Table 4 Studies on the association of obesity/overweight with gait and function.

[43]

Study

25.5 ± 6.9

(with obesity),

26.6 ± 5.5

(with normal weight)

20

women;

10 women with obesity, and

10 women with normal weight

34.1 ± 3.2

(with obesity),

20.4 ± 2.1

(with normal weight)

Height, body

mass, lean

body mass, percent

body fat,

VO2max, standing

VO2, and

preferred walking

speed, metabolic

rate, energy cost

per distance, and

relative aerobic

effort.

None.

Treadmill (Track

Master 425; Full

Vision, Inc.,

Newton, KS),

whole body DXA

scanner (DPXIQ;

Lunar Corp.,

Madison, WI),

12-lead electrocardiogram, and

open

circuit respirometry

(CardiO2/CP

Gas Exchange

System; Med-

Graphics, St.

Paul, MN).

Subjects with obesity showed 11% higher metabolic cost when averaged across different walking speeds, greater

relative aerobic effort

while walking at preferred speed, and

a similar preferred walking speed compared to normal subjects. No

difference in the gross

energetic cost per distance (Joules per

kilogram per meter) of

walking.

[44]

Study

25.3 ± 7.3

(with obesity);

26.6 ± 5.5

(with normal weight)

39 (T), 19

(W)

33.8 ± 3.3

(women with obesity),

20.4 ± 2.1

(women with normal weight),

33.5 ± 2.1

(men with obesity),

22.3 ± 1.9

(men with normal weight)

Waist-to-hip

ratio, percent

body fat, lean

body mass,

metabolic rate,

segment measurements

and

composition,

VO2 max, preferred

walking

speed.

None.

Composition

using a whole

body DEXA

scanner (DPXIQ;

Lunar Corp.,

Madison, WI) and

open-circuit

respirometry

system

(CardiO2/CP,

Med Graphics,

St. Paul, MN).

The net metabolic rate of women with obesity was 10% higher than that of men with obesity and normal-weight women, and 20% higher than that of normal-weight men.

[42]

Cross-sectional

comparison

44.5 ± 10.3

(with obesity),

44.2 ± 10.1

(normal)

20 women; 10 with obesity, 10 with normal weight

38.9 ± 6.6

(with obesity),

21.7 ± 1.5

(with normal weight)

Thoracic and

pelvic segment

displacement

(deg), mediolateral

width of the

base of support

(cm), hip joint

and thoracolumbar

spine range

of motion (deg),

during seated

and standing

forward flexion;

thoracic and

pelvic segment

angular displacement

(deg), hip

joint and thoracolumbar

spine

angular displacement

(deg),

hip-to-bench distance

(cm) and

hip joint moment

during the simulated

standing

work task.

None.

A single camera

motion analysis

system (Peak

Motus).

Seated and standing posture: Reduced trunk forward flexion motion and increased mediolateral width of

the base of support in subjects with obesity. No changes in pelvic segment displacement

and hip joint range of motion. Motion restrictions were observed in the thoracic segment and thoracolumbar spine range of motion. Standing work task:

Significant postural

adaptations and increased hip joint

moment.

[41]

Study

38.4 ± 10.2

(with obesity),

30.2 ± 6.8

(with normal weight)

20 women; 10 with obesity, 10 with normal weight

38.7 ± 3.5

(with obesity),

19.9 ± 0.8

(healthy)

Three movements

of the trunk:

forward flexion,

bilateral bending,

and rotation.

None.

A 6-camera optoelectronic

motion

analysis system

(Vicon 460,

Oxford Metrics

Group, Oxford,

UK).

Subjects with obesity were characterized by a

different standing posture, limited spinal

range of motion, larger

pelvic tilt angle in

the initial position, and a

limited thoracic movement. Obesity affects thoracic movement during forward flexion and lateral bending.

[39]

Study

48.37 ± 6.30

(overweight);

50.85 ± 6.01

(slight obesity);

48.28 ± 5.05

(moderate obesity),

52.80 ± 2.58

(normal)

27 women

24.51 ± 0.95

(overweight),

27.61 ± 1.8

(slight obesity),

39.13 ± 13.93

(moderate obesity),

21.90 ± 0.68

(normal)

Peak plantar

pressure in 7 foot

regions.

