Prehabilitation and Rehabilitation Issues

Obesity is a multifactorial chronic disease associated with poorer health outcomes, including musculoskeletal (MSk) pain and impaired physical function. This chapter explores the relationship between obesity, pain and musculoskeletal disease, emphasising the importance of care before and after surgery for people living with obesity (PLwO). Pain is a common issue among PLwO, it contributes to reduced physical activity (PA) and adaptive behaviours. Traditional treatment approaches to obesity, which focus solely on calorie restriction and increased PA, overlook the more complex physiological mechanisms underlying obesity. A holistic approach is required when treating obesity and musculoskeletal disease. Tailored interventions such as prehabilitation programmes should be used to optimise surgical outcomes. Prehabilitation aims to enhance functional capacity before surgery. However, the efficacy of prehabilitation in improving postoperative outcomes varies among patients, which highlights the importance of individualised care. Postoperative rehabilitation also plays a crucial role in restoring physical function following orthopaedic surgery, particularly in PLwO. While rehabilitation outcomes may differ based on the type of surgery, carefully planned rehabilitation programmes can reduce risks and improve long-term outcomes. Overall, this chapter highlights the need for prehabilitation and rehabilitation treatments that address the complex relationship between obesity, pain and musculoskeletal disease. By combining a multidisciplinary approach and individualised care plans, healthcare professionals can support PLwO in achieving optimal outcomes and therefore improving their quality of life.