A Growing Challenge

A growing challenge

By: Daniel McCann

It’s a snowballing health crisis: Just as the number of obese Americans continues to swell, so do the ranks of those considered severely, or morbidly, obese. And the latter pose new challenges to long-term care operators interested in serving them — challenges ranging from orienting staff to this special needs population, to acquiring specialized equipment and devising appropriate physical therapy and occupational therapy goals.

Moreover, using 2004 as a baseline, the National Bureau of Economic Research forecasts that by 2020, Class 3 obesity will climb 80% for both men (from 3.3% to 6.3%) and women (from 6.9% to 12.8%). Class 3, or morbid obesity, is defined as having a BMI at 40 or above. People in this category are 50% to 100% — or 100 pounds — above their ideal weight.

At Kindred Healthcare, the primary physical therapy priority for bariatric patients “is to get them moving immediately,” says Vienna Lafrenz, OTR/L, CLT, rehabilitation education and compliance coordinator, West Region, for Kindred’s Rehabcare rehab division.

Once residents  are ambulatory, the priority is to gradually increase the exercise level, says Pidich.

“You select an enjoyable aerobic exercise, such as walking, to be done in conjunction with strength training, and you start very slowly, about 15 minutes a day,” she says. “They learn to pace themselves and not to conserve their energy so they don’t become too fatigued.”

She adds that aquatic therapy is among the most effective physical therapies for bariatric patients. Compared to exercising on land, aquatic exercise can feel almost effortless because of the body’s natural buoyancy in water.

“The reason overweight people often quit exercising is because of pain,” says Michele Reber, public relations director for HydroWorx, a maker of therapeutic pools and other aquatic therapy equipment.

The company’s therapeutic pools can be equipped with treadmills, which can more comfortably provide the same calorie burn in water as on land.

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