Physical Activity in Women With Obesity: Fatigue, Knee Symptoms, and Functional Capacity.

Abstract

Background and purpose: Women with obesity often experience low physical activity alongside functional limitations, musculoskeletal symptoms, and perceived barriers. The concurrent associations of these domains with physical activity remain insufficiently clarified. This study examined the adjusted associations of functional capacity, musculoskeletal symptoms, and perceived barriers with total physical activity level and compared low and moderate physical activity groups.

Methods: This cross-sectional study included 85 women with obesity. Physical activity was assessed using the International Physical Activity Questionnaire-Short Form. Functional capacity was evaluated using the Timed Up and Go Test, 30-Second Chair Stand Test, and Duke Activity Status Index. Perceived barriers and musculoskeletal symptoms were assessed using the Self-Perceived Barriers for Physical Activity Scale and Extended Nordic Musculoskeletal Questionnaire, respectively. Univariate and multivariate regression analyses were performed.

Results: TUG performance, DASI-derived METs, fatigue-related barriers, and knee symptoms in the past 12 months were associated with total physical activity score in univariate analyses. In the multivariate model, fatigue-related barriers (B = -71.69, β = -0.298, p = 0.005) and knee symptoms (B = -261.62, β = -0.225, p = 0.026) remained negatively associated with total physical activity. The final model explained 26.2% of the variance (adjusted R² = 0.226). TUG performance and DASI-derived METs were not independently associated with physical activity after adjustment. Compared with the low activity group, women with moderate activity had higher DASI-derived METs, lower fatigue-related barrier scores, and lower lifetime knee symptom prevalence.

Discussion: Physical activity participation in women with obesity may not be fully captured by measured functional capacity alone and appears to be related to perceived fatigue and knee symptom burden. Physiotherapy practice may benefit from integrating fatigue management, knee symptom screening, progressive load management, and individualised pacing strategies alongside functional capacity training.