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肥胖步态中由体重大量减轻引起的机械适应性改变。

Massive weight loss-induced mechanical plasticity in obese gait.

机构信息

Department of Exercise and Sport Science, East CarolinaUniversity, Greenville, North Carolina, USA.

出版信息

J Appl Physiol (1985). 2011 Nov;111(5):1391-9. doi: 10.1152/japplphysiol.00291.2011. Epub 2011 Aug 18.

Abstract

We examined the hypothesis that metabolic surgery-induced massive weight loss causes mass-driven and behavioral adaptations in the kinematics and kinetics of obese gait. Gait analyses were performed at three time points over ∼1 yr in initially morbidly obese (mass: 125.7 kg; body mass index: 43.2 kg/m(2)) but otherwise healthy adults. Ten obese adults lost 27.1% ± 5.1 (34.0 ± 9.4 kg) weight by the first follow-up at 7.0 mo (±0.7) and 6.5 ± 4.2% (8.2 ± 6.0 kg) more by the second follow-up at 12.8 mo (±0.9), with a total weight loss of 33.6 ± 8.1% (42.2 ± 14.1 kg; P = 0.001). Subjects walked at a self-selected and a standard 1.5 m/s speed at the three time points and were also compared with an age- and gender-matched comparison group at the second follow-up. Weight loss increased swing time, stride length, gait speed, hip range of motion, maximal knee flexion, and ankle plantarflexion. Weight loss of 27% led to 3.9% increase in gait speed. An additional 6.5% weight loss led to an additional 7.3% increase in gait speed. Sagittal plane normalized knee torque increased and absolute ankle and frontal plane knee torques decreased after weight loss. We conclude that large weight loss produced mechanical plasticity by modifying ankle and knee torques and gait behavior. There may be a weight loss threshold of 30 kg limiting changes in gait kinematics. Implications for exercise prescription are also discussed.

摘要

我们检验了这样一个假设,即代谢手术引起的大量体重减轻会导致肥胖步态的运动学和动力学产生质量驱动和行为适应性。在大约 1 年的时间内,我们在最初患有病态肥胖症(体重:125.7 千克;体重指数:43.2 千克/平方米)但其他方面健康的成年人中,在三个时间点进行了步态分析。10 名肥胖成年人在首次随访的 7.0 个月(±0.7)时减轻了 27.1%±5.1(34.0±9.4 千克)的体重,在第二次随访的 12.8 个月(±0.9)时又减轻了 6.5±4.2%(8.2±6.0 千克),总减重为 33.6±8.1%(42.2±14.1 千克;P=0.001)。受试者在三个时间点以自我选择的和标准的 1.5 m/s 的速度行走,并在第二次随访时与年龄和性别匹配的对照组进行比较。体重减轻增加了摆动时间、步长、步态速度、髋关节活动范围、最大膝关节屈曲度和踝关节跖屈度。体重减轻 27%导致步态速度增加 3.9%。额外的 6.5%体重减轻导致步态速度额外增加 7.3%。体重减轻后,矢状面归一化的膝关节扭矩增加,踝关节和额状面的膝关节扭矩绝对值减小。我们的结论是,大量的体重减轻通过改变踝关节和膝关节的扭矩和步态行为产生了机械可塑性。可能存在 30 公斤的体重减轻阈值限制了步态运动学的变化。还讨论了对运动处方的影响。

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