Obesity modifies the body geometry by adding mass to different regions and it influences the biomechanics of activities of daily living. Weight influences postural stability, but there is no consensus as to whether the different fat distribution in males and females produces gender‐related effects on balance. The aim of this study was to investigate the effect of body weight increases on postural performance in males and females. A total of 22 obese females (BMI: 41.1 ± 4.1 kg/m2) and 22 obese males (BMI: 40.2 ± 5 kg/m2) were analyzed during a static posture trial on a force platform in standardized conditions. Twenty healthy subjects (10 females, 10 males) constituted the control group. We computed the following parameters related to the center of pressure (CoP): velocity and displacements along the antero‐posterior (AP) and medio‐lateral axis (ML). We found several statistically significant differences between healthy and obese men, in particular regarding the AP and ML CoP parameters, which were correlated to body weight (r = 0.36–0.58). The comparison between healthy and obese females pointed out statistically significant differences in AP parameters and no significant differences in ML displacements. Body weight was found to correlate with AP parameters (r = 0.36–0.74), but not with ML displacements. The increased body mass seems to produce AP instability in both genders and ML destabilization only in males. Rehabilitation programs should take these findings into account by adopting specific interventions to improve ML control in obese males, and through weight loss and strengthening of ankle flexors/extensors in both genders.

BackgroundPrader-Willi (PWS) and Down Syndrome (DS) are two genetic disorders characterised by some common clinical and functional features. A quantitative description and comparison of their patterns would contribute to a deeper understanding of the determinants of motor disability in these two syndromes. The aim of this study was to measure gait pattern in PWS and DS in order to provide data for developing evidence-based deficit-specific or common rehabilitation strategies.Methods19 PWS patients (17.7-40 yr) and 21 DS patients (18-39 yr) were evaluated with an optoelectronic system and force platforms for measuring kinematic and kinetic parameters during walking. The results were compared with those obtained in a group of normal-weight controls (Control Group: CG; 33.4 + 9.6 yr).Results and DiscussionThe results show that PWS and DS are characterised by different gait strategies. Spatio-temporal parameters indicated a cautious, abnormal gait in both groups, but DS walked with a less stable strategy than PWS. As for kinematics, DS showed a significantly reduced hip and knee flexion, especially at initial contact and ankle range of motion than PWS. DS were characterised by lower ranges of motion (p < 0.05) in all joints than CG and PWS. As for ankle kinetics, both PWS and DS showed a significantly lower push-off during terminal stance than CG, with DS yielding the lowest values. Stiffness at hip and ankle level was increased in DS. PWS showed hip stiffness values close to normal. At ankle level, stiffness was significantly decreased in both groups.ConclusionsOur data show that DS walk with a less physiological gait pattern than PWS. Based on our results, PWS and DS patients need targeted rehabilitation and exercise prescription. Common to both groups is the aim to improve hypotonia, muscle strength and motor control during gait. In DS, improving pelvis and hip range of motion should represent a major specific goal to optimize gait pattern.

Background: Being severely overweight is a distinctive clinical feature of Prader-Willi Syndrome (PWS). PWS is a complex multisystem disorder, representing the most common form of genetic obesity. The aim of this study was the analysis of the gait pattern of adult subjects with PWS by using three-Dimensional Gait Analysis. The results were compared with those obtained in a group of obese patients and in a group of healthy subjects.

Backgroundobesity is nowadays a pandemic condition. Obese subjects are commonly characterized by musculoskeletal disorders and particularly by non-specific chronic low back pain (cLBP). However, the relationship between obesity and cLBP remains to date unsupported by an objective measurement of the mechanical behaviour of the spine and its morphology in obese subjects. Such analysis may provide a deeper understanding of the relationships between function and the onset of clinical symptoms.Purposeto objectively assess the posture and function of the spine during standing, flexion and lateral bending in obese subjects with and without cLBP and to investigate the role of obesity in cLBP.Study designCross-sectional studyPatient samplethirteen obese subjects, thirteen obese subjects with cLBP, and eleven healthy subjects were enrolled in this study.Outcome measureswe evaluated the outcome in terms of angles at the initial standing position (START) and at maximum forward flexion (MAX). The range of motion (ROM) between START and MAX was also computed.Methodswe studied forward flexion and lateral bending of the spine using an optoelectronic system and passive retroreflective markers applied on the trunk. A biomechanical model was developed in order to analyse kinematics and define angles of clinical interest.Resultsobesity was characterized by a generally reduced ROM of the spine, due to a reduced mobility at both pelvic and thoracic level; a static postural adaptation with an increased anterior pelvic tilt. Obesity with cLBP is associated with an increased lumbar lordosis.In lateral bending, obesity with cLBP is associated with a reduced ROM of the lumbar and thoracic spine, whereas obesity on its own appears to affect only the thoracic curve.Conclusionsobese individuals with cLBP showed higher degree of spinal impairment when compared to those without cLBP. The observed obesity-related thoracic stiffness may characterize this sub-group of patients, even if prospective studies should be carried out to verify this hypothesis.

A reference equation specific for the obese population was provided; it can be used as realistic benchmark in the rehabilitation setting to assess functional capacity, plan exercise intensity and monitor changes over time.

Obese adults do not appear to alter their gait to improve pendular energy transduction and may select slower PWS to reduce mechanical and metabolic work.

Background: despite evidence of an obesity-related disability, there is a lack of objective muscle functional data in overweight subjects. Only few studies provide instrumental strength measurements in non-syndromal obesity, whereas no data about Prader-Willi syndrome (PWS) are reported. The aim of our study was to characterize the lower limb muscle function of patients affected by PWS as compared to non-syndromal obesity and normal-weight subjects.

Four hundred million adults are obese. Such a pandemic involves people of working age. Excess weight imposes abnormal mechanics on body movements, which could account for the high incidence of musculoskeletal disorders in these subjects. This article reviews the physiological and biomechanical causes of the reduced work capacity in obese workers and speculates on the relationships between occupational exposure and obesity. The reduction in work capacity appears to be due to the following factors: reduced spine flexibility, decay in endurance, limited range of movement of the major joints, reduced muscle strength and capacity to hold prolonged fixed postures, impaired respiratory capacity and visual control. Work capacity in morbidly obese workers should always be evaluated to match specific job demands. Due to the relationship between obesity, musculoskeletal disorders, disability and health costs, prevention of obesity and ergonomic interventions on-site are a priority in the work place.