Paolo Capodaglio - Rehabilitation Interventions in the Patient with Obesity

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It gives me great pleasure to write the foreword to this book onRehabilitation Interventions in the Patient with Obesity, edited by Dr. Paolo Capodaglio. It is a very important book because it contributes to the field of obesity, presenting evidence-based rehabilitation protocols to rehabilitation professionals, as well as giving guidelines for effectively overcoming the difficult phase of obesity rehabilitation.

Also, it provides to the field of obesity management the dimension of Physical and Rehabilitation Medicine, necessary for tailoring individual multidisciplinary rehabilitation plans.

I would like to congratulate all the well-known (European and non-European) PRM physicians and other health professionals, who have contributed several chapters to this unique book on obesity rehabilitation. I would also like to extend my congratulations to the editorial team for their contribution to this educative book.

As President of the European Society of PRM, I encourage all the PRM physicians in Europe to use this very important resource in their daily practice, improving the therapeutic results of their work in obesity rehabilitation for the benefit of their patients.

While the age old advice to just eat less and move more is well known and often repeated to people living with obesity, the science of physical activity and its role in weight regulation and rehabilitation is still rather underdeveloped and often misunderstood. Thus, it is commendable that this volume brings together a stellar group of experts in the field, to discuss the current knowledge and knowledge gaps around the specific requirements and recommendations related to physical activity and rehabilitation for people living with obesity. The book covers a range of topics from the role of aerobic and strength training to the use of virtual reality and post-surgical rehabilitation to improve the health and well-being of people living with obesity. Thus, these pages should be of considerable interest to all researchers and health professionals working in the field of obesity medicine and bariatric care.

Obesity is a global health crisis with detrimental effects on all organ systems leading to poor health status, rising health costs and disability. A significant twist may occur in the fight scenario against complicated obesity in the near future: the massive gap between lifestyle interventions and bariatric surgery could be bridged by newly released drugs. They provide hope for increasing the medicinal armoire against obesity with more effective treatment strategies. However, the present rates of the condition worldwide call for the immediate action of all of the health professionals involved. Those at the forefront and called upon to face the disabling functional consequences of comorbid obesity are physiotherapists, physical activity experts and physical medicine and rehabilitation physicians.

Decreased effort tolerance and respiratory capacity, pain and impaired function, reduced strength and balance, and increased risk of falling canper selead to disability. Associated comorbidities can tip the balance of independence in patients who already have functional limitations or develop conditions (diabetes, cardiovascular conditions, nonalcoholic fatty liver disease, skin conditions, sarcopenia, sleep apnoea) where an abnormal metabolism of adipose tissue prevails. Nonetheless, the impact of obesity on individual capacities and rehabilitative outcomes is often neglected by physiotherapists and physical trainers alike. Rehabilitation units with optimal standards of care for normal-weight patients are often structurally, organizationally and technologically inadequate for patients with severe obesity. The number of disabled subjects who are also obese is now increasing worldwide, as is the rate of obese patients admitted to post-acute rehabilitation units. They require careful comprehensive assessment, appropriate therapeutic and rehabilitative protocols carried out by specially trained physiotherapists and physical activity experts in an ergonomically sound and safe environment.

This book has a unique focus on the physiotherapy techniques and training methods that are ideally suited to the patient with obesity. The aim of the present volume is to provide rehabilitation specialists an up-to-date practical guide to evidence-based exercise and rehabilitation protocols for patients with obesity with either post-acute or chronic disabling conditions. With this volume, we intend to fill the gap rehabilitation professionals may feel when treating patients with obesity, providing them with support while venturing out of the comfort zone of treating lean patients. With their multidisciplinary backgrounds, the volumes authors illustrate why multidisciplinarity is indeed the key approach. Two chapters review the existing physiological evidence on the effectiveness of strength and aerobic training modalities. The most recent adapted physical therapiessuch as whole-body cryotherapy, whole-body vibration and repetitive transcranial magnetic stimulationor rehabilitation strategiessuch as motor control exercises, aquatic exercises, balance exercises, virtual reality, lymphatic drainage and mobile technologieswhich have shown results, in some cases only preliminary, in patients with obesity are reviewed in other chapters by experts in the respective field. The relationship between nutrition and exercise, crucial to counteract obesity-related sarcopenia, and the clinical red flags in the post-acute neurological and orthopaedic patient with obesity are also discussed to promote a multidisciplinary and holistic approach.