Characteristic gait patterns in older adults with obesity—Results from the Baltimore Longitudinal Study of Aging

Abstract

Obesity in older adults is a growing public health problem. Excess weight causes biomechanical burden to lower extremity joints and contribute to joint pathology. The aim of this study was to identify specific characteristics of gait associated with body mass index (BMI). Preferred and maximum speed walking and related gait characteristics were examined in 164 (50-84 years) participants from Baltimore Longitudinal Study of Aging (BLSA) able to walk unassisted. Participants were divided into three groups based on their BMI: normal weight (19 ≤ BMI < 25 kg/ m 2 ), overweight (25 ≤ BMI < 30 kg/m 2 ) and obese (BMI 30 ≤ BMI < 40 kg/m 2 ). Total ankle generative mechanical work expenditure (MWE) in the anterior-posterior (AP) plane was progressively and significantly lower with increasing BMI for both preferred (p = 0.026) and maximum speed walking (p < 0.001). In the medial-lateral (ML) plane, total knee generative MWE was higher in obese participants in the preferred speed task (p = 0.002), and total hip absorptive MWE was higher in obese in both preferred speed (p < 0.001) and maximum speed (p = 0.002) walking task compared to the normal weight participants. Older adults with obesity show spatiotemporal gait patterns which may help to reduce contact impacts. In addition, in obese persons mechanical energy usages tend to be lower in the AP plane and higher in the ML plane. Since forward progression forces are mainly implicated in normal walking, this pattern found in obese participants is suggestive of lower energetic efficiency.

Ground reaction forces and plantar pressure distribution during occasional loaded gait

“…However, for the general adult population, there is not clear what is the load limit for preventing musculoskeletal injury while carrying a backpack. The I Class Obesity (BMI > 30 kg/m 2 ) is a well documented risk factor for traumatic-orthopedic injuries being considered as possible threshold for such dysfunctions (Ko et al, 2010;WHO, 2000). We would like to assess the effect of a potential harmful load on the musculoskeletal system.…”

“…Some possible limitations in this study should be considered. First, the backpack load used was not the same for all participants; we could have normalize the load using either percentage of body mass or a fixed load: however, since the locomotor system of people with BMI � 30 kg/m 2 is considered more susceptible to injuries (Ko et al, 2010;WHO, 2000), we preferred to use the BMI of 30 kg/m 2 as load criterion in order to promote a possible harmful load. We did not intend to reproduce obesity features in our participants, but only the total amount of mechanical load found in obese subjects (which is differently located compared to backpakers).…”

In-Shoe Plantar Pressures and Ground Reaction Forces During Overweight Adults' Overground Walking

“…Obesity is associated with a range of disabling musculoskeletal conditions in adults (Anandacoomarasamy, Caterson, Sambrook, Fransen, & March, 2007). The repetitive overload during overweight people's gait has been related to the predisposition to pathological gait patterns, loss of mobility, and subsequent progression of disability (Messier, Ettinger, & Doyle, 1996), as well as to a higher risk for hip and knee osteoarthritis (Felson, 1990;Hochberg et al, 1995;Ko, Stenholm, & Ferrucci, 2010), an increase in the likelihood of foot ulceration (Vela, Lavery, Armstrong, & Anaim, 1998), and heel pain (Prichasuk, 1994). Thus, more attention must be given to the physical/mechanical consequences of repetitive overload, mainly in the lower limbs, to provide support in the areas of prevention, treatment, and control of obesity (Hills, Hennig, Byrne, & Steele, 2002).…”

Anthropometric, functional and foot trajectory determinants of stride length in self-reliant community-dwelling elderly persons in Talca, Chile

“…10 It has been recommended that the values obtained using these parameters should be corrected in order to ensure pertinent comparisons for both kinematic indicators and muscle performance. 9 Although the values obtained for height and the BMI in the present study produced moderate and significant correlations ( Figures 1A and 1B), they also exhibited a low explanation value for SL (coefficient of determination: r 2 <0.20).…”

“…7 Besides speed, the most robust biomechanical gait indicator is stride length (SL), due to the relevance of what its complete cycle represents in spatial terms, 8 as well as the fact that it measures mechanical and physiological efficiency. 9 In this sense, it is conditioned by pre-established anthropometric characteristics 10 and specific functions. 4,11 It remains unknown which of these determinant variables has the most significant impact on the spatial expression of the gait cycle.…”