Jaccard A, Webber L. Morbid obesity in the UK: A modelling projection study to 2035. Scand J Public Health. 2020;48(4):422-427. https://doi.org/10.1177/1403494818794814
  4. Williamson K, Nimegeer A, Lean M. Rising prevalence of BMI ≥40 kg/m2 : A high-demand epidemic needing better documentation. Obes Rev. 2020;21(4):e12986. https://doi.org/10.1111/obr.12986
  5. Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, et al. American association of clinical endocrinologists and American college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22 Suppl 3:1-203. https://doi.org/10.4158/EP161365.GL
  6. Alley DE, Chang VW. The changing relationship of obesity and disability, 1988-2004. JAMA. 2007;298(17):2020-7. https://doi.org/10.1001/jama.298.17.2020
  7. An R, Shi Y. Body weight status and onset of functional limitations in U.S. middle-aged and older adults. Disabil Health J. 2015;8(3):336-44. https://doi.org/10.1016/j.dhjo.2015.02.003
  8. James AB. Activities of daily living and instrumental activities of daily living. In: E Crepeau, E Cohn, B Boyt. Schell, Willard & Spackman’s OccupationalTherapy. 11-th ed. Baltimore MD: Lippincott, Williams & Wilkins; 2009.
  9. Backholer K, Wong E, Freak-Poli R, Walls HL, Peeters A. Increasing body weight and risk of limitations in activities of daily living: a systematic review and meta-analysis. Obes Rev. 2012;13(5):456-68. https://doi.org/10.1111/j.1467-789X.2011.00970.x
  10. Baumgartner RN, Wayne SJ, Waters DL, Janssen I, Gallagher D, Morley JE. Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res. 2004;12(12):1995-2004. https://doi.org/10.1038/oby.2004.250
  11. Chen LJ, Steptoe A, Ku PW. Obesity, Apolipoprotein E ε4, and Difficulties in Activities of Daily Living Among Older Adults: a 6-Year Follow-up Study. Ann Behav Med. 2017;51(2):251-260. https://doi.org/10.1007/s12160-016-9848-y
  12. Wojzischke J, Bauer JM, Hein A, Diekmann R. The Relevance of Obesity for Activities of Daily Living in Geriatric Rehabilitation Patients. Nutrients. 2021;13(7):2292. https://doi.org/10.3390/nu13072292
  13. Ozturk GZ, Egici MT, Bukhari MH, Toprak D. Association between body mass index and activities of daily living in homecare patients. Pak J Med Sci. 2017;33(6):1479-1484. doi:10.12669/pjms.336.13748
  14. Monteiro F, Ponce DAN, Silva H, Pitta F, Carrilho AJF. Physical Function, Quality of Life, and Energy Expenditure During Activities of Daily Living in Obese, Post-Bariatric Surgery, and Healthy Subjects. Obes Surg. 2017;27(8):2138-2144. https://doi.org/10.1007/s11695-017-2619-4
  15. Aravitska MG. Analiz gender-zalezhnogo rukhovogo patternu u patsiyentiv z morbidnym ozhyrinnyam za rezultatamy testovykh vprav FUNCTIONAL MOVEMENT SCREEN [Analysis of the gender-dependent motor pattern in patients with morbid obesity by FUNCTIONAL MOVEMENT SCREEN test exercise results]. Art of Medicine. 2020;2(14):16-22. [Ukrainian]. https://doi.org/10.21802/artm.2020.2.14.16
  16. Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. Md State Med J. 1965;14:61-5.
  17. Gosman-Hedström G, Svensson E. Parallel reliability of the functional independence measure and the Barthel ADL index. Disabil Rehabil. 2000;22(16):702-15. https://doi.org/10.1080/09638280050191972
  18. Nossum R, Johansen AE, Kjeken I. Occupational problems and barriers reported by individuals with obesity. Scand J Occup Ther. 2018;25(2):136-144. https://doi.org/10.1080/11038128.2017.1279211
  19. Ervin CM, Whalley D, von Huth Smith L, Crawford R, Dine J, Fehnel SE. Development of the impact of weight on daily activities questionnaire: A patient-reported outcome measure. Clin Obes. 2020;10(6):e12387. https://doi.org/10.1111/cob.12387
  20. Aravitska MG. Analiz indyvidualnykh shlyakhiv pokrashchennya komplayensu khvorykh ozhyrinnyam yak aspekt vyznachennya tsiley reabilitatsiyi [Analysis of Individual Ways of Compliance Improvement in Obese Patients as an Aspect of Determining Rehabilitation Goals]. Ukr Zh Med Biol Sportu. 2019;6 (22): 362-369. [Ukrainian]. https://doi.org/10.26693/jmbs04.06.362