Partial Unweighting in Obese Persons Enhances Tactile Transmission From the Periphery to Cortical Areas: Impact on Postural Adjustments.

Tactile plantar information is known to play an important role in balance maintenance and to contribute to the setting of anticipatory postural adjustments (APAs) prior to stepping. Previous studies have suggested that somatosensory processes do not function optimally for obese individuals due to the increased pressure of the plantar sole resulting in balance issues. Here, we investigated whether decreasing the compression of the mechanoreceptors by unweighting the plantar sole would enhance tactile sensory processes leading to an increased stability and an accurate setting of the APAs in obese individuals. More specifically, we tested the hypothesis that the somatosensory cortex response to electric stimulation (SEP) of the plantar sole in standing obese persons will be greater with reduced body weight than with their effective weight. The level of unweighting was calculated for each participant to correspond to a healthy body mass index. We showed an increase SEP amplitude in the unweighted condition compared to the effective body weight for all participants. This increase can be explained by the reduction of weight itself but also by the modified distribution of the pressure exerted onto the foot sole. Indeed, in the unweighted condition, the vertical ground reaction forces are evenly distributed over the surface of the foot. This suggests that decreasing and equalizing the pressure applied on the plantar mechanoreceptors results in an increase in somatosensory transmission and sensory processes for obese persons when unweighted. These sensory processes are crucial prior to step initiation and for setting the anticipatory postural adjustments (i.e., thrust). These cortical changes could have contributed to the observed changes in the spatiotemporal characteristics of the thrust prior to step initiation.