The interplay between emotion dysregulation, psychological distress, emotional eating, and weight status: A path model

Background/objective: The aim of the current cross-sectional study is to assess the relations between emotion dysregulation, psychological distress, emotional eating, and BMI in a sample of Italian young adults (20-35).Methods: A total sample of 600 participants frm the general population, were asked to fill in demographical and physical data, the Difficulties in Emotion Regulation Scale, the Depression Anxiety and Stress Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire via an online anonymous survey. Relations between variables have been inspected using a path model. Results: Results showed that emotion dysregulation was a contributor to higher levels of psychological distress [b= 0.348; SE: 0.020; p=<0.001; 95% BC-CI (0.306–0.387)] and emotional eating [b= 0.010; SE: 0.002; p=<0.001; 95% BC-CI (0.006–0.014)] which in turn, was related to higher Body Mass Index [b= 0.0574; SE: 0.145; p=<0.001; 95% BC-CI (0.286–0.863)]. Conclusions: By providing additional evidence concerning the role of emotion dysregulation for physical and psychological outcomes, the current study could inform for improving psychological interventions aimed to promote emotion regulation strategies aimed at fostering physical and psychological well-being. (AU)

Intervenciones de terapia ocupacional en el manejo de sobrepeso y obesidad: revisión sistemática exploratoria / Occupational therapy interventions for the management of overweight and obesity: scoping review

Introducción: Existe limitado conocimiento sobre las características y evidencia disponible de intervenciones de terapia ocupacional en el manejo y reducción de la obesidad y sobrepeso, traduciéndose en una limitada consideración en políticas y programas de salud. Objetivo: Caracterizar las intervenciones de terapia ocupacional en sobrepeso y/u obesidad. Métodos: Revisión Sistemática Exploratoria (Scoping Review) en las bases de datos EBSCOhost, Embase, PubMed, PsychInfo, Scielo y Scopus, de estudios publicados a junio 2020. Se usó estructura PRISMA ScR, incorporando artículos que cumplieran los criterios: a) Evaluasen una intervención de terapia ocupacional en sobrepeso y/u obesidad, b) Informasen resultados cuantitativos, y c) Publicados en revista con evaluación de pares. Resultados: Cinco estudios fueron incluidos en la revisión. Cuatro utilizaron un diseño cuasi experimental (pretest-postest, sin grupo de comparación), y un estudio utilizó un diseño mixto con estudio pretest-postest adicionando estudio cualitativo. Las intervenciones son heterogéneas y sus resultados atribuibles no fueron significativos en el desenlace reducción de peso corporal. Se relevan resultados favorables en otras dimensiones, como la resignificación del uso de tiempo libre y el aprendizaje de hábitos saludables. Discusión: Las intervenciones de terapia ocupacional refieren protocolos de intervención heterogéneos, asociados a programas de manejo de sobrepeso y obesidad. Los estudios disponibles proporcionan evidencia limitada su efectividad, y sus potenciales desenlaces son más consistentes con dimensiones psicosociales por sobre dimensiones morfológicas como el peso corporal. Se requiere con urgencia investigación experimental que permita establecer la acción de terapia ocupacional en estos problemas de relevancia para la salud pública.

Introduction: The knowledge about the characteristics and available evidence of occupational therapy interventions in the management of obesity and overweight is scarce, with also limited scalability of occupational therapy in health policies and programs. Objective: To characterize occupational therapy interventions for the management of overweight and/or obesity. Method: Scoping Review. EBSCOhost, Embase, PubMed, PsychInfo, Scielo and Scopus databases were included, with studies published from inception to June 2020. PRISMA ScR guidelines were used. Criteria for article selection included interventions that: a) Evaluated an occupational therapy intervention in overweight and/or obesity, b) Reported quantitative results, and c) Were published in a peer-reviewed journal, d) Full text available in English, Spanish, and Portuguese. Results: 5 studies were included in the review. Four studies corresponded to quasi-experimental design (pretest-posttest, no comparison group), and one study used a mixed-method design with a pretest-postest study adding a qualitative component. Interventions found were heterogeneous and changes were not significant for the outcome weight reduction. Significant results were found in other dimensions, such as resignification of the use of leisure time and the incorporation of healthy habits. Discussion: Occupational therapy interventions include heterogeneous protocols embedded in larger overweight and obesity management programs. Available studies provide limited evidence of their effectiveness, and their potential outcomes are more consistent with psychosocial dimensions than morphological ones, such as body weight. Experimental research is remarkably needed to establish the action of occupational therapy in these problems of public health relevance.

