Abstract
Discerning whether individuals with obesity transfer walking adaptation from treadmill to over-ground walking is critical to advancing our understanding of walking adaptation and its usefulness in rehabilitating obese populations. We examined whether the aftereffects following split-belt treadmill adaptation transferred to over-ground walking in adults with normal-weight body mass index (BMI) and obese BMI. Nineteen young adults with obesity and 19 age-matched adults with normal weight walked on flat ground at their preferred speed before and after walking on a treadmill with tied belts (preferred speed) and with the split-belt at their preferred speed and at a speed 50% slower than their preferred speed. The adaptation and aftereffects in step length and double-limb support time symmetry were calculated. We found that the amount of temporal adaptation was similar for adults with obesity and with normal weight (p > 0.05). However, adults with obesity showed greater asymmetry for double-limb support time following split-belt treadmill walking compared to adults with normal weight (p < 0.05). Furthermore, the transfer of asymmetry for double-limb support time from the treadmill to over-ground walking was less in adults with obesity than in adults with normal weight (p < 0.05). The transfer of adapted gait following split-belt treadmill walking provides insight into how atypical walking patterns in individuals with obesity could be remediated using long-term gait training.
Highlights
Obesity is a public health epidemic, elevating the risk of numerous comorbid conditions, including heart disease, stroke, type 2 diabetes, and certain cancers that may cause premature death [1]
The results revealed that the adapted walking pattern following split-belt treadmill walking partially transfers to over-ground in healthy young adults, suggesting that the treadmill walking adaptation influenced some aspects of over-ground walking
The symmetry value for the double-limb support time was significantly greater in adults with obesity than in adults with normal weight during the early tied-belt washout period
Summary
Obesity is a public health epidemic, elevating the risk of numerous comorbid conditions, including heart disease, stroke, type 2 diabetes, 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 old and has increased 12% over the past 20 years [2]. Individuals with obesity fall short of physical activity recommendations [4]. Walking is a recommended and cost-effective intervention used to increase overall physical activity, walking may be harmful to individuals with obesity [5]. Common characteristics of individuals with obesity include altered spatiotemporal gait parameters (slower speed and shorter and wider steps) and joint kinematics (less flexed lower extremity joints) compared to adults with normal weight [6,7,8], which likely serve as ways to compensate for a lack of postural stability [9]
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