与正常体重的年轻成年人相比，肥胖者的垂直负荷率更高。
Greater vertical loading rate in obese compared to normal weight young adults.
作者信息
Pamukoff Derek N, Lewek Michael D, Blackburn J Troy
机构信息
Department of Kinesiology, California State University, Fullerton, 800 N State College, Fullerton, CA 92831, USA; Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, 209 Fetzer Hall, Chapel Hill, NC 27599-8700, USA; Curriculum in Human Movement Science, The University of North Carolina at Chapel Hill, Bondurant Hall, Suite 3000, Chapel Hill, NC 27599-7135, USA.
Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, 209 Fetzer Hall, Chapel Hill, NC 27599-8700, USA; Curriculum in Human Movement Science, The University of North Carolina at Chapel Hill, Bondurant Hall, Suite 3000, Chapel Hill, NC 27599-7135, USA; Division of Physical Therapy, The University of North Carolina at Chapel Hill, Bondurant Hall, Suite 3000, Chapel Hill, NC 27599-7135, USA.
出版信息
Clin Biomech (Bristol). 2016 Mar;33:61-65. doi: 10.1016/j.clinbiomech.2016.02.007. Epub 2016 Feb 23.
BACKGROUND
Obesity is a risk factor for knee osteoarthritis. Altered gait biomechanics are common in obese individuals, and may contribute to the development of knee osteoarthritis. Research has focused on older obese adults with knee osteoarthritis, and it is unclear if young obese individuals display similar aberrant biomechanics. The purpose of this study was to compare gait biomechanics between normal-weight and obese young adults.
METHODS
15 normal-weight (body mass index=21.5 (1.1)) and 15 obese (body mass index=33.5 (3.7)) young adults were recruited and categorized by body mass index. Lower extremity kinematics and kinetics were collected while participants walked at standardized (1m/s) and self-selected speeds. Analysis of variance (group by condition) was used to compare peak vertical ground reaction force, vertical loading rate, peak internal knee extension moment, peak internal knee abduction moment, peak knee flexion angle, and knee flexion excursion between groups.
FINDINGS
Gait biomechanics did not differ between groups during walking at a self-selected speed. When walking at a standardized speed, obese subjects displayed greater instantaneous vertical loading rates (46.2 vs. 35.0 N/s, P<0.001), and lesser knee flexion excursion (5.5° vs. 7.7°, P=0.04). Instantaneous vertical loading rate was greater during walking at a self-selected speed compared to a standardized speed in the obese (P=0.007) and normal weight groups (P=0.001).
INTERPRETATION
As greater loading rates are related to cartilage degeneration, these results suggest that obesity may contribute to knee osteoarthritis. Prospective studies are needed to identify the influence of higher loading rates on knee osteoarthritis.
背景
肥胖是膝关节骨关节炎的一个风险因素。步态生物力学改变在肥胖个体中很常见，并且可能促使膝关节骨关节炎的发展。研究主要集中在患有膝关节骨关节炎的老年肥胖成年人，目前尚不清楚年轻肥胖个体是否表现出类似的异常生物力学特征。本研究的目的是比较正常体重和肥胖年轻成年人之间的步态生物力学。
方法
招募了15名正常体重（体重指数=21.5（1.1））和15名肥胖（体重指数=33.5（3.7））的年轻成年人，并根据体重指数进行分类。在参与者以标准化速度（1米/秒）和自选速度行走时，收集下肢运动学和动力学数据。采用方差分析（组×条件）比较两组之间的峰值垂直地面反作用力、垂直加载率、峰值膝关节内伸力矩、峰值膝关节外展力矩、峰值膝关节屈曲角度和膝关节屈曲幅度。
结果
在自选速度行走时，两组之间的步态生物力学没有差异。当以标准化速度行走时，肥胖受试者表现出更高的瞬时垂直加载率（46.2对35.0牛/秒，P<0.001），以及更小的膝关节屈曲幅度（5.5°对7.7°，P=0.04）。与标准化速度相比，肥胖组（P=0.007）和正常体重组（P=0.001）在自选速度行走时的瞬时垂直加载率更高。
解读
由于更高的加载率与软骨退变有关，这些结果表明肥胖可能促使膝关节骨关节炎的发生。需要进行前瞻性研究以确定更高加载率对膝关节骨关节炎的影响。
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