Effects of a Combined Endurance/Strength Training Program on Circulating Irisin Levels in Overweight/Obese Men and Women with Type 2 Diabetes Mellitus.

Irisin is a promising therapeutic target in patients with type 2 diabetes mellitus (T2DM), as studies have demonstrated that irisin can induce "browning" of adipocytes and mitigate pro-inflammatory conditions. Sex-specific changes in irisin levels have been reported in a study involving healthy men and women following physical training. The present study aims to analyze the effects of an 8-week training intervention on circulating irisin levels in patients with T2DM and to find out whether the training responses differ between T2DM men and women. Twenty-nine overweight/obese T2DM patients (19 men, 10 women; age: 46-74 years; body mass index >25 kg/m2) participated in a combined moderate-intensity endurance/strength training program (3 times a week). The irisin levels of men and women did not differ significantly. The post-training irisin levels did not differ significantly from the pre-training values, and there was no interaction effect of sex. This study shows no training-induced (sex-specific) changes in circulating irisin levels in T2DM patients. Large-scale studies using other forms of training are needed to fully clarify whether basal irisin levels can be changed in T2DM men and/or women to counteract T2DM.

Effect of telerehabilitation applied during COVID-19 isolation period on physical fitness and quality of life in overweight and obese individuals.

BACKGROUND/OBJECTIVES: The aim of the study was to examine the effects of exercise training through telerehabilitation applied during COVID-19 isolation period on overweight and obese individuals on physical fitness and quality of life. SUBJECTS/METHODS: In our study, 41 participants between the ages of 18-65 years and whose BMI values were 25 kg/m2 and above were randomly divided into two groups as telerehabilitation group (n: 21) and control group (n: 20). Exercise training applied to the telerehabilitation group with remote live connection included warm-up exercises, trunk stabilization exercises and breathing exercises under the supervision of a physiotherapist for 6 weeks, 3 days in a week. The control group was only informed about the importance of exercise for one session and evaluated at baseline and after 6 weeks. The physical fitness levels of individuals was assessed by Senior Fitness Test protocol and quality of life by Short Form-36. RESULTS: As a result of the study, statistically significant improvements were obtained in all parameters of physical fitness, quality of life in the telerehabilitation group (p < 0.05). In the difference values of the two groups, all parameters of physical fitness and quality of life were observed that there were statistically significant differences in favor of telerehabilitation group (p < 0.05). CONCLUSIONS: As a result, it was found that exercise training applied through telerehabilitation during the COVID-19 pandemic process was an effective, safe and viable approach in overweight and obese individuals. In the future, studies investigating the long-term effectiveness of telerehabilitation in this population are needed.

The Relevance of Obesity for Activities of Daily Living in Geriatric Rehabilitation Patients.

