The effect of severe obesity on three-dimensional ground reaction force signals during walking

Abstract

Background: The gait pattern of adults with class I obesity [30 ≤ body mass index < 35kg/m²] was characterized by altered three-dimensional ground reaction force signals compared to lean adults (18.5 ≤ body mass index < 25 kg/m²). However, results might not be generalizable to adults with severe obesity (class II and III; body mass index ≥ 35 kg/m²). Hence, the purpose of the present study was to investigate the differences in relative ground reaction force signals, i.e., normalized by body weight, between adults with severe obesity and lean adults using functional principal component analysis.

Methods: Thirteen lean and eighteen sedentary adults with severe obesity performed a 5-min walking trial (1.11 m/s) on an instrumented treadmill. The first five functional principal components of the relative force signals (mediolateral, anterior-posterior, and vertical directions) were obtained using functional principal component analysis. Functional principal component scores were compared between groups using an analysis of covariance with age as covariable.

Findings: Functional principal component analysis reported a statistically significant group effect for first functional principal component score for mediolateral (P = 0.004), and second and fifth functional principal component scores for anterior-posterior (P ≤ 0.02) force signals. Adults with severe obesity displayed a greater mediolateral force during most of the stance but similar magnitudes of the anterior-posterior and vertical forces compared to lean adults.

Interpretation: Therefore, increasing the obesity level accentuates differences in mediolateral force but promotes no specific changes in anterior-posterior force likely due to chronic loading adaptation.

Keywords: Biomechanics; Dimensionality reduction; Functional principal component analysis; Gait analysis.