Kinematic and kinetic changes in obese gait in bariatric surgery-induced weight loss

Vartiainen, Paavo; Bragge, Timo; Lyytinen, Tarja; Hakkarainen, Marko; Karjalainen, Pasi A.; Arokoski, Jari

doi:10.1016/j.jbiomech.2012.05.002

Cited by 31 publications

(22 citation statements)

References 20 publications

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“…Greater postsurgical weight loss also correlated with less time spent in double support and more time spent in single support during the gait cycle. The direction and magnitude of these results are consistent with changes in gait observed 3 to 12 months after surgery in other studies [4, 17, 18], indicative of a shift toward more normal gait. Thus, these findings show that simply moving into a lower obesity class via surgical weight loss is associated with long-term sustainment of functional recovery.…”

Section: Discussionsupporting

confidence: 90%

“…Functional recovery is an important correlate of the significant weight loss that results from bariatric surgery and can occur rapidly in the short term [4, 10, 16-18]. This study provides new evidence that improvements in walking gait are maintained even 4 to 5 years after surgery.…”

Section: Discussionmentioning

confidence: 88%

“…Roux-en-Y gastric bypass (RYGB), historically the most common procedure, creates a small gastric pouch, a gastrojejunostomy, and a jejunojejunostomy [10, 11], leading to weight loss via accelerated satiety, altered gut hormonal responses, and significant restriction of caloric intake [12]. Typically, RYGB results in loss of 55-75 % of excess weight [13-15], which is associated with functional improvement shortly after surgery [4, 10, 16-18]. It is not well-known whether postsurgical functional gains are sustained over longer time periods.…”

Section: Introductionmentioning

confidence: 99%

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Excess Body Weight Loss is Associated with Nonpathological Gait Patterns in Women 4 to 5 Years After Bariatric Surgery

et al. 2013

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Background This study examined relationships between excess body weight (EBW) loss and current gait and functional status in women 5 years after Roux-en-Y gastric bypass surgery. Methods Gait data were analyzed in nine female bariatric patients for relationships with longitudinal changes in weight, body composition, and physical function assessed by the Short Musculoskeletal Functional Assessment (SMFA) questionnaire and the timed “get-up-and-go” (TGUG) test. Gait characteristics in the bariatric sample were also compared to an age- and BMI-matched nonsurgical reference sample from the Fels Longitudinal Study. Results Bariatric patients lost an average of 36.4 kg (61.1 %) of EBW between preoperative and 5-year follow-up visits (P <0.01); SMFA function index scores and TGUG times also decreased (both P <0.01). Degree of EBW loss was correlated with less time spent in initial double support and more time in single support (both P =0.02), and for all gait variables, the bariatric sample fell within the 95 % confidence intervals of gait/EBW relationships in the reference sample. Conclusions Gait and function 5 years after bariatric surgery were characteristic of current weight, not preoperative obesity, suggesting that substantial, sustained recovery of physical function is possible with rapid surgical weight loss.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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Excess Body Weight Loss is Associated with Nonpathological Gait Patterns in Women 4 to 5 Years After Bariatric Surgery

et al. 2013

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“…Yet, these differences are associated with increased safety risks [15]. Decreased weight following surgery can minimize obesity’s effect on walking biomechanics; adults show decreased hip and knee joint moments [10] and ground reaction forces [24, 25] following bariatric surgery. Previous work shows kinematic differences during obstacle crossing [4, 16, 26].…”

Section: Discussionmentioning

confidence: 99%

“…After Roux-en-Y bariatric surgery, adults’ body mass decreases by nearly 35% with most weight loss occurring by one year post surgery [8]. In studies showing improved gait during flat ground walking at 3 months [9], 8.8 months [10], 12 months [11–13], and up to 5 years [14], after surgery, patients decreased step width (i.e., lateral distance between the feet) [9, 10], and increased velocity, step length, and single limb support time [9]. …”

Section: Introductionmentioning

confidence: 99%

Changes in spatiotemporal gait patterns during flat ground walking and obstacle crossing 1 year after bariatric surgery