The obesity pandemic has reached old age but the effect of obesity on functional recovery in geriatric rehabilitation patients has not been investigated to date. In this prospective cohort study, patients admitted into geriatric rehabilitation were consecutively included between September 2015 and September 2016, aged ≥70 years. Individual activities of daily living were documented by the Barthel index (BI, 0-100 points). Obesity was assessed by the measurement of body mass index (BMI, kg/m²), waist circumference (WC, cm) and percentage of body fat mass (%FM) based on triceps' skinfold thickness at admission (t1), discharge (t2) and six months after discharge (t3). A total of 122 patients were included in the analysis. Prevalence of obesity according to BMI, WC and %FM was 33.6%, 83.6% and 71.3% respectively. Patients with a high WC and patients with a high BMI had lower BI values at t1, t2, t3 and the improvement in BI (t1-t2, t2-t3) was lower than in those with low WC and low BMI, but without statistical significance. In multiple regression analysis, BMI, WC and %FM were not associated with BI at t3 and improvement of BI (t2-t3). Obesity was highly prevalent in geriatric rehabilitation patients, but it was not associated with BI during the 6-month follow-up.

Weight management and determinants of weight change in patients with coronary artery disease.

OBJECTIVE: To study the effects of a comprehensive secondary prevention programme on weight loss and to identify determinants of weight change in patients with coronary artery disease (CAD). METHODS: We performed a secondary analysis focusing on the subgroup of overweight CAD patients (BMI ≥27 kg/m2) in the Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists-2 (RESPONSE-2) multicentre randomised trial. We evaluated weight change from baseline to 12-month follow-up; multivariable logistic regression with backward elimination was used to identify determinants of weight change. RESULTS: Intervention patients (n=280) lost significantly more weight than control patients (n=257) (-2.4±7.1 kg vs -0.2±4.6 kg; p<0.001). Individual weight change varied widely, with weight gain (≥1.0 kg) occurring in 36% of interventions versus 41% controls (p=0.21). In the intervention group, weight loss of ≥5% was associated with higher age (OR 2.94), lower educational level (OR 1.91), non-smoking status (OR 2.92), motivation to start with weight loss directly after the baseline visit (OR 2.31) and weight loss programme participation (OR 3.33), whereas weight gain (≥1 kg) was associated with smoking cessation ≤6 months before or during hospitalisation (OR 3.21), non-Caucasian ethnicity (OR 2.77), smoking at baseline (OR 2.70), lower age (<65 years) (OR 1.47) and weight loss programme participation (OR 0.59). CONCLUSION: The comprehensive secondary prevention programme was, on average, effective in achieving weight loss. However, wide variation was observed. As weight gain was observed in over one in three participants in both groups, prevention of weight gain may be as important as attempts to lose weight. TRIAL REGISTRATION NUMBER: NTR3937.

Physical activity motives, barriers, and preferences in people with obesity: A systematic review.

BACKGROUND: Although the benefits of physical activity (PA) are well known, physical inactivity is highly prevalent among people with obesity. The objective of this systematic review was to i) appraise knowledge on PA motives, barriers, and preferences in individuals with obesity, and ii) quantify the most frequently reported PA motives, barriers and preferences in this population. METHODS: Six databases (Pubmed, CINAHL, Psyarticle, SportDiscus, Web of science and Proquest) were searched by independent reviewers to identify relevant quantitative or qualitative articles reporting PA motives, barriers or preferences in adults with body mass index ≥ 30 kg/m2 (last searched in June 2020). Risk of bias for each study was assessed by two independent reviewers with the Mixed Methods Appraisal Tool (MMAT). RESULTS: From 5,899 papers identified, a total of 27 studies, 14 quantitative, 10 qualitative and 3 mixed studies were included. About 30% of studies have a MMAT score below 50% (k = 8). The three most reported PA motives in people with obesity were weight management, energy/physical fitness, and social support. The three most common PA barriers were lack of self-discipline/motivation, pain or physical discomfort, and lack of time. Based on the only 4 studies available, walking seems to be the preferred mode of PA in people with obesity. CONCLUSIONS: Weight management, lack of motivation and pain are key PA motives and barriers in people with obesity, and should be addressed in future interventions to facilitate PA initiation and maintenance. Further research is needed to investigate the PA preferences of people with obesity.

