obesity and stroke rehabilitation

[cord]

I just wonder if anyone has had experience with morbidly obese patients in regards to stroke rehabilitation. I would be interested in both- personal experience but also papers or other literature (e.g. rehab guidelines or physiotherapy accounts) highlighting the special circumstances and challenges sourrounding this group of patients. There is a lot of literature about secondary prevention of stroke but nothing about the special needs (physio, special hoists, chairs, oversize rhabilitation kit,etc.) and complications around rehabilitation of large patients. Do they do as well as the general population after stroke, do they have higher complication rate (one would assume) and less succesful rehabilitation, what help is available, what extra measures are needed, etc.

I would be grateful for any input and response.

Regards,

Cord Spilker

[Dottie from Iowa]

Trying to rehabilitate an obese patient after a stroke is indeed more difficult. For instance, just getting the patient up out of a wheel chair with a gait belt poses problems.
My husband is a big guy and I feel his weight when I try to steady him to rise from his wheel chair. We have tumbled only once, but each time I help him transfer, I have this gnawing feeling that he is going to fall and sometime fall on me. That would be or could be disasterous. He has to have a larger wheel chair,a larger gait belt, a larger commode, a wider and taller walker. It is just harder to do many things. Harder to get into a shower stall. Harder to get into a bathroom because of the door opening that won't let his wheel chair through. I think he tires more easily. and etc. What more can I say?