Exercise Guidelines for Enhancing Mobility and Stability in Individuals with Severe Obesity

Severe obesity is frequently accompanied by restricted joint mobility and chronic pain, both of which compromise quality of life and functional independence. Despite well-documented benefits of exercise in managing severe obesity, adherence remains low due to perceived physical limitations and discomfort. This study identified primary physical limitations faced by individuals with severe obesity and proposed evidence-based, accessible exercise modalities tailored to their needs. A systematic literature search was conducted using Scopus, PubMed, Web of Science, and Google Scholar. Search terms included combinations of 'obese,' 'severe obesity,' 'exercise,' 'training,' 'stability,' 'mobility,' and 'pain.' Ten studies examining effects of exercise interventions on mobility, stability, and pain in severely obese individuals were selected based on predefined inclusion criteria. Findings consistently indicated that low-impact exercise modalities such as yoga-based stretching, core training, and stabilization exercises using balance pads, chairs, and gym balls significantly improve mobility, enhance postural stability, and reduce musculoskeletal pain over intervention periods as short as 4 weeks. Interventions incorporating core muscle stretching and instability-based training were particularly effective in improving functional outcomes and balance control. This review highlights prevalent musculoskeletal and neuromuscular impairments associated with severe obesity and underscores the functional role of core musculature in mitigating these limitations. Based on synthesized evidence, we propose a set of low-complexity, high-accessibility exercise strategies feasible in both clinical and home-based settings. These recommendations provide a practical framework for improving physical function and reducing pain among individuals with severe obesity, supporting more sustainable engagement in physical activity.