Fitness, Fatness, and Mortality in Men and Women From the UK Biobank: Prospective Cohort Study.

Background Cardiorespiratory fitness may moderate the association between obesity and all-cause mortality (ie, the "fat-but-fit" hypothesis), but unaddressed sources of bias are a concern. Methods and Results Cardiorespiratory fitness was estimated as watts per kilogram from a submaximal bicycle test in 77 169 men and women from the UK Biobank cohort and combined with World Health Organization standard body mass index categories, yielding 9 unique fitness-fatness combinations. We also formed fitness-fatness combinations based on bioimpedance as a direct measure of body composition. All-cause mortality was ascertained from death registries. Multivariable-adjusted Cox regression models were used to estimate hazard ratios and 95% CIs. We examined the association between fitness-fatness combinations and all-cause mortality in models with progressively more conservative approaches for accounting for reverse causation, misclassification of body composition, and confounding. Over a median follow-up of 7.7 years, 1731 participants died. In our base model, unfit men and women had higher risk of premature mortality irrespective of levels of adiposity, compared with the normal weight-fit reference. This pattern was attenuated but maintained with more conservative approaches in men, but not in women. In analysis stratified by sex and excluding individuals with prevalent major chronic disease and short follow-up and using direct measures of body composition, mortality risk was 1.78 (95% CI, 1.17-2.71) times higher in unfit-obese men but not higher in obese-fit men (0.94 [95% CI, 0.60-1.48]). In contrast, there was no increased risk in obese-unfit women (1.09 [95% CI, 0.44-1.05]) as compared with the reference. Conclusions Cardiorespiratory fitness modified the association between obesity and mortality in men, but this pattern appeared susceptible to biases in women.

Acceptability of a structured diet and exercise weight loss intervention in breast cancer survivors living with an overweight condition or obesity: A qualitative analysis.

BACKGROUND: Weight loss increases survivorship following breast cancer diagnosis. However, most breast cancer survivors (BCS) do not meet diet and exercise recommendations. AIM: The purpose of this study was to explore the barriers and facilitators of BCS who had lymphedema and who participated in a 22-week weight loss lifestyle intervention. METHODS AND RESULTS: Participants completed semi-structured interviews about barriers and facilitators to intervention adherence. Interviews were transcribed verbatim and a thematic analysis was conducted. Participants (n = 17) were 62 ± 8.0 years of age with a mean body mass index of 34.0 ± 7.1 kg/m2 . Four themes emerged: (1) facilitators of intervention adherence, (2) barriers of intervention adherence, (3) continuation of healthy habits post intervention, and (4) recommendations for intervention improvements. Facilitators of intervention adherence were education, social support, routine, motivation, goal-setting, meal-provisioning, self-awareness, and supervised exercise. Barriers to intervention adherence were personal life, health, meal dissatisfaction, seasonality, unchallenging exercises, and exercising alone. All women planned to continue the acquired healthy habits post intervention. Recommendations to improve the study included addressing the exercise regime, meal-provisioning, and dietary intake monitoring methods. CONCLUSION: Future strategies to engage BCS in weight loss interventions should promote group exercise, offer individualized meal-provisioning and exercise regimes, provide transition tools, and allow participants to choose their self-monitoring method.

Disability assessment in an Italian cohort of patients with obesity using an International Classification of Functioning, Disability and Health (ICF)-derived questionnaire.

