Physical Function and Biomechanics of gait in Obese Adults after Weight Loss

Obesity is associated with several musculoskeletal disorders such as the development and progression of knee osteoarthritis (OA). Thus, impaired physical function, impaired health sense, muscle strength and body balance and differences in gait biomechanics have all been observed in obese subjects and in knee OA subjects.

The present series of studies was designed to examine how body mass index (BMI), bariatric surgery and subsequent weight loss could affect gait biomechanics, physical function, the structure of quadriceps femoris muscle (QFm) and the subjective disabilities of subjects with excessive weight. Special emphasis was placed on investigating both objectively and subjectively measured physical function with a test battery of physical function tests and questionnaires (RAND-36 and WOMAC). The properties of the QFm were evaluated with ultrasound and the skin mounted accelerometers (SMAs) and ground reaction forces were used to estimate knee impact loading during walking. The repeatability of SMAs in combination with simultaneous surface electromyography (EMG) measurements of lower extremities and standing balance in healthy subjects and knee OA patients was also examined.

The overweight and obese subjects loaded their lower extremity more than lean individuals during level walking. Weight loss after bariatric surgery decreased impulsive knee joint loading during walking, inducing a simple mass-related adaptation in gait and also accomplishing a degree of mechanical plasticity in gait strategy. The weight loss occurring after bariatric surgery exerted a positive impact on physical function, reducing the subcutaneous fat thickness of the QFm and improving the subjects’ perception of their health status. However, major weight loss had a negative effect on the QFm muscle thickness and the CSA and the fat and connective tissue proportion of the QFm. SMA and EMG were revealed as being reproducible tools for evaluating joint impact loading and muscle activation of QFm during walking in healthy subjects, but not in knee OA subjects. Subjects with knee OA do not have a standing balance deficit, but they do exhibit increased muscle activity in QFm during standing in comparison to control subjects.


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City (for University):
University of Eastern Finland