Original article| Volume 95, ISSUE 6, P1055-1059, June 2014

Download started.


Effect of Body Mass Index on Stroke Rehabilitation

Published:February 06, 2014DOI:



      To investigate the association between body mass index (BMI) and the functional progress of patients with stroke, admitted to a rehabilitation hospital.


      A retrospective cohort study.


      A freestanding university rehabilitation hospital stroke unit.


      All patients (N=819) admitted to the stroke unit of a rehabilitation hospital during the study.


      Not applicable.

      Main Outcome Measures

      The primary study outcome measure was the FIM efficiency of patients by BMI category.


      For the 819 patients admitted during the observation period, BMI was compared with FIM score changes per day (FIM efficiency). After adjusting for age and sex, the FIM efficiency differed by BMI. The underweight group had the lowest FIM efficiency, followed by the obese and normal-weight subgroups. The overweight group had the highest FIM efficiency (P=.05) when compared with the obese subgroup.


      Among patients admitted to an acute rehabilitation hospital for stroke rehabilitation, overweight patients had better functional progress than did patients in the other weight categories.


      List of abbreviations:

      BMI (body mass index)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Flegal K.M.
        • Carroll M.D.
        • Kit B.K.
        • Ogden C.L.
        Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010.
        JAMA. 2012; 307: 491-497
        • Flegal K.M.
        • Kit B.K.
        • Orpana H.
        • Graubard B.I.
        Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis.
        JAMA. 2013; 309: 71-82
        • Field A.E.
        • Coakley E.H.
        • Must A.
        • et al.
        Impact of overweight on the risk of developing common chronic diseases during a 10-year period.
        Arch Intern Med. 2001; 161: 1581-1586
        • Gurm H.S.
        • Brennan D.M.
        • Booth J.
        • Tcheng J.E.
        • Lincoff A.M.
        • Topol E.J.
        Impact of body mass index on outcome after percutaneous coronary intervention (the obesity paradox).
        Am J Cardiol. 2002; 90: 42-45
        • Ray D.E.
        • Matchett S.C.
        • Baker K.
        • Wasser T.
        • Young M.J.
        The effect of body mass index on patient outcomes in a medical ICU.
        Chest. 2005; 127: 2125-2131
        • Gurm H.S.
        • Fathi R.
        • Kapadia S.R.
        • et al.
        Impact of body mass index on outcome in patients undergoing carotid stenting.
        Am J Cardiol. 2005; 96: 1743-1745
        • Curtis J.P.
        • Selter J.G.
        • Wang Y.
        • et al.
        The obesity paradox: body mass index and outcomes in patients with heart failure.
        Arch Intern Med. 2005; 165: 55-61
      1. World Health Organization. Obesity and overweight, fact sheet N°311. Available at: Accessed December 2013.

        • Lee I.M.
        • Manson J.E.
        • Hennekens C.H.
        • Paffenbarger Jr., R.S.
        Body weight and mortality. A 27-year follow-up of middle-aged men.
        JAMA. 1993; 270: 2823-2828
        • Azimi A.
        • Charlot M.G.
        • Torp-Pedersen C.
        • et al.
        Moderate overweight is beneficial and severe obesity detrimental for patients with documented atherosclerotic heart disease.
        Heart. 2013; 99: 655-660
        • Romero-Corral A.
        • Montori V.M.
        • Somers V.K.
        • et al.
        Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies.
        Lancet. 2006; 368: 666-678
        • Heymsfield S.B.
        • Cefalu W.T.
        Does body mass index adequately convey a patient's mortality risk?.
        JAMA. 2013; 309: 87-88
        • Gu D.
        • He J.
        • Duan X.
        • et al.
        Body weight and mortality among men and women in China.
        JAMA. 2006; 295: 776-783
        • Brown C.V.
        • Neville A.L.
        • Rhee P.
        • Salim A.
        • Velmahos G.C.
        • Demetriades D.
        The impact of obesity on the outcomes of 1,153 critically injured blunt trauma patients.
        J Trauma. 2005; 59 (discussion 1051): 1048-1051
        • Akinnusi M.E.
        • Pineda L.A.
        • El Solh A.A.
        Impact of obesity on intensive care morbidity and mortality: a metaanalysis.
        Chest. 2007; 132 (441b-2)
        • Kurth T.
        • Gaziano J.M.
        • Berger K.
        • et al.
        Body mass index and the risk of stroke in men.
        Arch Intern Med. 2002; 162: 2557-2562
        • Strazzullo P.
        • D'Elia L.
        • Cairella G.
        • Garbagnati F.
        • Cappuccio F.P.
        • Scalfi L.
        Excess body weight and incidence of stroke: meta-analysis of prospective studies with 2 million participants.
        Stroke. 2010; 41: e418-e426
        • Song Y.M.
        • Sung J.
        • Davey Smith G.
        • Ebrahim S.
        Body mass index and ischemic and hemorrhagic stroke: a prospective study in Korean men.
        Stroke. 2004; 35: 831-836
        • Anstey K.J.
        • Cherbuin N.
        • Budge M.
        • Young J.
        Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies.
        Obes Rev. 2011; 12: e426-e437
        • Choban P.S.
        • Weireter Jr., L.J.
        • Maynes C.
        Obesity and increased mortality in blunt trauma.
        J Trauma. 1991; 31: 1253-1257
        • Bochicchio G.V.
        • Joshi M.
        • Bochicchio K.
        • Nehman S.
        • Tracy J.K.
        • Scalea T.M.
        Impact of obesity in the critically ill trauma patient: a prospective study.
        J Am Coll Surg. 2006; 203: 533-538
        • Meroz Y.
        • Gozal Y.
        Management of the obese trauma patient.
        Anesthesiol Clin. 2007; 25: 91-98
        • Neville A.L.
        • Brown C.V.
        • Weng J.
        • Demetriades D.
        • Velmahos G.C.
        Obesity is an independent risk factor of mortality in severely injured blunt trauma patients.
        Arch Surg. 2004; 139: 983-987
        • Flegal K.M.
        • Graubard B.I.
        • Williamson D.F.
        • Gail M.H.
        Excess deaths associated with underweight, overweight, and obesity.
        JAMA. 2005; 293: 1861-1867
        • Vincent H.K.
        • Weng J.P.
        • Vincent K.R.
        Effect of obesity on inpatient rehabilitation outcomes after total hip arthroplasty.
        Obesity (Silver Spring). 2007; 15: 522-530
        • Stevens-Lapsley J.E.
        • Petterson S.C.
        • Mizner R.L.
        • Snyder-Mackler L.
        Impact of body mass index on functional performance after total knee arthroplasty.
        J Arthroplasty. 2010; 25: 1104-1109
        • Kalichman L.
        • Rodrigues B.
        • Gurvich D.
        • Israelov Z.
        • Spivak E.
        Impact of patient's weight on stroke rehabilitation results.
        Am J Phys Med Rehabil. 2007; 86: 650-655