BACKGROUND: Obesity is a clinical condition that contributes to the development of related disability in different areas (physical, psychological and social). Multidisciplinary treatment calls for specific instruments able to evaluate all related functional problems. We have developed a tool (an ICF-based assessment instrument, the ICF-OB schedule) to evaluate obesity-related disability, composed of an inventory of 71-items from the WHO International Classification of Functioning, Disability and Health (ICF). AIM: The aim of the present study was to validate this new tool for the definition of obesity-related disability. We also sought to examine the relationship between obesity disability, an index of multimorbidity (Cumulative Illness Rating Scale [CIRS]) and a well-validated score of perceived obesity-related disability (Italian Obesity Society Test for Obesity-Related Disability [TSD-OC]). DESIGN: Process validation of the ICF-OB schedule. SETTING: Baseline conditions of out- and in-patients. POPULATION: A large cohort of obese patients recruited from 9 multidisciplinary centers belonging to the Italian Obesity Society (SIO) network, which provide specialized obesity care. METHODS: A total of 353 patients (F: 70%, age: 50.2±12.7yrs, BMI: 41.4±8.3kg/m2) were enrolled between January 2017 and June 2018. The ICF-OB was used to define patients' functioning and disability profiles in order to set and appraise rehabilitation goals. RESULTS: We described the distribution of body functions (BF), body structures (BS) and activities and participations (A&P) categories and the agreement rates were significant for the majority of these. The ICF-OB was more often significantly associated, and with stronger coefficients, with patients' comorbidities as described by the CIRS rather than with Body Mass Index (BMI). The TSD-OC also presented a strong association with A&P indexes. CONCLUSIONS: The complexity of clinical condition, that generates disability in obesity might be well identified with the use of this new instrument that appear significant related to the perceived disability for each patients and also with their multimorbidity. CLINICAL REHABILITATION IMPACT: The ICF-OB shows great promise as a tool for goal setting in the rehabilitation of obese patients.

Efeito do treinamento de força sobre a aptidão física em pós - bariátricos: revisão sistemática / Efecto del entrenamiento de fuerza sobre la aptitud física tras cirugía bariátrica: revisión sistemática / Effect of strength training on fitness in pos - bariatric: systematic review

INTRODUÇÃO: A cirurgia bariátrica tem efeito na redução de peso. O exercício físico apresenta relação positiva sobre os aspectos fisiológicos para indivíduos pós-bariátricos. No entanto, o efeito do treinamento de força e sua aplicação no pós-operatório permanecem obscuros. OBJETIVO: O presente estudo objetivou realizar uma revisão sistemática dos efeitos do treinamento de força sobre os aspectos fisiológicos em indivíduos pós-bariátricos. MÉTODOS: Uma pesquisa foi conduzida em bases de dados, seguindo em conformidade com os critérios do PRISMA. Os estudos incluídos foram avaliados utilizando a escala PEDro. A pontuação do Kappa de Cohen avaliou o nível de concordância. RESULTADOS: Sete estudos foram incluídos na revisão. Os períodos de duração das intervenções e indivíduos avaliados foram homogêneos. Os estudos demonstraram melhoras significativas para as variáveis de aptidão física. No entanto, foram identificadas descrições inconsistentes na sessão de treinamento, dificultando a orientação prática adequada. CONCLUSÃO: Os estudos reportaram efeitos positivos sobre as variáveis analisadas

INTRODUCCIÓN: La cirugía bariátrica tiene efecto en la reducción de peso. El ejercicio físico presenta relación positiva sobre los aspectos fisiológicos para individuos posbariátricos. Sin embargo, el efecto del entrenamiento de fuerza y su aplicación en el posoperatorio permanecen obscuros. OBJETIVO: Realizar una revisión sistemática de los efectos del entrenamiento de fuerza sobre aspectos fisiológicos en sujetos posbariátricos. MÉTODOS: Una búsqueda bibliográfica se realizó en bases de datos, siguiendo los criterios del PRISMA. Los estudios incluidos fueron evaluados utilizándose la escala PEDro. La puntuación del Kappa de Cohen evaluó el nivel de acuerdo. RESULTADOS: Siete estudios fueron incluidos en la revisión. Los periodos de duración de las intervenciones e individuos evaluados fueron homogéneos. Los estudios demostraron mejoras significativas a las variables de aptitud física. Pero, fueron identificadas descripciones inconsistentes en la sesión de entrenamiento, obstaculizando la orientación de la práctica adecuada. CONCLUSIÓN: Los estudios reportaron efectos positivos sobre las variables analizadas

