Department of Kinesiology, Utah State University, Logan, UT, United States.
School of Kinesiology, University of Michigan, Ann Arbor, MI, United States.
Gait Posture. 2022 Feb;92:421-427. doi: 10.1016/j.gaitpost.2021.12.019. Epub 2021 Dec 25.
Individuals with obesity have impaired gait and muscle function that may contribute to reduced mobility and increased fall risk.
(1) what is the difference in spatiotemporal gait parameters and joint kinetics between individuals with and without obesity; (2) what is the association between spatiotemporal gait parameters, joint kinetics, and quadriceps function?
Forty-eight young adults with obesity (BMI = 33.0 ± 4.1 kg/m) and 48 without obesity (BMI = 21.6 ± 1.7 kg/m) completed assessments of quadriceps function (peak torque and early/late rate of torque development (RTD)) and walking biomechanics at self-selected speed. Spatiotemporal gait parameters (stance time, double support time, double support to stance ratio, step width, step length, cadence, and gait stability ratio (GSR)) and joint kinetics (total support moment, and relative contribution from extensor moments) were compared using one-way MANOVAs. Partial correlation examined the association between the total support moment and quadriceps function, and spatiotemporal gait parameters controlling for sex and speed.
Individuals with obesity walked with longer stance (p = 0.01), longer double-limb support (p < 0.001), wider steps (p < 0.001), lower cadence (p = 0.03), and a greater absolute (p < 0.001) but lesser normalized total support moment (p = 0.03) compared with adults without obesity. In those with obesity, greater PT was associated with less double limb support (p = 0.011) and smaller double support to stance ratio (p = 0.006); greater early RTD was associated with less double limb support (r = -0.455, p = 0.0021), less stance time (r = -0.384, p = 0.008), and a smaller double support to stance ratio (r = -0.371, p = 0.011). In those without obesity, a larger total support moment was associated with longer step length (r = 0.512, p < 0.001), lesser cadence (r = -0.497, p < 0.001), and smaller GSR (-0.460, p = 0.001).
Individuals with obesity walk with altered spatiotemporal gait parameters and joint kinetics that may compromise stability. Extended periods of support may be a strategy used by individuals with obesity to increase stability during gait and accomodate insufficient quadriceps function.
肥胖个体的步态和肌肉功能受损,这可能导致其活动能力下降和跌倒风险增加。
(1)肥胖个体和非肥胖个体的时空步态参数和关节动力学有何差异;(2)时空步态参数、关节动力学与股四头肌功能之间有何关联?
48 名肥胖个体(BMI=33.0±4.1kg/m²)和 48 名非肥胖个体(BMI=21.6±1.7kg/m²)完成了股四头肌功能(峰值扭矩和早期/晚期扭矩发展率(RTD))和自主选择速度下的步行生物力学评估。使用单因素 MANOVAs 比较了时空步态参数(站立时间、双支撑时间、双支撑与站立时间比、步宽、步长、步频和步态稳定比(GSR))和关节动力学(总支撑力矩和伸肌力矩的相对贡献)。偏相关分析控制性别和速度,检验总支撑力矩与股四头肌功能和时空步态参数之间的关联。
与非肥胖成年人相比,肥胖个体的站立时间更长(p=0.01),双支撑时间更长(p<0.001),步幅更宽(p<0.001),步频更低(p=0.03),绝对总支撑力矩更大(p<0.001),但归一化总支撑力矩更小(p=0.03)。在肥胖个体中,更大的 PT 与更少的双支撑时间(p=0.011)和更小的双支撑与站立时间比(p=0.006)相关;更大的早期 RTD 与更少的双支撑时间(r=-0.455,p=0.0021)、更少的站立时间(r=-0.384,p=0.008)和更小的双支撑与站立时间比(r=-0.371,p=0.011)相关。在非肥胖个体中,更大的总支撑力矩与更长的步长(r=0.512,p<0.001)、更低的步频(r=-0.497,p<0.001)和更小的 GSR(r=-0.460,p=0.001)相关。
肥胖个体的步态时空参数和关节动力学发生改变,这可能会影响其稳定性。肥胖个体可能会延长支撑时间,以增加步态稳定性并适应不足的股四头肌功能。