None.

Height & Weight:

JEXIN (Korea)

& DS-102.Inbody

4.0 (Biospace,

Korea); Gait

analysis using

FootMat System

(Tekscan, USA).

Increased BMI

resulted in higher

plantar pressure in

certain foot regions

while crossing an

obstacle of 10 cm or above.

[46]

Study

37.7 ± 4.8

(with obesity),

(38.1 ± 4.5

(with normal weight)

10 women with obesity

and 10

women with normal weight

36.1 ± 4.2

(with obesity),

22.6 ± 2.3

(with normal weight)

None.

BMI, hip and waist

Circumference, hip

and knee moment, and

VO2max.

30-min walking

trial on treadmill;

GAITRite mat,

force plates, and

Optotrak motion

analysis system

for measuring

spatiotemporal,

kinetic, and

kinematic gait

data; VO2 max

was calculated

using Ebbeling

protocol.

Both individuals with obesity and those without obesity experienced increased knee extensor moments after a 30-min walking session.

Hip extensor moments

decreased for both

groups. No changes in

knee and hip adduction

moments. A weak

association was observed between hip/knee moments with BMI.

[38]

Study

45–65

(57.4 ± 5.3)

163 women; 39 with obesity, 59 with overweight, 65 with normal weight

27.06 ± 5.3

Plantar pressure

parameters

(PPPs) in 10

foot regions: contact

percentage,

absolute pressure

impulse, relative

pressure impulse,

and absolute

peak pressure.

None.

BMI: digital

medical scale

with a stadiometer

(InBody

BSM370;

BioSpace, Seoul,

South Korea);

Gait analysis:

Footscan pressure

measurement

system (RSscan

International,

Olen, Belgium).

Mean peak pressure

values and absolute

pressure impulse: Significant between-group differences for all foot regions except for

the second through fifth

toes; Contact pressure:

Significant between-group difference for

the metatarsal regions

and midfoot; Relative pressure impulse: significant between-group difference for

all foot regions except

for the second through

fifth toes and first

metatarsal.

[40]

Study

36.16 ± 12.76

(class I

BMI),

41.17 ± 5.89

(class II

BMI),

42.72 ± 11.43

(class III

BMI),

38.20 ± 7.04

(normal)

67

women;

13 normal,

18

class I

BMI, 16

class II

BMI, 20

class III

29.36 ± 3.19

(overweight/-

Class I), 37.78 ± 1.42

(class II), 44.31 ± 4.24

(class

III), 22.56 ± 1.61

(normal

BMI)

Velocity, percent

of the gait cycle

spent in swing,

and percent of

the gait cycles

spent in stance.

None.

Pressure-sensitive

gait carpet (Protokinetics,

LLC,

Peekskill, NY,

USA).

Normal BMI had

faster gait velocity,

a shorter percentage of

gait cycle spent in

stance, and a larger percentage

in swing compared to those in higher

BMI classes. No difference

in velocities

between class II and

class III BMI group.

Normal BMI had

lower variability in

velocities compared to

all other groups. Class

I had lower variability

in velocity compared

to class II and

class III.

[45]

Study

18–30

young,

65–80

older

39

women;

10 (young,

healthy),

10 (young, people with obesity),

10 (older, healthy),

9 (older, people with obesity)

22.5 ± 1.8

(young, healthy),

33.7 ± 2.9

(young, with obesity),

22.7 ± 3.0

(older, healthy),

32.5 ± 2.0

(older, with obesity)

Knee, hip, and

ankle strength,

ground reaction

forces, segmental

kinematics, and

torques at joints.

None.

Force plate

(Model 9090;

Bertec Corporation,

Columbus,

OH), dynamometer

(System 3;

Biodex Medical

Systems, Inc.,

Shirley, NY),

a six-camera

motion capture

system (MX-T10;

Vicon Motion

Systems Inc., Los

Angeles, CA).

Women with obesity walk with a greater relative effort, which was attributed to obesity-related increases in joint toques rather than strength.