INTRODUCTION: Bariatric surgery has an effect on reducing body weight. Physical exercise has a positive relation on the physiological aspects for post-bariatric individuals. However, the effect of strength training and its application in the postoperative period remain obscure. OBJECTIVE: The present study aimed to perform a systematic review of the effects of strength training on the physiological aspects in post-bariatric subjects. METHODS: A survey was conducted in databases, following the PRISMA criteria. The included studies were evaluated using the PEDro scale. Cohen's kappa score assessed the level of agreement. RESULTS: Seven studies were included in the review. The duration of the interventions and individuals evaluated were homogeneous. Studies have shown significant improvements for physical fitness variables. However, inconsistent descriptions were identified in the training session, hindering proper practice guidance. CONCLUSION: The studies reported positive effects on the analyzed variables

Webpalestra: acompanhamento psicológico no pós operatório da cirurgia bariátrica

No que se refere ao acompanhamento psicológico esta palestra pretende contribuir para a reflexão sobre o processo de reabilitação do paciente após realização da cirurgia bariátrica, compreendendo a importância do território de saúde e a importância da informação ao paciente para o fortalecimento da melhoria da qualidade de vida. Assista mais vídeos da série sobre Obesidade no link abaixo: https://www.youtube.com/playlist?list...

Webpalestra: acesso ao pré-operatório multiprofissional no Programa de Cir. Bariátrica do HUCAM/ES

Epidemiologia da obesidade. Acesso a fila de espera. Regulação da fila. Etapas do pré-operatório.

Webpalestra: atendimento psicológico pré cirurgia bariátrica

Aspectos sobre a avaliação psicológica, assim como, o preparo do paciente e sua família para a cirurgia.Abordagem de fatores biopsicossociais inerentes ao processo de instauração da obesidade com foco preventivo e educativo.

Webpalestra: cirurgia plástica pós bariátrica, atualizações para equipes multi-profissionais

"Cirurgia Plástica Pós Bariátrica: Atualizações para o acompanhamento de equipes multi-profissionais" WebPalestra gravada em: 25/11/2019 Acesse os slides das nossas palestras na Biblioteca Virtual do Telessaúde ES! Confira a data da exibição e encontre o material desejado. Faça download e tenha o material preparado pelos nossos palestrantes. https://telessaude.ifes.edu.br/biblio...

WebPalestra: atuação fisioterapêutica no pré operatório de cirurgia bariátrica

Fisiologia do sistema respiratório. Volumes e capacidades pulmonares. Obesidade como fator de risco. Terapia incentivadora da inspiração.

WebPalestra: cirurgia bariátrica no pós operatório tardio, sinais de alerta

Serão abordados os aspectos normais no pós operatório tardio (após 18 meses) e os sinais de alerta para investigação e referência ao cirurgião bariátrico.

Distinct abdominal and gluteal adipose tissue transcriptome signatures are altered by exercise training in African women with obesity.

The differential associations of adipose depots with metabolic risk during obesity have been proposed to be controlled by environmental and genetic factors. We evaluated the regional differences in transcriptome signatures between abdominal (aSAT) and gluteal subcutaneous adipose tissue (gSAT) in obese black South African women and tested the hypothesis that 12-week exercise training alters gene expression patterns in a depot-specific manner. Twelve young women performed 12-weeks of supervised aerobic and resistance training. Pre- and post-intervention measurements included peak oxygen consumption (VO2peak), whole-body composition and unbiased gene expression analysis of SAT depots. VO2peak increased, body weight decreased, and body fat distribution improved with exercise training (p < 0.05). The expression of 15 genes, mainly associated with embryonic development, differed between SAT depots at baseline, whereas 318 genes were differentially expressed post-training (p < 0.05). Four developmental genes were differentially expressed between these depots at both time points (HOXA5, DMRT2, DMRT3 and CSN1S1). Exercise training induced changes in the expression of genes associated with immune and inflammatory responses, and lipid metabolism in gSAT, and muscle-associated processes in aSAT. This study showed differences in developmental processes regulating SAT distribution and expandability of distinct depots, and depot-specific adaptation to exercise training in black South African women with obesity.

