Effects of obesity and foot arch height on gait mechanics: A cross-sectional study.

Daekyoo Kim,Cara L Lewis,Simone V Gill,Jean L Mccrory

doi:10.1371/journal.pone.0260398

Abstract

Foot arch structure contributes to lower-limb joint mechanics and gait in adults with obesity. However, it is not well-known if excessive weight and arch height together affect gait mechanics compared to the effects of excessive weight and arch height alone. The purpose of this study was to determine the influences of arch height and obesity on gait mechanics in adults. In this study, 1) dynamic plantar pressure, 2) spatiotemporal gait parameters, 3) foot progression angle, and 4) ankle and knee joint angles and moments were collected in adults with normal weight with normal arch heights (n = 11), normal weight with lower arch heights (n = 10), obesity with normal arch heights (n = 8), and obesity with lower arch heights (n = 18) as they walked at their preferred speed and at a pedestrian standard walking speed, 1.25 m/s. Digital foot pressure data were used to compute a measure of arch height, the Chippaux-Smirak Index (CSI). Our results revealed that BMI and arch height were each associated with particular measures of ankle and knee joint mechanics during walking in healthy young adults: (i) a higher BMI with greater peak internal ankle plantar-flexion moment and (ii) a lower arch height with greater peak internal ankle eversion and abduction moments and peak internal knee abduction moment (i.e., external knee adduction moment). Our results have implications for understanding the role of arch height in reducing musculoskeletal injury risks, improving gait, and increasing physical activity for people living with obesity.

Highlights

Obesity is a major public health concern worldwide
The results of this study suggest that body mass index (BMI) and arch height are each associated with particular measures of ankle and knee joint mechanics during walking in healthy young adults: (i) a higher BMI with greater internal ankle plantar-flexion moment and internal knee extension moment and (ii) a lower arch height with greater internal peak ankle eversion and abduction moments and internal knee abduction moment
There was no significant interaction between BMI and arch height; BMI did not influence the association between arch height and joint kinematic and kinetic measures, and arch height did not influence the association between BMI and joint kinematic and kinetic measures

Summary

Introduction

Obesity is a major public health concern worldwide. Obesity increases the risk of other health problems such as heart disease, stroke, type-2 diabetes, osteoarthritis, and certain cancers that may cause premature death [1]. The prevalence of obesity in the United States is 42.4% among adults over 20 years of age and has increased 12% over the past 20 years [2]. To combat obesity, increasing energy expenditure via increasing physical activity level has been strongly recommended; physical activity promotes weight loss, prevents weight gain and regain, and can help maintain cardiovascular and metabolic health [1]. Walking is a common and cost-effective intervention used to increase overall physical activity and to meet the recommended 150 minutes of weekly moderate-to-vigorous physical activity [3]. Most adults with obesity fall short of these recommendations [4]

Objectives

Methods

Results

Discussion

Conclusion