Gill

Walsh

Pratt

et al. 2016

Surgery for Obesity and Related Diseases

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Background Obesity negatively impacts motor function leading to an increase in fall risk. Massive weight loss improves some aspects of gait on flat ground. However, we have little information about whether gait changes during flat ground walking and during more complex motor tasks beyond flat ground walking. Objectives Our objectives were to examine how massive weight loss after Roux-en-Y bariatric surgery affects gait during flat ground walking and obstacle crossing one year post surgery. Setting United States Methods Nineteen adult females walked under five conditions: initial baseline walking on flat ground, crossing three obstacle heights, and final baseline walking on flat ground for a total of 25 trials. Spatio-temporal gait parameters were collected simultaneously using a gait carpet and body-worn sensors. Results Gait improved post surgery with the strongest effect observed for double limb support time during flat ground walking (p<.001) and obstacle crossing (p<.001). The reduction in body mass index was correlated with improved swing (p<.01) and double limb support time (p<.01) during flat ground walking and improved swing during obstacle crossing on low (p<.01), medium (p<.01), and high (p<.01) obstacles. Improved gait post surgery was more pronounced on high obstacles for velocity (p<.001) and double limb support time (p<.001). Conclusions Massive weight loss results in improved spatio-temporal gait patterns during flat ground walking. Examining how massive weight loss affects spatio-temporal gait may help create ways to encourage a more active lifestyle for adults with obesity.

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Effects of Bariatric Surgery on Knee Articular Cartilage and Osteoarthritis Symptoms—A 12‐Month Follow‐Up Using T2 Relaxation Time and WOMAC Osteoarthritis Index

Lehtovirta,

Kemppainen,

Haapea

et al. 2024

Magnetic Resonance Imaging

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BackgroundObesity is a significant risk factor for osteoarthritis (OA). The most effective treatment for morbid obesity is bariatric surgery.PurposeTo study the effects of potential surgically induced weight loss on knee articular cartilage and OA symptoms of obese patients over a 12‐month follow‐up.Study TypeProspective longitudinal cohort study.Subjects45 obese patients (38 female, BMI = 42.3 ± 6.5 kg/m2) who underwent gastric bypass (intervention group), and 46 age‐matched conservative‐care controls (37 female, BMI = 39.8 ± 4.6 kg/m2).Field Strength/SequenceMultiecho spin echo sequence at 3 T.AssessmentKnee cartilage T2 measurements and WOMAC Indices were measured presurgery and after 12 months. The intervention group was split into successful (≥20% total weight loss (TWL)) and unsuccessful (<20% TWL) weight loss groups. T2 and WOMAC indices were also measured in controls at baseline and after 12 months. Changes among the three groups were analyzed.Statistical TestsAnalysis of variance (significance level 0.05).ResultsTwenty‐six (58%) intervention patients achieved ≥20% TWL. The <20% TWL group demonstrated significantly more T2 reduction in the deep lateral femur over 12 months compared with the ≥20% TWL group (−3.83 ± 8.18 msec vs. 2.47 ± 6.54 msec, respectively), whereas no significant differences were observed on the medial femoral compartment (P = 0.385, P = 0.551, and P = 0.511 for bulk, superficial and deep regions, respectively). Changes in WOMAC indices over 12 months were significantly greater in the ≥20% TWL group compared with controls. In the <20% TWL group, pain significantly improved over 12 months compared with controls, while stiffness and function changes were not statistically significant (P = 0.063 and P = 0.051, respectively).Data ConclusionCartilage matrix, measured by T2, showed improvement on lateral femoral cartilage with <20% TWL compared with ≥20% TWL. Bariatric surgery provided significant improvements in knee symptoms with ≥20% TWL compared with conservative WL. This effect is also seen to some extent with <20% TWL compared with conservative WL.Level of Evidence2Technical EfficacyStage 4

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Kinematic and kinetic changes in obese gait in bariatric surgery-induced weight loss

Cited by 31 publications

References 20 publications

Excess Body Weight Loss is Associated with Nonpathological Gait Patterns in Women 4 to 5 Years After Bariatric Surgery

Excess Body Weight Loss is Associated with Nonpathological Gait Patterns in Women 4 to 5 Years After Bariatric Surgery

Changes in spatiotemporal gait patterns during flat ground walking and obstacle crossing 1 year after bariatric surgery

Effects of Bariatric Surgery on Knee Articular Cartilage and Osteoarthritis Symptoms—A 12‐Month Follow‐Up Using T2 Relaxation Time and WOMAC Osteoarthritis Index

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