Moderate-Intensity Exercise and High-Intensity Interval Training Affect Insulin Sensitivity Similarly in Obese Adults.

OBJECTIVE: We compared the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on insulin sensitivity and other important metabolic adaptations in adults with obesity. METHODS: Thirty-one inactive adults with obesity (age: 31 ±â€…6 years; body mass index: 33 ±â€…3 kg/m2) completed 12 weeks (4 sessions/week) of either HIIT (10 × 1-minute at 90%HRmax, 1-minute active recovery; n = 16) or MICT (45 minutes at 70%HRmax; n = 15). To assess the direct effects of exercise independent of weight/fat loss, participants were required to maintain body mass. RESULTS: Training increased peak oxygen uptake by ~10% in both HIIT and MICT (P < 0.0001), and body weight/fat mass were unchanged. Peripheral insulin sensitivity (hyperinsulinemic-euglycemic clamp) was ~20% greater the day after the final exercise session compared to pretraining (P < 0.01), with no difference between HIIT and MICT. When trained participants abstained from exercise for 4 days, insulin sensitivity returned to pretraining levels in both groups. HIIT and MICT also induced similar increases in abundance of many skeletal muscle proteins involved in mitochondrial respiration and lipid and carbohydrate metabolism. Training-induced alterations in muscle lipid profile were also similar between groups. CONCLUSION: Despite large differences in training intensity and exercise time, 12 weeks of HIIT and MICT induce similar acute improvements in peripheral insulin sensitivity the day after exercise, and similar longer term metabolic adaptations in skeletal muscle in adults with obesity. These findings support the notion that the insulin-sensitizing effects of both HIIT and MICT are mediated by factors stemming from the most recent exercise session(s) rather than adaptations that accrue with training.

Adipokines as Potential Biomarkers in the Neurorehabilitation of Obese Stroke Patients.

BACKGROUND: Limited studies concern the influence of obesity-induced dysregulation of adipokines in functional recovery after stroke neurorehabilitation. OBJECTIVE: To investigate the relationship between serum leptin, resistin, and adiponectin and functional recovery before and after neurorehabilitation of obese stroke patients. The adipokine potential significance as prognostic markers of rehabilitation outcomes was also verified. METHODS: Twenty obese post-acute stroke patients before and after neurorehabilitation and thirteen obese volunteers without-stroke, as controls, were examined. Adipokines were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits. Functional deficits were assessed before and after neurorehabilitation with the Barthel Index (BI), modified Rankin Scale (mRS), and Functional Independence Measure (FIM). RESULTS: Compared to controls, higher leptin and resistin values and lower adiponectin values were observed in stroke patients before neurorehabilitation and no correlations were found between adipokines and clinical outcome measures. Neurorehabilitation was associated with improved scores of BI, mRS, and FIM. After neurorehabilitation, decreased values of Body Mass Index (BMI) and resistin together increased adiponectin were detected in stroke patients, while leptin decreased but not statistically. Comparing adipokine values assessed before neurorehabilitation with the outcome measures after neurorehabilitation, correlations were observed for leptin with BI-score, mRS-score, and FIM-score. No other adipokine levels nor BMI assessed before neurorehabilitation correlated with the clinical measures after neurorehabilitation. The forward stepwise regression analysis identified leptin as prognostic factor for BI, mRS, and FIM. CONCLUSION: Our data show the effectiveness of neurorehabilitation in modulating adipokines levels and suggest that leptin could assume the significance of biomarker of functional recovery.