Abstract
BackgroundObesity is known to affect balance and gait pattern increasing the risk of fall and injury as compared to the lean population. Such risk is particularly high during postural transitions. Gait initiation (GI) is a transient procedure between static upright posture and steady-state locomotion, which includes anticipatory antero-posterior and lateral movements. GI requires propulsion and balance control. The aim of this study was to characterise quantitatively the strategy of obese subjects during GI using parameters obtained by the Center of Pressure (CoP) track.Methods20 obese individuals and 15 age-matched healthy subjects were tested using a force platform during the initiation trials. CoP plots were divided in different phases, which identified the anticipatory postural adjustments (APA1, APA2) and a movement phase (LOC). Duration, length and velocity of the CoP trace in these phases were calculated and compared.Results and discussionThe results show that the main characteristic of GI in obese participants is represented by a higher excursion in medio-lateral direction. This condition lead to longer APA length and duration, which are statistical significant during APA2 when compared to control subjects. We also found longer duration of APA1 and LOC phases. In terms of velocity, most of the phases were characterised by a reduced CoP velocity in antero-posterior direction and faster movement in medio-lateral direction as compared to the control group.ConclusionsOur findings provide novel evidence in GI in obese subjects that may serve for developing exercise programs aimed at specifically improving balance in both the antero-posterior and lateral directions. Such programs together with weight management may be beneficial for improving stability during postural transitions and reducing risk of fall in this population.
Highlights
Obesity is known to affect balance and gait pattern increasing the risk of fall and injury as compared to the lean population
Our findings provide novel evidence in Gait initiation (GI) in obese subjects that may serve for developing exercise programs aimed at improving balance in both the antero-posterior and lateral directions
The same anticipatory postural adjustment strategies were adopted, but the average Center of Pressure (CoP) trajectory of obese subjects seems to be wider as compared to normal-weight subjects (Figure 3)
Summary
Obesity is known to affect balance and gait pattern increasing the risk of fall and injury as compared to the lean population. Such risk is high during postural transitions. Gait initiation (GI) is a transient procedure between static upright posture and steady-state locomotion, which includes anticipatory antero-posterior and lateral movements. Most studies concerning human gait have focused on steady state walking. The transition from standing to walking is a task, which is often required in daily life balance control. Compared to steady state walking, the demands placed on the neuromuscular system are increased in gait initiation, since a complex integration on neural mechanisms, muscle activity and biomechanical forces is necessary [1,2]. Postural adjustment and muscle activity at ankle and hip level are needed to initiate gait
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