Title:
The Effects of Obesity on Functional Work Capacity and Quality of Life in Phase II Cardiac Rehabilitation
Objective:
Many patients referred to cardiac rehabilitation (CR) programs are obese and such patients are at elevated risk for dropout. However, it is unclear whether obese individuals who complete CR derive reduced benefit from their participation.
Methods:
Complete data from 393 CR patients was extracted from a clinical database. Participants were categorized into normal weight (BMI 18.5-24.9; N = 71), overweight (BMI 25-29.9; N = 173), Class I obese (BMI 30-34.9; N = 85), and Class II or III obese (BMI >= 35; N = 64) groups. Functional work capacity (estimated METS from treadmill testing) and physical and mental quality of life (Physical Composite Score and Mental Composite Score from the SF-36) were examined at baseline and 12-week completion of CR program.
Results:
After adjusting for demographic and medical conditions, Class II/III obese persons showed lower work capacity and physical quality of life than other groups at both baseline and follow-up. When comparing changes from baseline to follow-up Class II/III obese individuals showed smaller gains in work capacity all other groups, though no differences emerged for physical or mental quality of life. See Figures below.
Conclusions:
Although patients with a BMI >= 35 do benefit from participation in CR, they do not benefit as much as patients with lower BMI. Further work is needed to identify strategies for improving outcome in obese patients, including the possible benefits of an exercise maintenance program at the completion of CR.