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

Abstract

Purpose: Because walking is highly recommended for prevention and treatment of obesity and some of its biomechanical aspects are not clearly understood for overweight people, we compared the absolute and normalized ground reaction forces (GRF), plantar pressures, and temporal parameters of normal-weight and overweight participants during overground walking. Method: A force plate and an in-shoe pressure system were used to record GRF, plantar pressures (foot divided in 10 regions), and temporal parameters of 17 overweight adults and 17 gender-matched normal-weight adults while walking. Results: With high effect sizes, the overweight participants showed higher absolute medial-lateral and vertical GRF and pressure peaks in the central rearfoot, lateral midfoot, and lateral and central forefoot. However, analyzing normalized (scaled to body weight) data, the overweight participants showed lower vertical and anterior-posterior GRF and lower pressure peaks in the medial rearfoot and hallux, but the lateral forefoot peaks continued to be greater compared with normal-weight participants. Time of occurrence of medial-lateral GRF and pressure peaks in the midfoot occurred later in overweight individuals. Conclusions: The overweight participants adapted their gait pattern to minimize the consequences of the higher vertical and propulsive GRF in their musculoskeletal system. However, they were not able to improve their balance as indicated by medial-lateral GRF. The overweight participants showed higher absolute pressure peaks in 4 out of 10 foot regions. Furthermore, the normalized data suggest that the lateral forefoot in overweight adults was loaded more than the proportion of their extra weight, while the hallux and medial rearfoot were seemingly protected.

Influence of pressure-relief insoles developed for loaded gait (backpackers and obese people) on plantar pressure distribution and ground reaction forces

“…The musculoskeletal system is often either permanently loaded, as in obese people, or occasionally loaded as in walkers that wear weighted backpacks (backpackers). In both cases (labeled as loaded populations), alterations in the biomechanical parameters of gait, such as in plantar pressure distribution (Castro et al, 2013;Castro et al, 2014;Hills et al, 2001) and ground reaction forces (GRF) (Birrell and Haslam, 2010;Birrell et al, 2007;Browning and Kram, 2007;Castro et al, 2013;Castro et al, 2014;Messier et al, 1996;Simpson et al, 2012) has been shown. Possibly, these biomechanical alterations may contribute to the higher incidence of low back pain (Grimmer and Williams, 2000;Skaggs et al, 2006), higher perceived exertion and shoulder discomfort (Simpson et al, 2011), second metatarsal stress fractures (Arndt et al, 2002), muscle strain (Birrell and Haslam, 2009), joint problems (Birrell and Haslam, 2009), and foot blisters (Knapik et al, 1992) found in backpackers; and the loss of mobility (Messier et al, 1996), higher risk of hip and knee osteoarthritis (Felson, 1990;Hochberg et al, 1995;Ko et al, 2010), foot ulceration (Vela et al, 1998), and heel pain (Prichasuk and Subhadrabandhu, 1994) described in obese people.…”

Plantar Pressure Differences Between Nordic Walking Techniques

“…Taking into account these observations, relieving between 28-83% of the pressure experienced under these areas by practicing NW may imply an important benefit for these populations. High plantar pressure associated with some biomechanical adaptations indicates the need of new strategies that would contribute to reducing this pressure by means of exercise, especially in some populations like obese people who experience an increment in plantar pressure under several regions of the foot (Castro et al, 2014), older people in whom it has been demonstrated that high plantar pressure generated during the gait may contribute to foot pain and risk of falls (Mickle et al, 2010), and in women at the third trimestral of pregnancy that experience an increase of pressure at forefoot regions (Karadagan-Saygi et al, 2010). …”

“…In this sense, even the use of low-impact activities such as walking in programmes of physical activity for obese patients has been observed to increase plantar pressure in four of the ten areas analyzed, especially under the heel, metatarsal heads and lateral of the foot (De Castro et al, 2014). Hudson (2014) demonstrated that by modifying the ground contact technique during walking with poles it was possible to reduce plantar pressure under the metatarsals heads, although this reduction was not observed under the hallux.…”

Influence of gait cadence on plantar pressures and ground reaction forces during obese adults’ walking

“…Based on previous studies assessing normal-weight subjects (6,13,24) , one could expect increases in GRF and plantar pressure peaks when obese people changed their gait cadence from low to high cadences. However, differences in gait pattern between obese and normal-weight people were previously described (4,17) . Therefore, it is currently unclear how changing gait cadence affects the magnitude of these biomechanical gait parameters in obese subjects, and which foot regions are more or less loaded.…”