Department of Industrial and Systems Engineering, Virginia Polytechnic and State University, 1145 Perry Street, Blacksburg, VA, USA.
Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, USA.
Appl Ergon. 2023 Jan;106:103879. doi: 10.1016/j.apergo.2022.103879. Epub 2022 Sep 1.
The objective of this study was to quantify performance in an obstacle clearance task among individuals with excess body weight or body mass index (BMI). Task performance was operationalized as the maximum obstacle height cleared, four duration measures of successful task completion and compensatory movements used in the process of task completion. Eighteen participants with a BMI exceeding 30 kg/m completed a laboratory experiment that required stepping over seven lightweight obstacles. Obstacle heights were sequentially increased from 36 cm in 5 cm increments until participants were unsuccessful or unable to clear the obstacle up to 66 cm. Successful task completions decreased from 100% at an obstacle height of 36 cm to 66.1% at 66 cm. Higher obstacle heights were associated with significantly fewer task completions, longer leading and trailing leg stance and overall task duration, and more frequent use of compensatory movements for successful obstacle clearance. Cox PH regression was used to test the association between probability of obstacle clearance and normalized obstacle height adjusting for BMI, standing balance, and type of compensatory movement used, namely, hover and pivot motions involving the leg, and hands for bracing. The probability of successful task completion significantly decreased with increases in BMI (hazard ratio, HR = 1.14, 95% CI: 1.05-1.25), and increased with use of a leg pivot motion (HR = 0.30, 95% CI: 0.09-0.96) during task completion, after adjusting for standing balance and other types of compensatory movements. Overall, the results demonstrated that obstacle clearance performance is affected by an individual's BMI and the use of compensatory behaviors for regaining stability. The ability to recruit internal and external stabilization techniques could potentially serve as a clinical indicator of reduced fall risk and be the focus of fall prevention interventions. Implications for evaluating stability, fall risk, and identifying modifiable factors for fall prevention in the obese population are discussed.
本研究的目的是量化超重或身体质量指数（BMI）个体在清除障碍物任务中的表现。任务表现被操作化为最大障碍物高度、成功完成任务的四个持续时间测量值以及在任务完成过程中使用的补偿运动。18 名 BMI 超过 30kg/m2 的参与者完成了一项实验室实验，该实验要求他们跨过七个轻量级障碍物。障碍物高度从 36cm 开始，以 5cm 的增量递增，直到参与者无法成功或无法清除障碍物，最高可达 66cm。在障碍物高度为 36cm 时，成功完成任务的比例为 100%，而在 66cm 时降至 66.1%。更高的障碍物高度与更少的任务完成、更长的前导和尾随腿站立时间以及更长的整体任务时间显著相关，并且更频繁地使用补偿运动来成功清除障碍物。Cox PH 回归用于测试障碍物清除概率与标准化障碍物高度之间的关联，调整 BMI、站立平衡和使用的补偿运动类型，即涉及腿的悬停和枢轴运动以及手的支撑。成功完成任务的概率随着 BMI 的增加而显著降低（危险比，HR=1.14，95%置信区间：1.05-1.25），并且随着在任务完成过程中使用腿枢轴运动（HR=0.30，95%置信区间：0.09-0.96）而增加，调整站立平衡和其他类型的补偿运动后。总体而言，结果表明障碍物清除表现受个体 BMI 和恢复稳定性的补偿行为的影响。招募内部和外部稳定技术的能力可能是降低跌倒风险的临床指标，并成为跌倒预防干预的重点。讨论了在肥胖人群中评估稳定性、跌倒风险和识别可改变的跌倒预防因素的意义。
