Effects of obesity and knee osteoarthritis on gait and postural stability in pre-bariatric surgery candidates

Abstract

Knee osteoarthritis (OA) is the most common cause of chronic disability and is frequently comorbid with obesity. The personal burden of knee OA and obesity are substantial. Adults with knee OA with obesity demonstrate postural instability, which makes them susceptible to falls. The purpose of this study was to investigate gait and postural stability during flat ground walking and obstacle crossing in pre-bariatric surgery candidates. Forty-four adults with obesity (mean BMI = 43.35, SD = 4.33) and 30 adults without obesity (mean BMI = 23.10, SD–3.98) walked 60 feet at self-selected paces for 25 trials under five conditions: initial baseline on flat ground, crossing low (4 cm), medium (11 cm), and high (16 cm) obstacles, and final baseline on flat ground. Spatiotemporal kinematics were collected with a gait carpet (Protokinetics). During the final baseline, for adults with obesity, most parameters improved ( P s < 0.05); at the final baseline condition, participants had the fastest step times, stance times, single limb support times, and velocities. The analyses also revealed that during obstacle negotiation, participants had longer step times, slower velocity and wider step widths compared to level ground walking ( P s < 0.05). Most alterations in gait for individuals with obesity were observed during high obstacle crossing ( P s < 0.05). The findings suggest that obstacles pose a challenge beyond flat ground walking for pre-bariatric surgery candidates. Obstacle height also influenced participants’ gait. This supports the utility of examining gait in this population during tasks beyond flat ground walking.