Bragge Timo, Lyytinen Tarja, Hakkarainen Marko, Vartiainen Paavo, Liikavainio Tuomas, Karjalainen Pasi A, Arokoski Jari P
Department of Applied Physics, University of Eastern Finland, Finland.
Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Finland; Palokka Health Center, Jyväskylä, Finland.
Knee. 2014 Mar;21(2):534-40. doi: 10.1016/j.knee.2013.11.012. Epub 2013 Nov 27.
There are currently very few of studies which have evaluated the role of bariatric surgery in joint loadings and changes in gait. We wanted to examine how impulsive loading would change level and stair walking in severely or morbidly obese subjects after they had undergone bariatric surgery and weight loss.
Thirteen female and three male adults aged between 30 and 63 years, cleared for Roux-en-Y gastric bypass, were recruited into this study. All subjects were severely or morbidly obese i.e., body mass index was >35 kg/m(2). The measurement methods consisted of triaxial skin mounted accelerometers and ground reaction force (GRF); conducted at two different predetermined gait speeds.
The average weight loss was 27.4 (SD8.7) kg after 8.8 (SD3.9) months of follow-up period. Most of the absolute GRF parameters decreased in proportion to weight loss. However, medio-lateral GRF parameters decreased more than expected. The general trend in the knee accelerations demonstrated lower impulsive loadings in both axial and horizontal directions after weight loss. We did not observe any significant changes in stair walking.
Weight loss after bariatric surgery not only induces a simple mass-related adaptation in gait but also achieves mechanical plasticity in gait strategy.
目前很少有研究评估减肥手术在关节负荷和步态变化中的作用。我们想研究在接受减肥手术并体重减轻后，严重肥胖或病态肥胖受试者的冲击负荷会如何改变其平地行走和上楼梯行走。
招募了13名年龄在30至63岁之间、符合Roux-en-Y胃旁路手术条件的成年女性和3名成年男性参与本研究。所有受试者均为严重肥胖或病态肥胖，即体重指数>35kg/m²。测量方法包括三轴体表加速度计和地面反作用力（GRF）；在两种不同的预定步态速度下进行测量。
在8.8（标准差3.9）个月的随访期后，平均体重减轻了27.4（标准差8.7）kg。大多数绝对GRF参数随体重减轻而下降。然而，内外侧GRF参数下降幅度超过预期。膝关节加速度的总体趋势表明，体重减轻后，轴向和水平方向的冲击负荷均降低。我们未观察到上楼梯行走有任何显著变化。
减肥手术后体重减轻不仅会引起与体重相关的简单步态适应性变化，还会在步态策略上实现机械可塑性。
