title: Body mass index and functional mobility outcome following early rehabilitation after a total knee replacement: a retrospective study in Taiwan.
abstract: OBJECTIVE
  Obesity is associated with an increased risk of osteoarthritis, and the incidence of obese patients requiring a total knee replacement (TKR) has increased in recent years. A high body mass index (BMI) may influence post-TKR rehabilitation outcomes. We investigated the effects of obesity on functional mobility outcomes following post-TKR rehabilitation in Asian patients whose BMIs were not as high as those reported in similar studies performed in non-Asian countries.
  
  
  METHODS
  A total of 113 patients were categorized as normal weight (n = 23), overweight (n = 32), class I obese (n = 31), or class II/III obese (n = 27). Patients were retrospectively followed up for 6 months after undergoing TKR followed by 2 months of active rehabilitation. Outcome measures were recorded at baseline and at the 2-month and 6-month followup assessments and included the Western Ontario and McMaster Universities Osteoarthritis Index and the following tests: functional reach, single-leg stance, ten-meter walk, timed up and go, chair rise, and stair climbing.
  
  
  RESULTS
  A 4 × 3 (group × time) repeated-measures analysis of variance showed significant improvement in all of the outcome measures for all of the BMI groups at the 2-month and 6-month followup assessments (P < 0.05 for all). No significant intergroup differences at the 2-month and 6-month followup assessments were observed for any of the mobility measures except the functional reach and single-leg stance (P < 0.05).
  
  
  CONCLUSIONS
  Patients with class II/III obesity benefit from early post-TKR outpatient rehabilitation and respond as well as patients with lower BMIs.
authors.affiliation: Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chun-de
authors.initials: CD
authors.lastname: Liao
authors.affiliation: National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Li-Fong
authors.initials: LF
authors.lastname: Lin
authors.affiliation: Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Huang
authors.affiliation: Shuang Ho Hospital and Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.
authors.forename: Tsan-Hon
authors.initials: TH
authors.lastname: Liou
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000534:rehabilitation*; D044466:Asian People; D001696:Biomechanical Phenomena; D015992:Body Mass Index; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome