Effects of Obesity on the Biomechanics of Walking at different speeds: 9:30AM–19:45AM

PURPOSE Walking is a recommended form of exercise for the treatment of obesity, but walking may be a critical source of biomechanical loads that link obesity and musculoskeletal pathology, particularly knee osteoarthritis. We hypothesized that compared with normal-weight adults 1) obese adults would have greater absolute ground-reaction forces (GRF) during walking, but their GRF would be reduced at slower walking speeds; and 2) obese adults would have greater sagittal-plane absolute leg-joint moments at a given walking speed, but these moments would be reduced at slower walking speeds. METHODS We measured GRF and recorded sagittal-plane kinematics of 20 adults (10 obese and 10 normal weight) as they walked on a level, force-measuring treadmill at six speeds (0.5-1.75 m.s(-1)). We calculated sagittal-plane net muscle moments at the hip, knee, and ankle. RESULTS Compared with their normal-weight peers, obese adults had much greater absolute GRF (N), stance-phase sagittal-plane net muscle moments (N.m) and step width (m). CONCLUSIONS Greater sagittal-plane knee moments in the obese subjects suggest that they walked with greater knee-joint loads than normal-weight adults. Walking slower reduced GRF and net muscle moments and may be a risk-lowering strategy for obese adults who wish to walk for exercise. When obese subjects walked at 1.0 versus 1.5 m.s(-1), peak sagittal-plane knee moments were 45% less. Obese subjects walking at approximately 1.1 m.s(-1) would have the same absolute peak sagittal-plane knee net muscle moment as normal-weight subjects when they walk at their typical preferred speed of 1.4 m.s(-1).

[1]  T. Griffin,et al.  The Role of Mechanical Loading in the Onset and Progression of Osteoarthritis , 2005, Exercise and sport sciences reviews.

[2]  R. Hooper,et al.  The kinetic and kinematic effects of increasing load carriage upon the lower limb , 1999 .

[3]  W. Ettinger,et al.  Physical disability from knee osteoarthritis: the role of exercise as an intervention. , 1994, Medicine and science in sports and exercise.

[4]  I. Paul,et al.  Role of mechanical factors in pathogenesis of primary osteoarthritis. , 1972, Lancet.

[5]  J. Dowling,et al.  Analysis of body segment parameter differences between four human populations and the estimation errors of four popular mathematical models. , 2003, Journal of biomechanical engineering.

[6]  S. Simon,et al.  Biomechanical gait analysis in obese men. , 1991, Archives of physical medicine and rehabilitation.

[7]  F. Cicuttini,et al.  Obesity: a preventable risk factor for large joint osteoarthritis which may act through biomechanical factors , 2004, British Journal of Sports Medicine.

[8]  T. Miyazaki,et al.  Dynamic load at baseline can predict radiographic disease progression in medial compartment knee osteoarthritis , 2002, Annals of the rheumatic diseases.

[9]  D. Kerrigan,et al.  Predicting peak kinematic and kinetic parameters from gait speed. , 2003, Gait & posture.

[10]  J. Peters,et al.  Environmental contributions to the obesity epidemic. , 1998, Science.

[11]  Flavia Cicuttini,et al.  Knee structural alteration and BMI: a cross-sectional study. , 2005, Obesity research.

[12]  T. Andriacchi Dynamics of knee malalignment. , 1994, The Orthopedic clinics of North America.

[13]  K. Patrick,et al.  Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine , 1995 .

[14]  D. A. Winter,et al.  Joit torque and energy patterns in normal gait , 1978, Biological Cybernetics.

[15]  J. Donelan,et al.  Mechanical and metabolic requirements for active lateral stabilization in human walking. , 2004, Journal of biomechanics.

[16]  Paul DeVita,et al.  Obesity is not associated with increased knee joint torque and power during level walking. , 2003, Journal of biomechanics.

[17]  J. Donelan,et al.  Force treadmill for measuring vertical and horizontal ground reaction forces. , 1998, Journal of applied physiology.

[18]  F Guilak,et al.  The influence of mechanical compression on the induction of osteoarthritis-related biomarkers in articular cartilage explants. , 2005, Osteoarthritis and cartilage.

[19]  T. Andriacchi,et al.  The knee adduction moment during gait in subjects with knee osteoarthritis is more closely correlated with static alignment than radiographic disease severity, toe out angle and pain , 2002, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[20]  R. Kram,et al.  Effects of obesity and sex on the energetic cost and preferred speed of walking. , 2006, Journal of applied physiology.

[21]  S. Messier,et al.  Severe Obesity: Effects on Foot Mechanics During Walking , 1994, Foot & ankle international.

[22]  M. K. James,et al.  Obesity: Effects on Gait in an Osteoarthritic Population , 1996 .

[23]  R. Kram,et al.  Metabolic cost of generating muscular force in human walking: insights from load-carrying and speed experiments. , 2003, Journal of applied physiology.

[24]  E. Radin,et al.  Effects of mechanical loading on the tissues of the rabbit knee , 1984, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[25]  H J Yack,et al.  Comparison of vertical ground reaction forces during overground and treadmill walking. , 1998, Medicine and science in sports and exercise.

[26]  U. Croce,et al.  A kinematic and kinetic comparison of overground and treadmill walking in healthy subjects. , 2007, Gait & posture.

[27]  R. Kram,et al.  Mechanical and metabolic determinants of the preferred step width in human walking , 2001, Proceedings of the Royal Society of London. Series B: Biological Sciences.

[28]  James O. Hill,et al.  Obesity and the Environment: Where Do We Go from Here? , 2003, Science.

[29]  A. Belli,et al.  A treadmill ergometer for three-dimensional ground reaction forces measurement during walking. , 2001, Journal of biomechanics.

[30]  P. Leva Adjustments to Zatsiorsky-Seluyanov's segment inertia parameters. , 1996 .

[31]  Andrew A Biewener,et al.  Muscle mechanical advantage of human walking and running: implications for energy cost. , 2004, Journal of applied physiology.

[32]  T. Spector,et al.  Osteoarthritis: New Insights. Part 1: The Disease and Its Risk Factors , 2000, Annals of Internal Medicine.

[33]  S. Rössner,et al.  Is walking for exercise too exhausting for obese women? , 1997, International Journal of Obesity.

[34]  N Taylor,et al.  Knee joint kinematics from familiarised treadmill walking can be generalised to overground walking in young unimpaired subjects. , 2000, Gait & posture.

[35]  G. Deuschl,et al.  Gait analysis during treadmill and overground locomotion in children and adults. , 1997, Electroencephalography and clinical neurophysiology.

[36]  R. Kram,et al.  Energetic cost and preferred speed of walking in obese vs. normal weight women. , 2005, Obesity research.

[37]  G. J. van Ingen Schenau,et al.  Some fundamental aspects of the biomechanics of overground versus treadmill locomotion. , 1980, Medicine and science in sports and exercise.

[38]  Murray Mp,et al.  Treadmill vs. floor walking: kinematics, electromyogram, and heart rate. , 1985, Journal of applied physiology.

[39]  T. Andriacchi,et al.  Increased knee joint loads during walking are present in subjects with knee osteoarthritis. , 2002, Osteoarthritis and cartilage.

[40]  H. Ralston Energy-speed relation and optimal speed during level walking , 1958, Internationale Zeitschrift für angewandte Physiologie einschließlich Arbeitsphysiologie.