Physical capacity outcomes in patients with severe obesity after 12 months of physician-led multidisciplinary team care: A case series from a public hospital clinical obesity service
| Autor: | Nic Kormas, Suzanne Edwards, Milan K. Piya, Kathryn Skelsey, Vincent T. Ho, Lachlan Rickards, Evan Atlantis, Kiri Langford |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Referral 030309 nutrition & dietetics Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Disease Walking Body Mass Index 03 medical and health sciences 0302 clinical medicine Weight loss Internal medicine Diabetes mellitus Physicians medicine Humans Aged 0303 health sciences business.industry Hospitals Public Medical record Middle Aged medicine.disease Obesity Exercise Therapy Obesity Morbid Treatment Outcome Female medicine.symptom business Body mass index Case series |
| Zdroj: | Clinical obesityREFERENCES. 9(6) |
| ISSN: | 1758-8111 |
| Popis: | Impaired physical capacity is common in people with severe levels of obesity. We aimed to investigate changes in physical capacity outcomes in patients with severe obesity following 12 months of physician-led multidisciplinary care from a "real world" Australian public hospital setting using a case series study design. We extracted data from medical records for all of the eligible patients referred to our clinical obesity service from 2010 to 2015 (69 of 239). We found significant (P < .05) pre-test/post-test (mean ± SD) improvements in the 6-minute walk test (6MWT) (339 ± 120 to 417 ± 112 m); 30-second sit-to-stand test (11 ± 4 to 15 ± 6 counts) and sit-and-reach test (-12 ± 13 to -8 ± 15 cm). Using linear mixed-effects models adjusting for repeated measurements over time (baseline vs 12 months) and testing for potential predictors, we found: mean 6MWT was associated with 12-month time period (56 m), body mass index (BMI, -3 m), no walking aid over 12 months (106 m) and no opioid analgesics (75 m); mean sit-to-stand was associated with 12-month time period (3 counts), age at referral (-0.2 counts), BMI (-0.2 counts), and diabetes (3 counts); and mean sit-and-reach was associated with 12-month time period (5 cm), female gender (5 cm) and total medications (-0.9 cm). Using causal mediation analysis, our results show that total exercise classes partially mediates change in walking capacity among those with cardiovascular disease. Our study shows that significant and clinically important improvements in physical capacity outcomes in patients with severe obesity can be achieved following 12 months of intensive specialist obesity services, such as ours. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
| Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |