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Jorgić BM, Đorđević SN, Hadžović MM, Milenković S, Stojiljković NĐ, Olanescu M, Peris M, Suciu A, Popa D, Plesa A. The Influence of Body Composition on Sagittal Plane Posture among Elementary School-Aged Children. CHILDREN (BASEL, SWITZERLAND) 2023; 11:36. [PMID: 38255350 PMCID: PMC10814759 DOI: 10.3390/children11010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/25/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
Proper posture, characterized by the appropriate alignment of the cervical, thoracic, and lumbar segments of the spine, enables these regions to maintain their normal curvature. Body composition is recognized as one of the factors that can influence overall postural alignment of the spine. The objective of this study was to determine the influence of the parameters of body composition on the prevalence of postural disorders in the sagittal plane. The cross-sectional study was conducted on 152 children of both genders (78 boys), at a mean age of 11 years ± 6 months. In order to evaluate postural disorders, the Formetric 4D System, a tool manufactured by Diers, Schlangenbad, Germany was used. Based on its output data, the following variables were obtained: hyperkyphosis, hyperlordosis, kypholordosis, flatback, and normal alignment of the body in the sagittal plane. The evaluation of body composition parameters was conducted using the InBody 770 device. To determine how body composition influences the postural status of the spinal column, a discriminant analysis was employed. The results showed that approximately 65.8% of children exhibit various types of postural disorders when assessing the alignment of the spine in the sagittal plane. The most prevalent disorder observed was hyperkyphosis, affecting 34.2% of the subjects, followed by kypholordosis at 16.4%. Moreover, the results demonstrated that body composition significantly influences body posture (p = 0.004). An increase in fat mass corresponds to a deviation from normal body posture, whereas an increase in the percentage of skeletal muscle mass and fat-free mass is associated with a reduction in postural abnormalities in the sagittal plane. Considering the results, it is clear that body composition parameters serve as more reliable predictors of the influence on body posture compared to simply calculating the body mass index. Furthermore, it can be concluded that there are consistent patterns of influence by specific body composition parameters, including fat mass, percentage of skeletal muscle, and fat-free mass, on body posture among children from various climates. These results underscore the significance of implementing strength exercises in children, particularly during periods of rapid growth and development, as a means of preventing and correcting postural disorders.
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Affiliation(s)
- Bojan M. Jorgić
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia; (B.M.J.); (S.N.Đ.); (M.M.H.); (S.M.); (N.Đ.S.)
| | - Stefan N. Đorđević
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia; (B.M.J.); (S.N.Đ.); (M.M.H.); (S.M.); (N.Đ.S.)
| | - Miljan M. Hadžović
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia; (B.M.J.); (S.N.Đ.); (M.M.H.); (S.M.); (N.Đ.S.)
| | - Saša Milenković
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia; (B.M.J.); (S.N.Đ.); (M.M.H.); (S.M.); (N.Đ.S.)
| | - Nenad Đ. Stojiljković
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia; (B.M.J.); (S.N.Đ.); (M.M.H.); (S.M.); (N.Đ.S.)
| | - Mihai Olanescu
- Faculty of Automotive, Mechatronics and Mechanical Engineering, Technical University of Cluj-Napoca, 400641 Cluj-Napoca, Romania; (A.S.); (D.P.); (A.P.)
| | - Miruna Peris
- Faculty Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400641 Cluj-Napoca, Romania;
| | - Adrian Suciu
- Faculty of Automotive, Mechatronics and Mechanical Engineering, Technical University of Cluj-Napoca, 400641 Cluj-Napoca, Romania; (A.S.); (D.P.); (A.P.)
| | - Danut Popa
- Faculty of Automotive, Mechatronics and Mechanical Engineering, Technical University of Cluj-Napoca, 400641 Cluj-Napoca, Romania; (A.S.); (D.P.); (A.P.)
| | - Alin Plesa
- Faculty of Automotive, Mechatronics and Mechanical Engineering, Technical University of Cluj-Napoca, 400641 Cluj-Napoca, Romania; (A.S.); (D.P.); (A.P.)
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Bahramian M, Arjmand N, El-Rich M, Parnianpour M. Effect of obesity on spinal loads during load-reaching activities: A subject- and kinematics-specific musculoskeletal modeling approach. J Biomech 2023; 161:111770. [PMID: 37633816 DOI: 10.1016/j.jbiomech.2023.111770] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/24/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023]
Abstract
Obesity has been associated to increase the risk of low back disorders. Previous musculoskeletal models simulating the effect of body weight on intervertebral joint loads have assumed identical body postures for obese and normal-weight individuals during a given physical activity. Our recent kinematic-measurement studies, however, indicate that obese individuals adapt different body postures (segmental orientations) than normal-weight ones when performing load-reaching activities. The present study, therefore, used a subject- and kinematics-specific musculoskeletal modeling approach to compare spinal loads of nine normal-weight and nine obese individuals each performing twelve static two-handed load-reaching activities at different hand heights, anterior distances, and asymmetry angles (total of 12 tasks × 18 subjects = 216 model simulations). Each model incorporated personalized muscle architectures, body mass distributions, and full-body kinematics for each subject and task. Results indicated that even when accounting for subject-specific body kinematics obese individuals experienced significantly larger (by ∼38% in average) L5-S1 compression (2305 ± 468 N versus 1674 ± 337 N) and shear (508 ± 111 N versus 705 ± 150 N) loads during all reaching activities (p < 0.05 for all hand positions). This average difference of ∼38% was similar to the results obtained from previous modeling investigations that neglected kinematics differences between the two weight groups. Moreover, there was no significant interaction effect between body weight and hand position on the spinal loads; indicating that the effect of body weight on L5-S1 loads was not dependent on the position of hands. Postural differences alone appear, hence, ineffective in compensating the greater spinal loads that obese people experience during reaching activities.
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Affiliation(s)
- M Bahramian
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - N Arjmand
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.
| | - M El-Rich
- Healthcare Engineering Innovation Center, Department of Mechanical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
| | - M Parnianpour
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
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Zeng J, Huang J, Liu Z, Xia H. Influence of peroneus longus tendon autograft for ACL reconstruction on donor-side ankle function in obese patients: A retrospective study of 87 patients. Asian J Surg 2023; 46:5305-5307. [PMID: 37541897 DOI: 10.1016/j.asjsur.2023.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/09/2023] [Indexed: 08/06/2023] Open
Affiliation(s)
- Jin Zeng
- The First District of Department of Orthopedics, Xiangtan Central Hospital, Xiangtan, China; Hengyang Medical College, University of South China, Hengyang, China
| | - Jiaqiang Huang
- The First District of Department of Orthopedics, Xiangtan Central Hospital, Xiangtan, China
| | - Zhaoxiang Liu
- Trauma Center of Xiangtan Central Hospital, Xiangtan, China
| | - Hong Xia
- The First District of Department of Orthopedics, Xiangtan Central Hospital, Xiangtan, China.
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Bayartai ME, Luomajoki H, Tringali G, De Micheli R, Grugni G, Sartorio A. Differences in spinal postures and mobility among adults with Prader-Willi syndrome, essential obesity, and normal-weight individuals. Front Endocrinol (Lausanne) 2023; 14:1235030. [PMID: 37800136 PMCID: PMC10548364 DOI: 10.3389/fendo.2023.1235030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
Introduction Spinal kinematics/motion are reported to be altered in adolescents and adults with essential obesity, while no information is available in patients with Prader-Willi syndrome so far. The aim of this study was to examine cross-sectionally the characteristics of spinal postures and mobility in 34 patients with PWS, in 35 age- and sex-matched adults with essential obesity, and in 37 normal-weight individuals. Methods Spinal posture and mobility were assessed using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Differences in spinal posture and mobility between the three groups were determined using a two-way analysis of variance. Results Adults with Prader-Willi syndrome had greater thoracic kyphosis [difference between groups (Δ) = 9.60, 95% CI 3.30 to 15.60, p = 0.001], less lumbar lordosis (Δ = -6.50, 95% CI -12.70 to -0.30, p = 0.03) as well as smaller lumbar and hip mobility than those with normal weight. Discussion Although the characteristics of the spine in patients with Prader-Will syndrome appear to be similar to that found in subjects with essential obesity, Prader-Willi syndrome was found to influence lumbar movements more than thoracic mobility. These results provide relevant information about the characteristics of the spine in adults with Prader-Willi syndrome to be taken into careful consideration in the management of spinal conditions. These findings also highlight the importance of considering the musculoskeletal assessment of spinal postures and approaches targeting spinal and hip flexibility in adults with Prader-Willi syndrome.
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Affiliation(s)
- Munkh-Erdene Bayartai
- Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, (ZHAW), Winterthur, Switzerland
- Department of Physical and Occupational Therapy, School of Nursing, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Hannu Luomajoki
- Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, (ZHAW), Winterthur, Switzerland
| | - Gabriella Tringali
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy
| | - Roberta De Micheli
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy
| | - Graziano Grugni
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Division of Auxology, Piancavallo-Verbania, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy
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Bayartai ME, Luomajoki H, Tringali G, De Micheli R, Abbruzzese L, Sartorio A. Differences in spinal posture and mobility between adults with obesity and normal weight individuals. Sci Rep 2023; 13:13409. [PMID: 37591910 PMCID: PMC10435449 DOI: 10.1038/s41598-023-40470-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/10/2023] [Indexed: 08/19/2023] Open
Abstract
The aim of this study was to cross-sectionally investigate the relationships between obesity and spinal posture as well as mobility by comparing the spinal parameters between adults with obesity and normal-weight individuals. The spinal parameters were measured in 71 adults with obesity and 142 normal-weight individuals using a radiation-free back scan, the Idiag M360. Differences in spinal posture and movements between the two groups were determined using a two-way analysis of variance. Adults with obesity had greater thoracic kyphosis [difference between groups (Δ) = 6.1°, 95% CI 3.3°-8.9°, p < 0.0001] and thoracic lateral flexion (Δ = 14.5°, 95% CI 5.1°-23.8°, p = 0.002), as well as smaller thoracic flexion (Δ = 3.5°, 95% CI 0.2°-6.9°, p = 0.03), thoracic extension (Δ = 4.1°, 95% CI 1.1°-7.1°, p = 0.008), lumbar flexion (Δ = 10.4°, 95% CI 7.7°-13.5°, p < 0.0001), lumbar extension (Δ = 4.8°, 95% CI 2.2°-7.4°, p = 0.0003) and lumbar lateral flexion (Δ = 12.8°, 95% CI 9.8°-15.7°, p = < 0.0001) compared to those with normal weight. These findings provide relevant information about the characteristics of the spine in adults with obesity to be taken into careful consideration in the prescription of adapted physical activities within integrated multidisciplinary pathways of metabolic rehabilitation.
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Affiliation(s)
- Munkh-Erdene Bayartai
- Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, ZHAW, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland.
- Department of Physical and Occupational Therapy, School of Nursing, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
| | - Hannu Luomajoki
- Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, ZHAW, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
| | - Gabriella Tringali
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy
| | - Roberta De Micheli
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy
| | - Laura Abbruzzese
- Istituto Auxologico Italiano, IRCCS, Division of Eating and Nutrition Disorders, Piancavallo-Verbania, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy
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Lucha-López MO, Hidalgo-García C, Monti-Ballano S, Márquez-Gonzalvo S, Ferrández-Laliena L, Müller-Thyssen-Uriarte J, Lucha-López AC. Body Mass Index and Its Influence on Chronic Low Back Pain in the Spanish Population: A Secondary Analysis from the European Health Survey (2020). Biomedicines 2023; 11:2175. [PMID: 37626672 PMCID: PMC10452522 DOI: 10.3390/biomedicines11082175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Risk factors such as obesity and a sedentary lifestyle contribute to the development of chronic low back pain. PURPOSE To describe how body mass index (BMI) influences the prevalence of chronic low back pain in the general Spanish population and assess this influence given other factors as sex, age, physical occupational demands, and recreational physical activity. METHODS An analytical cross-sectional design was performed based on secondary data from the European Health Survey in Spain (2020). Data on age, gender, physical occupational demands, physical activity, BMI, and presence of chronic low back pain were extracted. RESULTS A total of 19,716 (52.2% women) subjects with a median age of 53 years old were analyzed. Of these, 18.3% had chronic low back pain, 39% were overweight, and 16.1% were obese. The adjusted generalized linear model showed that being obese increased the odds of chronic low back pain by 1.719 times (p < 0.001). Being a woman increased the odds by 1.683 times (p < 0.001). Performing occupational tasks requiring high physical demands increased the odds by 1.403 times (p < 0.001). Performing physical activity in leisure time several times a week decreased the odds by 0.598 times (p < 0.001). For every additional year of age, the odds of chronic low back pain increased by 3.3% (p < 0.001). CONCLUSIONS Obesity is related with the presence of chronic low back pain in the general Spanish population. This association persists, being the more relevant factor, after adjusting the association of BMI and chronic low back pain with other factors such as sex, age, physical occupational demands, and recreational physical activity.
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Affiliation(s)
- María Orosia Lucha-López
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (L.F.-L.); (J.M.-T.-U.)
| | - César Hidalgo-García
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (L.F.-L.); (J.M.-T.-U.)
| | - Sofía Monti-Ballano
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (L.F.-L.); (J.M.-T.-U.)
| | - Sergio Márquez-Gonzalvo
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (L.F.-L.); (J.M.-T.-U.)
| | - Loreto Ferrández-Laliena
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (L.F.-L.); (J.M.-T.-U.)
| | - Julián Müller-Thyssen-Uriarte
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (L.F.-L.); (J.M.-T.-U.)
| | - Ana Carmen Lucha-López
- Unidad de Investigación en Fisioterapia, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain;
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Zadoń H, Michnik R, Nowakowska-Lipiec K. Exploring the impact of body mass change on fatigue and activity of the muscular system during daily routine. Technol Health Care 2023; 31:2487-2498. [PMID: 37955073 DOI: 10.3233/thc-235014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND Correct body weight is one of the factors that allows you to maintain a properly functioning body. Abnormal body weight can cause muscle tissue remodelling, affecting activity and muscle fatigue. Changes in the muscular system can cause occurrence of functional limitations. OBJECTIVE To determine the effect of weight change on fatigue and activity of the muscular system during daily activities. METHODS The evaluation of musculoskeletal functioning was based on the results of computer simulations conducted in the AnyBody Modeling System. The following activities were analysed: standing, sitting down and getting up from a chair, holding and lifting an object, and walking. The simulations of the activities were carried out using averaged kinematic data, and by changing body mass in the range of 50 kg to 100 kg by increments of 2 kg, to map different nutritional status from excessive thinness to extreme obesity. Identification of loads in the musculoskeletal system was based on solving an inverse dynamics problem and then the estimation of muscle force values using static optimization. The simulation results allowed to determine the value of muscle fatigue and the level of muscle activity. RESULTS For activities (i.e., standing, walking, sitting down and getting up from a chair) it was observed that the value of muscle fatigue increases with increasing body mass. However, for activities that cause more load on the musculoskeletal system, i.e. lifting and holding an object, the highest value of muscle fatigue was observed in underweight individuals. CONCLUSION The change in body weight alters the functioning of the muscular system and thus the ability to perform activities. It was shown that in case of underweight, overweight or obese people, abnormal body weight can be the reason for occurrence of difficulties in performing the activities of lifting and holding a 20 kg object, as well as walking.
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Overweight and smoking promote recurrent lumbar disk herniation after discectomy. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:604-613. [PMID: 35072795 DOI: 10.1007/s00586-022-07116-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 12/22/2021] [Accepted: 01/10/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE Recurrent lumbar disk herniation (rLDH) following lumbar microdiscectomy is common. While several risk factors for primary LDH have been described, risk factors for rLDH have only sparsely been investigated. We evaluate the effect of Body mass index (BMI) and smoking on the incidence and timing of rLDH. METHODS From a prospective registry, we identified all patients undergoing primary tubular microdiscectomy (tMD), with complete BMI and smoking data, and a minimum 12-month follow-up. We defined rLDH as reherniation at the same level and side requiring surgery. Overweight was defined as BMI > 25, and obesity as BMI > 30. Intergroup comparisons and age- and gender-adjusted multivariable regression were carried out. We conducted a survival analysis to assess the influence of BMI and smoking on time to reoperation. RESULTS Of 3012 patients, 166 (5.5%) underwent re-microdiscectomy for rLDH. Smokers were reoperated more frequently (6.4% vs. 4.0%, p = 0.007). Similarly, rLDH was more frequent in obese (7.5%) and overweight (5.9%) than in normal-weight patients (3.3%, p = 0.017). Overweight smokers had the highest rLDH rate (7.6%). This effect of smoking (Odds ratio: 1.63, 96% CI: 1.12-2.36, p = 0.010) and BMI (Odds ratio: 1.09, 95% CI: 1.02-1.17, p = 0.010) persisted after controlling for age and gender. Survival analysis demonstrated that rLDH did not occur earlier in overweight patients and/or smokers. CONCLUSIONS BMI and smoking may directly contribute to a higher risk of rLDH, but do not accelerate rLDH development. Smoking cessation and weight loss in overweight or obese patients ought to be recommended with discectomy to reduce the risk for rLDH.
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Hashimoto J, Yoshii T, Sakai K, Hirai T, Yuasa M, Inose H, Kawabata A, Utagawa K, Matsukura Y, Tomori M, Torigoe I, Yamada T, Kusano K, Otani K, Sumiya S, Numano F, Fukushima K, Tomizawa S, Arai Y, Shindo S, Okawa A. Impact of body mass index on surgical outcomes and complications in adult spinal deformity. J Orthop Sci 2022; 27:89-94. [PMID: 33468342 DOI: 10.1016/j.jos.2020.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Several studies have reported that overweightness and obesity are associated with higher complication rates in lumbar spine surgery. However, little is known about the effect of obesity on postoperative complications in adult spinal deformity (ASD) surgery, especially in the elderly. This study aimed to examine the effect of body mass index (BMI) on surgical outcomes and postoperative complications in elderly ASD patients undergoing surgical correction in Japan. METHODS We conducted a retrospective, multicenter, observational study of 234 consecutive patients diagnosed with ASD who underwent corrective surgery. Patients were divided into two groups according to BMI, BMI <25 (153 patients, mean age 71.9 years) and BMI ≥ 25 (overweight/obese, 81 patients, mean age 73.3 years). Radiographic results and perioperative complications were compared between the two groups. RESULTS Surgical complications occurred in approximately 20% of patients in each group; complications did not significantly differ between the two groups. A greater proportion of patients in the BMI ≥ 25 group experienced mechanical failure and DJK, although the difference was not significant. Preoperative mean lumbar lordosis (LL), pelvic incidence (PI) minus LL, sacral slope (SS) and sagittal vertical axis (SVA) were similar in the BMI < 25 and BMI ≥ 25 groups. However, the BMI ≥25 group had lower mean LL (p = 0.015) and higher PI minus LL (p = 0.09) postoperatively. The BMI ≥25 groups also had significantly smaller LL (p = 0.026), smaller SS (p = 0.049) and higher SVA (p = 0.041) at the final follow-up, compared to the BMI < 25 group. CONCLUSIONS In the present study, no difference in medical or surgical complications after ASD surgery was found between overweight/obese patients (BMI ≥ 25) and those with BMI < 25. However, correction of LL and SVA was smaller in patients with overweight/obese patients.
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Affiliation(s)
- Jun Hashimoto
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medial and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medial and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Kenichiro Sakai
- Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, 332-8558, Japan
| | - Takashi Hirai
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medial and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Masato Yuasa
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medial and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Hiroyuki Inose
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medial and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Atsuyuki Kawabata
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medial and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kurando Utagawa
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medial and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Yu Matsukura
- Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, 332-8558, Japan
| | - Masaki Tomori
- Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, 332-8558, Japan
| | - Ichiro Torigoe
- Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, 332-8558, Japan
| | - Tsuyoshi Yamada
- Department of Orthopaedic Surgery, Kudanzawa Hospital, 1-6-12 Kudanminami, Chiyoda-ku, Tokyo, 102-0074, Japan
| | - Kazuo Kusano
- Department of Orthopaedic Surgery, Kudanzawa Hospital, 1-6-12 Kudanminami, Chiyoda-ku, Tokyo, 102-0074, Japan
| | - Kazuyuki Otani
- Department of Orthopaedic Surgery, Kudanzawa Hospital, 1-6-12 Kudanminami, Chiyoda-ku, Tokyo, 102-0074, Japan
| | - Satoshi Sumiya
- Department of Orthopaedic Surgery, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama, Kanagawa, 231-8682, Japan
| | - Fujiki Numano
- Department of Orthopaedic Surgery, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama, Kanagawa, 231-8682, Japan
| | - Kazuyuki Fukushima
- Department of Orthopaedic Surgery, Saku Central Hospital, 3400-28 Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Shoji Tomizawa
- Department of Orthopaedic Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Toudaijima, Urayasu, Chiba, 279-0001, Japan
| | - Yoshiyasu Arai
- Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, 332-8558, Japan
| | - Shigeo Shindo
- Department of Orthopaedic Surgery, Kudanzawa Hospital, 1-6-12 Kudanminami, Chiyoda-ku, Tokyo, 102-0074, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medial and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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Lanuza-Cerzócimo C, Alfaro-Santafé J, Almenar-Arasanz AJ, Alfaro-Santafé JV, Pérez-Morcillo A, Gómez-Bernal A. Variación baropodométrica con la pérdida de peso: un estudio experimental. REVISTA ESPAÑOLA DE PODOLOGÍA 2022. [DOI: 10.20986/revesppod.2022.1627/2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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11
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Baek S, Jung J, Moon P, Park W. Obesity impacts on task performance and perceived discomfort during seated foot target reaches. ERGONOMICS 2021; 64:1569-1578. [PMID: 34018914 DOI: 10.1080/00140139.2021.1933202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
This study examined obesity impacts on task performance and perceived discomfort during seated foot target reaches. Three independent variables, participant group, movement distance, and, movement direction, were considered. The task performance measures employed were reaction time, movement time and task performance time. Perceived discomfort was measured using a modified Borg CR-10 scale. Statistical analyses revealed that: obesity was associated with increases in movement time, reaction time and performance time; movement distance significantly affected the three task performance measures and discomfort rating; and, movement direction significantly affected movement time, performance time and discomfort rating. The obesity impacts observed are thought to reflect the decelerating effects of the extra fat mass in the obese body during foot reaches and possibly obesity-related physiological and cognitive changes. Design improvements of foot-operated systems, such as reducing distances to targets, increasing target sizes and avoiding forward foot reaches, may help counteract the observed obesity impacts. Practitioner Summary: This study empirically investigated the obesity impacts on task performance and perceived discomfort during seated foot target reaches. Obesity was found to be associated with increases in movement time, reaction time and performance time. The observed obesity impacts seem attributable to the anthropometric, motor and cognitive characteristics of the obese.Abbreviations: ANOVA: analysis of variance; BMI: body mass index; ROM: range of motion; Borg CR-10: Borg's category ratio 10 scale.
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Affiliation(s)
- Seungwon Baek
- Department of Industrial Engineering, Seoul National University, Seoul, South Korea
| | - Jaemoon Jung
- Department of Industrial Engineering, Seoul National University, Seoul, South Korea
| | - Philjun Moon
- Department of Industrial Engineering, Seoul National University, Seoul, South Korea
| | - Woojin Park
- Department of Industrial Engineering, Seoul National University, Seoul, South Korea
- Institute for Industrial Systems Innovation, Seoul National University, Seoul, South Korea
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12
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Miura T, Miyakoshi N, Saito K, Kijima H, Iida J, Hatakeyama K, Suzuki K, Komatsu A, Iwami T, Matsunaga T, Shimada Y. Association between global sagittal malalignment and increasing hip joint contact force, analyzed by a novel musculoskeletal modeling system. PLoS One 2021; 16:e0259049. [PMID: 34710144 PMCID: PMC8553155 DOI: 10.1371/journal.pone.0259049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 10/11/2021] [Indexed: 01/02/2023] Open
Abstract
Patients with adult spinal deformity have various standing postures. Although several studies have reported a relationship between sagittal alignment and exacerbation of hip osteoarthritis, information is limited regarding how spinopelvic sagittal alignment changes affect hip joint loading. This study aimed to investigate the relationship between sagittal spinopelvic-lower limb alignment and the hip joint contact force (HCF) using a novel musculoskeletal model. We enrolled 20 women (78.3±6.7 years) from a single institution. Standing lateral radiographs were acquired to measure thoracic kyphosis, lumbar lordosis, the pelvic tilt, sacral slope, sagittal vertical axis (SVA), femur obliquity angle, and knee flexion angle. In the model simulation, the Anybody Modeling System was used, which alters muscle pathways using magnetic resonance imaging data. Each patient’s alignment was entered into the model; the HCF and hip moment in the standing posture were calculated using inverse dynamics analysis. The relationship between the HCF and each parameter was examined using Spearman’s correlation coefficient (r). The patients were divided into low SVA and high SVA groups, with a cutoff value of 50 mm for the SVA. The HCF was 168.2±60.1 N (%BW) and positively correlated with the SVA (r = 0.6343, p<0.01) and femur obliquity angle (r = 0.4670, p = 0.03). The HCF were 122.2 and 214.1 N (75.2% difference) in the low SVA and high SVA groups, respectively (p<0.01). The flexion moment was also increased in the high SVA group compared with that in the low SVA group (p = 0.03). The SVA and femur obliquity angle are factors related to the HCF, suggesting an association between adult spinal deformity and the exacerbation of hip osteoarthritis. Future studies will need to assess the relationship between the hip joint load and sagittal spinopelvic parameters in dynamic conditions.
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Affiliation(s)
- Takanori Miura
- Department of Orthopedic Surgery, Kakunodate General Hospital, Akita, Japan
- * E-mail:
| | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Kimio Saito
- Department of Rehabilitation Medicine, Akita University Hospital, Akita, Japan
| | - Hiroaki Kijima
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Jumpei Iida
- Department of Orthopedic Surgery, Omagari Kousei Medical Center, Akita, Japan
| | | | - Kotaro Suzuki
- Department of Mechanical Engineering, Akita University Faculty of Engineering Science, Akita, Japan
| | - Akira Komatsu
- National Institute of Technology (KOSEN), Sendai College, Sendai-shi, Miyagi, Japan
| | - Takehiro Iwami
- Department of Mechanical Engineering, Akita University Faculty of Engineering Science, Akita, Japan
| | - Tosiki Matsunaga
- Department of Rehabilitation Medicine, Akita University Hospital, Akita, Japan
| | - Yoichi Shimada
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
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Cavaggioni L, Gilardini L, Redaelli G, Croci M, Capodaglio P, Gobbi M, Bertoli S. Effects of a Randomized Home-Based Quality of Movement Protocol on Function, Posture and Strength in Outpatients with Obesity. Healthcare (Basel) 2021; 9:healthcare9111451. [PMID: 34828497 PMCID: PMC8618132 DOI: 10.3390/healthcare9111451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to determine the effects of two different home-based training interventions on functional parameters and body composition in obese patients. Sixty-four obese patients were recruited at the IRCCS Istituto Auxologico Italiano and randomly assigned into a movement quality group (MQ) and a conventional training group (CT). In the MQ, the training protocol combined various stimuli based on whole-body movement patterns, mobility, motor control and diaphragmatic breathing. The CT included traditional bodyweight resistance-training exercises. All patients were tested for movement efficiency (Functional Movement Screen, FMS), postural control (Modified Balance Error Scoring System, M-BESS), breathing pattern (Total Faulty Breathing Scale, TFBS), muscular strength (Handgrip Strength Test, HST and Five Repetition Sit to Stand, FRSTS) and body composition (Waist Circumference, WC, Body Mass Index, BMI, Body fat mass percentage, Fat Mass) before and after a 6-week period of training. Significant interactions and main effects of time (p < 0.0001) were found in MQ compared to CT in the FMS, M-BESS and TFBS parameters, while muscular strength (HST, FRSTS) and body composition parameters improved similarly in both groups with a main effect of time (p < 0.05). These findings suggest that a 6-week movement quality training is effective in ameliorating postural control and movement efficiency with similar improvements in muscular strength and body composition compared with a mere traditional home-based training. Fitness coaches and practitioners might consider the MQ intervention as a valuable alternative to conventional training when treating obesity.
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Affiliation(s)
- Luca Cavaggioni
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, 20129 Milan, Italy
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy; (L.G.); (G.R.); (M.C.); (S.B.)
- Correspondence: ; Tel.: +39-02-619111
| | - Luisa Gilardini
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy; (L.G.); (G.R.); (M.C.); (S.B.)
| | - Gabriella Redaelli
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy; (L.G.); (G.R.); (M.C.); (S.B.)
| | - Marina Croci
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy; (L.G.); (G.R.); (M.C.); (S.B.)
| | - Paolo Capodaglio
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, 28824 Verbania, Italy; (P.C.); (M.G.)
- Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, 10124 Turin, Italy
| | - Michele Gobbi
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, 28824 Verbania, Italy; (P.C.); (M.G.)
| | - Simona Bertoli
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy; (L.G.); (G.R.); (M.C.); (S.B.)
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
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Pau M, Capodaglio P, Leban B, Porta M, Galli M, Cimolin V. Kinematics Adaptation and Inter-Limb Symmetry during Gait in Obese Adults. SENSORS (BASEL, SWITZERLAND) 2021; 21:5980. [PMID: 34502875 PMCID: PMC8434679 DOI: 10.3390/s21175980] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/23/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022]
Abstract
The main purpose of this study is to characterize lower limb joint kinematics during gait in obese individuals by analyzing inter-limb symmetry and angular trends of lower limb joints during walking. To this purpose, 26 obese individuals (mean age 28.5 years) and 26 normal-weight age- and sex-matched were tested using 3D gait analysis. Raw kinematic data were processed to derive joint-specific angle trends and angle-angle diagrams (synchronized cyclograms) which were characterized in terms of area, orientation and trend symmetry parameters. The results show that obese individuals exhibit a kinematic pattern which significantly differs from those of normal weight especially in the stance phase. In terms of inter-limb symmetry, higher values were found in obese individuals for all the considered parameters, even though the statistical significance was detected only in the case of trend symmetry index at ankle joint. The described alterations of gait kinematics in the obese individuals and especially the results on gait asymmetry are important, because the cyclic uneven movement repeated for hours daily can involve asymmetrical spine loading and cause lumbar pain and could be dangerous for overweight individuals.
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Affiliation(s)
- Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy; (M.P.); (B.L.); (M.P.)
| | - Paolo Capodaglio
- Orthopaedic Rehabilitation Unit and Clinical Lab for Gait Analysis and Posture, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, 28824 Verbania, Italy;
- Department Surgical Sciences, Physical and Rehabilitation Medicine, University of Turin, 10124 Turin, Italy
| | - Bruno Leban
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy; (M.P.); (B.L.); (M.P.)
| | - Micaela Porta
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy; (M.P.); (B.L.); (M.P.)
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy;
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy;
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15
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Law NH, Li JX, Law NY, Varin D, Lamontagne M. Effects of body mass and sex on kinematics and kinetics of the lower extremity during stair ascent and descent in older adults. SPORTS MEDICINE AND HEALTH SCIENCE 2021; 3:165-170. [PMID: 35784519 PMCID: PMC9219291 DOI: 10.1016/j.smhs.2021.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/30/2021] [Accepted: 06/10/2021] [Indexed: 11/22/2022] Open
Abstract
The effects of body mass and sex on lower limb biomechanics during ascent and descent were examined in participants aged 50 to 75 with normal weight (n = 19), overweight (n = 18), and obese (n = 8). Peak joint angles and joint moment of the lower limb were analyzed with the VICON motion analysis system. Results from multivariate analysis of variance showed that during descent, the overweight participants had significantly higher knee extensor moment (0.98 ± 0.30 N∙m/kg-1) than the normal-weight participants (0.70 ± 0.29 N∙m/kg-1). The obese group had significantly higher ankle abductor moment (0.21 ± 0.11 N∙m/kg-1) than the normal weight (0.12 ± 0.08 N∙m/kg-1) and overweight groups (0.09 ± 0.06 N∙m/kg-1). During ascent, the obese participants had significant higher hip flexor moment (0.42 ± 0.20 N∙m/kg-1) than overweight participants (0.22 ± 0.17 N∙m/kg-1). Significant sex differences were found in knee extension angles (4.2 ± 3.4° vs 7.0 ± 3.3°) during descent, plantar flexion angles during ascent (23.7 ± 5.3° vs 15.6 ± 3.7°) and descent (29.9 ± 5.0° vs 22.1 ± 7.9°), and ankle adduction angles (6.8 ± 4.8° vs 2.5 ± 2.5°) during ascent. It is concluded that body mass has significant impact on joint loading of lower limbs during stair walking. Being overweight and obese increased hip joint loading during ascent, and knee and ankle joint loading during descent in older adults. Sex difference in joint kinematics was presented during stair walking regardless of the body mass.
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Affiliation(s)
| | - Jing Xian Li
- Corresponding author. School of Human Kinetics The University of Ottawa, Ottawa, Canada 125 University Private Ottawa, ON, K1N 6N5, Canada.
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Ghasemi M, Arjmand N. Spinal segment ranges of motion, movement coordination, and three-dimensional kinematics during occupational activities in normal-weight and obese individuals. J Biomech 2021; 123:110539. [PMID: 34044195 DOI: 10.1016/j.jbiomech.2021.110539] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 12/16/2022]
Abstract
Measurements of spinal segment ranges of motion (RoMs), movement coordination, and three-dimensional kinematics during occupational activities have implications in occupational/clinical biomechanics. Due to the large amount of adipose tissues, obese individuals may have different RoMs, lumbopelvic coordination, and kinematics than normal-weight ones. We aimed to measure/compare trunk, lumbar, and pelvis primary RoMs in all anatomical planes/directions, lumbopelvic ratios (lumbar to pelvis rotations at different trunk angles) in all anatomical planes/directions and three-dimensional spine kinematics during twelve symmetric/asymmetric statics load-handling activities in healthy normal-weight and obese individuals. Kinematics/motion data were collected from nine healthy young male normal-weight and nine age/height/sex matched obese individuals via a ten-camera Vicon motion capture system. Obese individuals had significantly smaller (p < 0.05) lumbar flexion (~9° in average) and larger pelvis right lateral bending (~5°) RoMs as well as smaller lumbopelvic ratios (~37%) in lateral bending and axial rotation movements as compared to normal-weight individuals. Moreover, the two groups had generally non-significant different segmental orientations (<20° and in most cases < 10°) in load-handling tasks that depended on the magnitude of load asymmetry angle (p < 0.05). Differences were larger for tasks performed near the floor, away from body, and at larger load asymmetry angles. Biomechanical models simulating pure lateral bending, axial rotation, or tasks involving large load asymmetry may therefore need subject-specific, rather than population-based, motion analysis due to the effects from body weight. In clinical applications, it should be noted that healthy obese individuals may have different RoMs and lumbopelvic rhythms than healthy normal-weight individuals in some anatomical planes/directions.
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Affiliation(s)
- M Ghasemi
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - N Arjmand
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.
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Baran E, Yildiz Tİ, Gursen C, Üzelpasaci E, Özgül S, Düzgün İ, Akbayrak T. The association of breast cancer-related lymphedema after unilateral mastectomy with shoulder girdle kinematics and upper extremity function. J Biomech 2021; 121:110432. [PMID: 33887538 DOI: 10.1016/j.jbiomech.2021.110432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 01/13/2023]
Abstract
The purpose of this study was to examine the association of breast cancer-related lymphedema on shoulder girdle kinematics and upper extremity function. The study included 67 breast cancer survivors with and without unilateral lymphedema. Individuals were divided into non-lymphedema, moderate and severe lymphedema groups according to the volumetric measurement difference between the affected and unaffected upper extremities. A three-dimensional motion monitor-electromagnetic system was used to analyze scapular movements during the elevation and depression phases of the upper extremity elevation in the scapular plane. Shoulder range of motion was assessed with a digital inclinometer. Upper extremity function was assessed with the 'Disabilities of the Arm, Shoulder, and Hand Questionnaire-Short Form (Quick-DASH)'. The scapular upward rotation was lower for the severe lymphedema group than for the non-lymphedema group in the 90-60-30° depression phases of arm elevation (p < .05). The scapular anterior tilt was higher for the severe lymphedema group than for the non-lymphedema group in the 30° depression phase of arm elevation (p < .05). Shoulder abduction range of motion was the lowest in the severe lymphedema group (p < .05). The non-lymphedema group had the lowest quick-DASH score and the severe lymphedema group had the highest score (p < .05). There were statistically significant moderate associations between the quick-DASH scores and scapular movements in all groups (p < .05). The development, presence and/or severity of lymphedema were associated with impaired shoulder-girdle kinematics and decreased upper extremity function. However, a need exists for longitudinal studies comparing individuals with and without lymphedema and healthy controls.
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Affiliation(s)
- Emine Baran
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Taha İbrahim Yildiz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Ceren Gursen
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Esra Üzelpasaci
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Serap Özgül
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - İrem Düzgün
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Türkan Akbayrak
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
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Balance Control in Obese Subjects during Quiet Stance: A State-of-the Art. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10051842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Obese individuals are characterized by a reduced balance which has a significant effect on a variety of daily and occupational tasks. The presence of excessive adipose tissue and weight gain could increase the risk of falls; for this reason, obese individuals are at greater risk of falls than normal weight subjects in the presence of postural stress and disturbances. The quality of balance control could be measured with different methods and generally in clinics its integrity is generally assessed using platform stabilometry. The aim of this narrative review is to present an overview on the state of art on balance control in obese individuals during quiet stance. A summary of knowledge about static postural control in obese individuals and its limitations is important clinically, as it could give indications and suggestions to improve and personalize the development of specific clinical programs.
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Bataweel EA, Ibrahim AI. Balance and musculoskeletal flexibility in children with obesity: a cross-sectional study. Ann Saudi Med 2020; 40:120-125. [PMID: 32241174 PMCID: PMC7118234 DOI: 10.5144/0256-4947.2020.120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Studies on the influence of obesity on different physical parameters such as postural balance and musculoskeletal flexibility are limited and have reported varying results. OBJECTIVES Measure effect of childhood obesity on balance and musculoskeletal flexibility in Saudi children. DESIGN Cross-sectional. SETTING Physiotherapy laboratory. SUBJECTS AND METHODS The study included a representative sample of Saudi elementary school children selected from a convenience sample of 150 children. Balance was examined using the Biodex balance system. Calf muscle flexibility was measured by the weight-bearing ankle lunge test while the chest flexibility was measured by the chest expansion test. MAIN OUTCOME MEASURES Postural stability indices and flexibility parameters. SAMPLE SIZE 90 elementary school children aged 6 to 11 years, 47 of normal weight and 43 obese children. RESULTS All stability indices at different stability levels were significantly impaired in children with obesity ( P≤.05). In terms of musculo-skeletal flexibility, the weight-bearing lunge test distance was shorter in children with obesity ( P=.01). In the chest expansion test, there was no significant difference between the two groups ( P=.32). CONCLUSIONS Postural balance at different stability levels was impaired in children with obesity and in all planes. The calf muscles were less flexible in obese children. LIMITATIONS Unblinded, convenience sample so findings are not generalizable. CONFLICT OF INTEREST None.
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Affiliation(s)
- Essraa A Bataweel
- From the Department of Physiotherapy, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Alaa I Ibrahim
- From the Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Joseph G, Arviv-Eliashiv R, Tesler R. A comparison of diet versus diet + exercise programs for health improvement in middle-aged overweight women. WOMEN'S HEALTH (LONDON, ENGLAND) 2020; 16:1745506520932372. [PMID: 32597335 PMCID: PMC7325539 DOI: 10.1177/1745506520932372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/31/2020] [Accepted: 05/11/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Obesity is an independent risk factor for many diseases. Many studies have investigated the benefits of losing weight as well as the best methods for weight loss. This research evaluated the impact of various weight loss programs on health enhancement among overweight women aged 40-60 years. METHODS This was a retrospective observational study that analyzed data from 145 overweight women in weight loss programs. Each woman joined one of four programs: 8 weeks of exercise plus diet (exe + nutr), 8 weeks of diet only (nutrition), 8 weeks of exercise only, or a control group. Women completed a psychological questionnaire and also underwent anthropometric tests, blood pressure checks, a predicted maximal oxygen consumption (VO2 max) test on an ergometer bicycle, a one-leg balance test, straight leg test, and a sit and reach test, both before and after the program. Participants also provided a blood sample. RESULTS All of the measured variables improved in the exe + nutr and nutrition programs when compared with the control group; the exe + nutr group improved the most: body mass index, -1.3 kg/m2; body fat, -2.9%; lean body mass, +1.1; VO2 max, +4.8; body image, +1.02; and p < 0.01. CONCLUSION The hypothesis-generating findings showed that weight loss programs improved anthropometric, biochemical, physiological, physical, and psychological variables in women aged 40-60 years. The program that included diet restriction with exercise, guidance, and regular counseling showed the best results.
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Affiliation(s)
- Gili Joseph
- Department of Physical Education, Faculty of Science, Seminar Hakibbutzim College, Tel Aviv, Israel
| | - Rinat Arviv-Eliashiv
- Department of Physical Education, Faculty of Science, Seminar Hakibbutzim College, Tel Aviv, Israel
| | - Riki Tesler
- Department of Health System Management, Faculty of Health Science, Ariel University, Ariel, Israel
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André MJG, Georges MV, Eméry EML, Savant MRL, Mathias Cyriaque N, Bernard PT, Alphonse M. Changes Induced by Physical Activity, Weight Loss and Calorie Restriction in Body Composition, Lipoproteins and Functional Capacity in Obese Congolese Women. Health (London) 2020. [DOI: 10.4236/health.2020.126043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Beack JY, Chun HJ, Bak KH, Choi KS, Bae IS, Kim KD. Risk Factors of Secondary Lumbar Discectomy of a Herniated Lumbar Disc after Lumbar Discectomy. J Korean Neurosurg Soc 2019; 62:586-593. [PMID: 31484233 PMCID: PMC6732352 DOI: 10.3340/jkns.2019.0085] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 05/30/2019] [Indexed: 11/27/2022] Open
Abstract
Objective To study risk factors of secondary lumbar discectomy (LD) for recurrent herniated lumbar disc (HLD) and identify methods to lower the rate of recurrence.
Methods Data from 160 patients who underwent primary LD were collected retrospectively. Demographic features, radiologic findings including Pfirrmann disc degeneration, and surgical information were analyzed to compare risks between revision and non-revision patients.
Results The revision rate was 15% (24 patients), and the mean follow-up was 28.3 months. HLD recurrence was not related to any demographic characteristics. Primary and secondary LD were most common at the L4–5 level, but the level of operation was not significantly associated with revision. Primary LD most commonly had a Pfirrmann disc degeneration grade of 3, followed by 4. For recurrent HLD, Pfirrmann grade 4 was most common and was statistically significant (p<0.05). A body mass index (BMI) over 30 was considered obese and was significantly related with HLD revision (p<0.05).
Conclusion Patients with high BMI or severe disc degeneration should be informed of HLD revision.
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Affiliation(s)
- Joo Yul Beack
- Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea
| | - Hyoung Joon Chun
- Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea
| | - Koang Hum Bak
- Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea
| | - Kyu-Sun Choi
- Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea
| | - In-Suk Bae
- Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea
| | - Kee D Kim
- Department of Neurological Surgery, University of California, Davis, CA, USA
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Colim A, Arezes P, Flores P, Braga AC. Effects of workers' Body Mass Index and task conditions on exertion psychophysics during Vertical Handling Tasks. Work 2019; 63:231-241. [PMID: 31156203 DOI: 10.3233/wor-192923] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Obesity prevalence in the workforce is clearly increasing. Simultaneously, manual lifting/lowering loads, referred to as Vertical Handling Tasks (VHT) in this paper, are common in industries and services. Performing VHT exposes workers to physical overload, which can be measured using a psychophysical approach. Various risk factors can increase this overload, including individual factors such as workers' Body Mass Index (BMI). OBJECTIVE To study the possible effects of workers' BMI and some task conditions on physical overload during VHT. METHODS Psychophysical data were collected from 51 participants having different body constitutions (including non-obese, overweight and obese). The participants performed 6 VHT (3 different loads ×2 workstation configurations), during which they lifted and lowered a test-box between their knees and shoulders. For each task, they reported their perceived exertion using the Borg Category Ratio-10 (CR-10) scale. RESULTS The results showed that the CR-10 scale is sensitive to the variation of the task conditions tested. However, the psychophysical data pointed to a tendency to decrease the perception of physical overload as workers' BMI increases. CONCLUSIONS This may compromise the validity of the application of psychophysical data as an ergonomic approach for Work-Related Musculoskeletal Disorders (WRMSD) prevention in obese workers.
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Affiliation(s)
- Ana Colim
- ALGORITMI Research Centre, School of Engineering, University of Minho, Guimarães, Portugal
| | - Pedro Arezes
- ALGORITMI Research Centre, School of Engineering, University of Minho, Guimarães, Portugal
| | - Paulo Flores
- MIT-Portugal Program, CMEMS-UMinho, School of Engineering, University of Minho, Guimarães, Portugal
| | - Ana Cristina Braga
- ALGORITMI Research Centre, School of Engineering, University of Minho, Guimarães, Portugal
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Uehara M, Takahashi J, Ikegami S, Tokida R, Nishimura H, Kuraishi S, Sakai N, Kato H. Impact of Diffuse Idiopathic Skeletal Hyperostosis on Sagittal Spinal Alignment in the General Elderly Population: A Japanese Cohort Survey Randomly Sampled from a Basic Resident Registry. JB JS Open Access 2019; 4:JBJSOA-D-18-00062. [PMID: 31592055 PMCID: PMC6766383 DOI: 10.2106/jbjs.oa.18.00062] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Interest is mounting regarding diffuse idiopathic skeletal hyperostosis (DISH) as the rate in the elderly increases. Although some studies have demonstrated an effect of DISH on sagittal spinal alignment, the pathogenetic mechanism remains unknown. Random sampling from the basic resident registry of a rural town for subject selection was used to investigate the impact of DISH on sagittal spinal alignment.
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Affiliation(s)
- Masashi Uehara
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Jun Takahashi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shota Ikegami
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Ryosuke Tokida
- Rehabilitation Center, Shinshu University Hospital, Matsumoto, Japan
| | - Hikaru Nishimura
- Rehabilitation Center, Shinshu University Hospital, Matsumoto, Japan
| | - Shugo Kuraishi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Noriko Sakai
- Department of Orthopaedic Surgery, New Life Hospital, Nagano, Japan
| | - Hiroyuki Kato
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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Gruevski KM, Callaghan JP. The effect of age on in-vivo spine stiffness, postures and discomfort responses during prolonged sitting exposures. ERGONOMICS 2019; 62:917-927. [PMID: 30889363 DOI: 10.1080/00140139.2019.1596317] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 03/11/2019] [Indexed: 06/09/2023]
Abstract
Many industrialised working populations are ageing and prolonged sitting exposures are prevalent across occupational sectors. The purpose of this work was to determine the effect of age and sex on passive spine stiffness, postures and discomfort in response to seated work. A total of 34 participants were recruited, with 17 older adults with an average age of (standard deviation) 63.7 (±3.9) years and 17 younger adults aged 23.8 (±5.0) years. Participants were asked to sit continuously for 90 min while typing. Baseline passive spine stiffness was higher in older adults at 40% flexion compared to younger adults (p = .0233). Older adults sat in less normalised flexion, at 33.4% (±16.4) compared to 60.9% (±20.2) in the younger group (p = .0003). Discomfort was higher among older adults in the neck, right shoulder and middle back regions (p < .0086). An understanding of age-specific responses to workplace exposures is essential to determine whether age-specific interventions are warranted. Practitioner summary: Older adults had higher passive spine stiffness and sat with less flexion during prolonged sitting. Discomfort was higher among older adults and occurred earlier in the simulation compared to younger participants, indicating that interventions, such as walking breaks may need to be implemented earlier during sitting for aged workers.
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Affiliation(s)
- Kristina M Gruevski
- a Department of Kinesiology, Faculty of Applied Health Sciences , University of Waterloo , Waterloo , Canada
| | - Jack P Callaghan
- a Department of Kinesiology, Faculty of Applied Health Sciences , University of Waterloo , Waterloo , Canada
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26
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Colim A, Arezes P, Flores P, Monteiro PRR, Mesquita I, Braga AC. Obesity effects on muscular activity during lifting and lowering tasks. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2019; 27:217-225. [PMID: 30810504 DOI: 10.1080/10803548.2019.1587223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Obesity is an emerging health problem and its incidence has been increasing throughout the workforce. In industrial workstations, vertical handling tasks (VHT), including lifting and lowering, are very common and can cause a significant muscular overload for the involved workers. During these tasks, muscular activity may be considerably affected by workers' body conditions. This study aims to analyze and compare the muscular activity in subjects with different obesity levels, using surface electromyography (EMG), during predefined VHT. Six different VHT (combining 5, 10 and 15-kg loads with two task styles) were performed. EMG data normalization was based on the percentage of maximum contraction during each task (MCT%). The results show that obesity influences the MCT%, which in turn increases the muscular effort during VHT. The current investigation demonstrates that obesity is a relevant musculoskeletal risk factor regarding VHT. The engineering analysis and design implications of this work can thus be perceived.
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Affiliation(s)
- Ana Colim
- ALGORITMI Research Centre, University of Minho, Portugal
| | - Pedro Arezes
- ALGORITMI Research Centre, University of Minho, Portugal
| | - Paulo Flores
- MIT Portugal Program and CMEMS-UMinho, University of Minho, Portugal
| | | | - Inês Mesquita
- CIR - Center for Rehabilitation Research, Institute Polytechnic of Porto, Portugal
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Central adiposity and mechanical, perceptual and physiological loading during long duration, repetitive lifting. Clin Biomech (Bristol, Avon) 2018; 60:170-176. [PMID: 30380444 DOI: 10.1016/j.clinbiomech.2018.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/05/2018] [Accepted: 10/10/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is an absence of information regarding the impact of central adiposity on loading during long duration, repetitive lifting, and very limited information of the impact of elevated body mass on mechanical loading of the lumbar spine. This information is important in evaluation of the validity of injury prevention standards and interventional approaches in this segment of the population. METHODS This study evaluated the mechanical, physiological, and perceptual loading during repetitive lifting in participants with central adiposity compared to participants with normal body mass index. Videography, accelerometry, heart rate and perceived exertion measures were used to examine alternations in kinematic, kinetic, and exertional parameters during a 1-hour lifting task (3 × 20-min sets; 4 lifts/min; self-selected mass). FINDINGS Low back torque [+69.1 (11.5) Nm], compressive force [+1036.6 (153.6) N] and heart rate [+7.0 (3.5)%] were substantially elevated in participants with central adiposity, however perceived exertion and self-selected mass did not differ between groups. With central adiposity a compensatory mechanism was observed, involving a reduction in trunk vertical displacement [-5.8 (1.9) cm], hip flexion [-6.4 (3.1) deg] and lower-trunk flexion [-10.0 (2.7) deg], which attenuated expected increases to work [9.8 (2.3)%], power [9.5 (4.0)%] and physiological effort. INTERPRETATION While mechanical loading increases secondary to elevated body mass are expected, these results provide new insight into origins of such increases for individuals with a central adiposity somatotype. The differences in mechanical, physiological and perceived loading support provision of individual-specific injury prevention strategies, as well as revision of existing mechanical- and physiological-based ergonomic standards.
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Quinn TD, Seo Y, Yorio PL, Aljaroudi A, Coca A, Kim JH, Roberge RJ, Jon Williams W. Using trunk posture to monitor heat strain at work. ERGONOMICS 2018; 61:1560-1568. [PMID: 30014772 DOI: 10.1080/00140139.2018.1497207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 06/29/2018] [Indexed: 06/08/2023]
Abstract
This study aimed to determine if trunk posture during walking is related to increases in rectal temperature (Tre). 24 males treadmill walked in one of four conditions (1): 30 min at 3.0 mph and 0% grade, 20 °C and 50% relative humidity (RH), wearing healthcare worker (HCW) PPE; (2): 30 min at 3.0 mph and 0% grade, 27.5 °C and 60% RH, HCW PPE; (3): 30 min at 3.0 mph and 0% grade, 32.5 °C and 70% RH, HCW PPE; and (4): 40 min at 40% VO2max, 30 °C and 70% RH, wearing firefighter PPE. Trunk posture (Zephyr BioHarness 3) and Tre were measured continuously. Tre was positively related to trunk posture, controlling for covariates (B = 3.49, p < .001). BMI and age moderated this relationship (Tre×age, B = 0.76, p < .001; Tre*BMI, B = -1.85, p < .001). Trunk posture measurement may be useful in monitoring fall potential and magnitude of heat stress of workers in hot environments. Practitioner Summary: Occupational hyperthermia increases worker risk for heat illness and injury but is difficult to monitor in the field. This investigation shows that trunk posture is independently and positively related to core temperature. Non-invasive measurement or visual inspection of trunk posture could provide novel insight on individual heat strain level.
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Affiliation(s)
- Tyler D Quinn
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Yongsuk Seo
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Patrick L Yorio
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Ali Aljaroudi
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Aitor Coca
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Jung-Hyun Kim
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Raymond J Roberge
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - W Jon Williams
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
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Ghesmaty Sangachin M, Cavuoto LA, Wang Y. Use of various obesity measurement and classification methods in occupational safety and health research: a systematic review of the literature. BMC OBESITY 2018; 5:28. [PMID: 30410773 PMCID: PMC6211422 DOI: 10.1186/s40608-018-0205-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 06/21/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND This study systematically examined obesity research in occupational safety and health regarding the use of various obesity measurement and classification methods. METHODS A systematic search of the PubMed database on English language publications from 2000 to 2015 using related keywords and search of citations resulted in selection of 126 studies. They were categorized into two groups based on their main research question: 1) general physical or mental work-related functioning; and 2) task or body part specific functioning. RESULTS Regardless of the study group, body mass index (BMI) was the most frequently used measure. Over 63% of the studies relied solely on BMI to define obesity. In only 22% of the studies, body fat was directly measured by methods such as dual energy x-ray absorptiometry. Abdominal obesity was defined using waist circumference in recent years, and waist-hip ratio in earlier years. Inconsistent cut-offs have also been used across studies investigating similar topics. CONCLUSIONS Few authors acknowledged the limitations of using indirect obesity measures. This is in part due to the limited understanding of some occupational safety and health researchers regarding the complex issues surrounding obesity classification and also the mixed recommendations over the past 2-3 decades and across populations. Efforts need to be made to promote appropriate obesity measurement and reporting in this field.
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Affiliation(s)
| | - Lora A. Cavuoto
- Department of Industrial and Systems Engineering, University at Buffalo, 324 Bell Hall, Buffalo, NY 14260 USA
| | - Youfa Wang
- Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN USA
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30
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Jeong Y, Heo S, Lee G, Park W. Pre-obesity and obesity impacts on passive joint range of motion. ERGONOMICS 2018; 61:1223-1231. [PMID: 29775425 DOI: 10.1080/00140139.2018.1478455] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 05/11/2018] [Indexed: 06/08/2023]
Abstract
UNLABELLED Despite the prevalence of pre-obesity and obesity, the physical capabilities of pre-obese/obese individuals are not well documented. As an effort to address this, this study investigated the pre-obesity and obesity impacts on joint range of motion (RoM) for twenty-two body joint motions. A publicly available passive RoM dataset was analysed. Three BMI groups (normal-weight, pre-obese, and obese [Class I]) were statistically compared in joint RoM. The pre-obese and obese groups were found to have significantly smaller RoM means than the normal-weight for elbow flexion and supination, hip extension and flexion, knee flexion and ankle plantar flexion. The pre-obese and obese groups exhibited no significant inter-group mean RoM differences except for knee flexion; for knee flexion, the obese group had significantly smaller RoM means than the pre-obese. The findings would be useful for designing work tasks and products/systems for high BMI individuals and developing digital human models representing differently sized individuals. Practitioner summary: This study investigated the pre-obesity and obesity impacts on joint range of motion (RoM) by comparing three participant groups: normal-weight; pre-obese and obese. The pre-obese and obese groups had significantly smaller RoM means than the normal-weight for elbow flexion and supination; hip extension and flexion; knee flexion and ankle plantar flexion. ABBREVIATIONS ANCOVA: Analysis of Covariance; BMI: Body Mass Index; CI: Confidence Interval; RoM: Range of Motion; SPSS: Statistical Package for the Social Sciences.
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Affiliation(s)
- Yihun Jeong
- a Department of Industrial Engineering , Seoul National University , Seoul , South Korea
| | - Suyeon Heo
- b Department of Mathematics , Pohang University of Science and Technology , Pohang , South Korea
| | - Giwhyun Lee
- c Department of Military Operations Research , Korea Army Academy at Yeongcheon , Yeongcheon , South Korea
| | - Woojin Park
- a Department of Industrial Engineering , Seoul National University , Seoul , South Korea
- d Institute for Industrial Systems Innovation, Seoul National University , Seoul , South Korea
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31
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Pan F, Firouzabadi A, Reitmaier S, Zander T, Schmidt H. The shape and mobility of the thoracic spine in asymptomatic adults - A systematic review of in vivo studies. J Biomech 2018; 78:21-35. [PMID: 30100219 DOI: 10.1016/j.jbiomech.2018.07.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 12/29/2022]
Abstract
A comprehensive knowledge of the thoracic shape and kinematics is essential for effective risk prevention, diagnose and proper management of thoracic disorders and assessment of treatment or rehabilitation strategies as well as for in silico and in vitro models for realistic applications of boundary conditions. After an extensive search of the existing literature, this study summarizes 45 studies on in vivo thoracic kyphosis and kinematics and creates a systematic and detailed database. The thoracic kyphosis over T1-12 determined using non-radiological devices (34°) was relatively less than measured using radiological devices (40°) during standing. The majority of kinematical measurements are based on non-radiological devices. The thoracic range of motion (RoM) was greatest during axial rotation (40°), followed by lateral bending (26°), and flexion (21°) when determined using non-radiological devices during standing. The smallest RoM was identified during extension (13°). The lower thoracic level (T8-12) contributed more to the RoM than the upper (T1-4) and middle (T4-8) levels during flexion and lateral bending. During axial rotation and extension, the middle level (T4-8) contributed the most. Coupled motion was evident, mostly during lateral bending and axial rotation. With aging, the thoracic kyphosis increased by about 3° per decade, whereas the RoM decreased by about 5° per decade for all load directions. These changes with aging mainly occurred in the lower region (T6-12). The influence of sex on thoracic kyphosis and the RoM has been described as partly contradictory. Obesity was found to decrease the thoracic RoM. Studies comparing standing, sitting and lying reported the effect of posture as significant.
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Affiliation(s)
- Fumin Pan
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Ali Firouzabadi
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Sandra Reitmaier
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Thomas Zander
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Hendrik Schmidt
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
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Dharmajaya R, Sari DK, Ganie RA. A Comparison of the Quality of Sleep between Pre and Post-Surgery Cervical Herniated Nucleus Pulposus Patients Utilizing the Anterior Discectomy Method. Open Access Maced J Med Sci 2017; 5:948-954. [PMID: 29362625 PMCID: PMC5771301 DOI: 10.3889/oamjms.2017.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/24/2017] [Accepted: 09/29/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Herniated Nucleus Pulposus (HNP) is the prolapse of the intervertebral disk through a tear in the annulus fibrosus. This causes nerve root compression with clinical pain manifestation and affects the quality of sleep. AIM The aim of this study was find out the comparison in the quality of sleep between before (pre) and after (post) surgery cervical HNP patients. METHODS This study was a retrospective cohort study. Ninety patients were asked to complete the Pittsburgh Sleep Quality Index (PSQI) questionnaire. All data which has been computed were analysed with the McNemar test. RESULT The outcome reveals that from 90 patient`s cervical HNP, 81 (90%) were 40 years old age group and 66 (73.3%) of them were women. The result showed that 66 (73.3%) patients have a bad sleep quality before surgery. Surgery has increased the quality of sleep after surgery 66 (73.3%) patients had good sleep quality. There was a significant difference in the quality of sleep pre and post operation (p = 0.001). CONCLUSION There was a significant difference in the quality of sleep between pre and post operation cervical HNP patient utilising anterior discectomy methods.
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Pajoutan M, Ghesmaty Sangachin M, Cavuoto LA. Central and peripheral fatigue development in the shoulder muscle with obesity during an isometric endurance task. BMC Musculoskelet Disord 2017; 18:314. [PMID: 28732481 PMCID: PMC5521062 DOI: 10.1186/s12891-017-1676-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/13/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Fatigue increases the likelihood of developing work-related musculoskeletal disorders and injury. Due to the physiological and neuromuscular changes that accompany obesity, it may alter the fatigue development mechanism and exacerbate injury risk. The upper extremities have the highest incidence rates for work-related musculoskeletal disorders. Therefore, the goals of this study were to investigate the effect of obesity on central vs. peripheral fatigue as well as on the physical signs of fatigue on the middle deltoid muscle. METHODS A measure of central activation ratio was used to quantify central fatigue by considering the increment in the torque output by superimposed twitch relative to its corresponding maximum voluntary contraction. For this purpose, electrical stimulation was delivered at the middle deltoid muscles of 22 non-obese (18 < body mass index (BMI) < 25 kg/m2) and 17 obese (30 < BMI < 40 kg/m2) individuals aged 18-32 years old. Participants completed superimposed maximum voluntary isometric contractions of shoulder abduction before and after a sustained isometric fatiguing task at either 30 or 60% of the muscle capacity. Differences in endurance time, torque fluctuation, torque loss, and muscle activity measured by an electromyography sensor were also investigated. RESULTS A greater reduction of voluntary activation of motor units (p = 0.001) with fatigue was observed for individuals who are obese. Contrary to the effect of obesity on central fatigue, a trend toward reduced peripheral fatigue (p = 0.06) was observed for the obese group compared to the non-obese group. On average, a 14% higher rate of torque loss per second was observed among individuals with obesity in comparison to non-obese participants. CONCLUSIONS The observed greater contribution of central fatigue during the sustained endurance tasks suggests that among young healthy obese individuals, the faster fatigue development with obesity, commonly reported in the literature, is most likely due to the central elements rather than the peripheral factors. This finding has implications for fatigue prevention programs during sustained exertions and can help to develop training, work, and rest schedules considering obesity.
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Affiliation(s)
- Mojdeh Pajoutan
- Industrial and Systems Engineering, University at Buffalo, 324 Bell Hall Buffalo, New York, 14260, USA
| | | | - Lora A Cavuoto
- Industrial and Systems Engineering, University at Buffalo, 324 Bell Hall Buffalo, New York, 14260, USA.
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Miles-Chan JL, Dulloo AG. Posture Allocation Revisited: Breaking the Sedentary Threshold of Energy Expenditure for Obesity Management. Front Physiol 2017; 8:420. [PMID: 28690547 PMCID: PMC5479887 DOI: 10.3389/fphys.2017.00420] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 05/31/2017] [Indexed: 12/22/2022] Open
Abstract
There is increasing recognition that low-intensity physical activities of daily life play an important role in achieving energy balance and that their societal erosion through substitution with sedentary (mostly sitting) behaviors, whether occupational or for leisure, impact importantly on the obesity epidemic. This has generated considerable interest for better monitoring, characterizing, and promoting countermeasures to sedentariness through a plethora of low-level physical activities (e.g., active workstations, standing desks, sitting breaks), amid the contention that altering posture allocation (lying, sitting, standing) can modify energy expenditure to impact upon body weight regulation and health. In addressing this contention, this paper first revisits the past and more recent literature on postural energetics, with particular emphasis on potential determinants of the large inter-individual variability in the energy cost of standing and the impact of posture on fat oxidation. It subsequently analyses the available data pertaining to various strategies by which posture allocations, coupled with light physical activity, may increase energy expenditure beyond the sedentary threshold, and their relevance as potential targets for obesity management.
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Affiliation(s)
| | - Abdul G Dulloo
- Department of Medicine Physiology, University of FribourgFribourg, Switzerland
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35
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Zemková E, Kyselovičová O, Jeleň M, Kováčiková Z, Ollé G, Štefániková G, Vilman T, Baláž M, Kurdiová T, Ukropec J, Ukropcová B. Muscular Power during a Lifting Task Increases after Three Months of Resistance Training in Overweight and Obese Individuals. Sports (Basel) 2017; 5:sports5020035. [PMID: 29910395 PMCID: PMC5968996 DOI: 10.3390/sports5020035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 05/20/2017] [Accepted: 05/25/2017] [Indexed: 12/04/2022] Open
Abstract
Background: This study evaluates the effect on power produced during a modified lifting task in the overweight and obese after three months of either resistance or aerobic training. Methods: Seventeen male subjects divided randomly into two groups performed deadlift and deadlift high pull, both with increasing weights up to maximal power, prior to and after the training programs (three sessions per week). Results: Their mean power increased significantly during the deadlift at 20 kg (14.3%, p = 0.026), 30 kg (17.7%, p = 0.008), 40 kg (16.5%, p = 0.011), 50 kg (14.5%, p = 0.020), and 60 kg (14.3%, p = 0.021) and during the deadlift high pull at 30 kg (9.9%, p = 0.037), 40 kg (10.1%, p = 0.035), and 50 kg (8.2%, p = 0.044) after the resistance training. However, the group that participated in the aerobic training failed to show any significant changes in power performance during either the deadlift or deadlift high pull. Conclusion: Three months of resistance training enhances power outputs during a lifting task with weights from 30 to 50 kg (~40–60% of 1-repetition maximum) in the overweight and obese. Because this test was sensitive in revealing pre-post training changes in lifting performance, it should be implemented in the functional diagnostics for overweight and obese individuals and also complement existing testing methods.
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Affiliation(s)
- Erika Zemková
- Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava 81469, Slovakia.
| | - Ol'ga Kyselovičová
- Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava 81469, Slovakia.
| | - Michal Jeleň
- Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava 81469, Slovakia.
| | - Zuzana Kováčiková
- Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava 81469, Slovakia.
| | - Gábor Ollé
- Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava 81469, Slovakia.
| | - Gabriela Štefániková
- Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava 81469, Slovakia.
| | - Tomáš Vilman
- Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava 81469, Slovakia.
| | - Miroslav Baláž
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava 83306, Slovakia.
| | - Timea Kurdiová
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava 83306, Slovakia.
| | - Jozef Ukropec
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava 83306, Slovakia.
| | - Barbara Ukropcová
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava 83306, Slovakia.
- Institute of Pathological Physiology, Faculty of Medicine, Comenius University in Bratislava, Bratislava 81372, Slovakia.
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Pajoutan M, Xu X, Cavuoto LA. The effect of obesity on postural stability during a standardized lifting task. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2017; 14:180-186. [PMID: 27715653 DOI: 10.1080/15459624.2016.1237032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The objective of this study was to assess the effect of obesity on postural stability during a standardized lifting task. Twelve young males, six obese and six non-obese, completed three replications of repeated six lifts (at a rate of six lifts per minutes) at two levels of loads (10% and 25% of capacity) crossed with two levels of orientation (0° and 45° from sagittal plane). Postural stability measures showed that center of pressure sway path and sway area were ∼21% and ∼53% lower with obesity, respectively. Additionally, frequency band of amplitude spectrum in the medial lateral direction at 0° lifting orientation was significantly lower with obesity. The results suggest that obesity, as measured by body mass index, does not impair balance control in healthy young males when lifting load is relative to the capacity.
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Affiliation(s)
- Mojdeh Pajoutan
- a Industrial and Systems Engineering, University at Buffalo, The State University of New York , Buffalo , New York
| | - Xu Xu
- b Edward P. Fitts Department of Industrial and Systems Engineering , North Carolina State University , Raleigh , North Carolina
| | - Lora A Cavuoto
- a Industrial and Systems Engineering, University at Buffalo, The State University of New York , Buffalo , New York
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Bezzoli E, Andreotti D, Pianta L, Mascheroni M, Piccinno L, Puricelli L, Cimolin V, Salvadori A, Codecasa F, Capodaglio P. Motor control exercises of the lumbar-pelvic region improve respiratory function in obese men. A pilot study. Disabil Rehabil 2016; 40:152-158. [PMID: 27830949 DOI: 10.1080/09638288.2016.1244292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Obese subjects have decreased pulmonary function. The hypothesis of our study was that poor coordination of the lumbar-pelvic musculature secondary to obesity may hinder the synergic activation of the respiratory muscles. The aim of the paper was to evaluate whether specific motor control exercises of the lumbar-pelvic musculature were able to improve respiratory function. METHOD Twenty obese male patients underwent a rehabilitation program including adapted physical activity and respiratory physiotherapy. Patients were randomly assigned to a Specific Motor Control Exercise Group (SG) and a Control Group (CG). SG followed a protocol according to the SMARTERehab concept aimed at improving posture, intra-abdominal pressure, rib cage mobility, and perception of correct muscle activation. CG performed an exercise training protocol to improve aerobic capacity and muscle strength. RESULT After intervention, both groups showed similar changes in body weight, fat, and fat-free mass. Respiratory function indexes improved in SG due to improved proprioception and coordination of the deep lumbar-pelvic muscles. CONCLUSION Our study provides preliminary evidence that breathing, postural control, and spinal stability are intertwined. Positive respiratory effects in obese men can be obtained by prescribing specific motor control exercises of the lumbar-pelvic muscles. Implications for rehabilitation Obese subjects present with decreased pulmonary function and postural changes. Poor coordination of the lumbar-pelvic muscles affects posture and the synergic activation of the respiratory muscles. Specific motor control exercises of the lumbar-pelvic musculature can improve respiratory function. Breathing and postural control are intertwined: positive respiratory effects can be obtained by enhancing motor control of the lumbar-pelvic muscles.
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Affiliation(s)
| | | | - Lucia Pianta
- a Istituto Auxologico Italiano , Piancavallo (VB) , Italy
| | | | | | - Luca Puricelli
- c Università degli studi dell'Insubria, Medical school, Bachelor degree Physiotherapy , Varese , Italy
| | - Veronica Cimolin
- d Bioengineering Department , Politecnico di Milano , Milan , Italy
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Wyszyńska J, Podgórska-Bednarz J, Drzał-Grabiec J, Rachwał M, Baran J, Czenczek-Lewandowska E, Leszczak J, Mazur A. Analysis of Relationship between the Body Mass Composition and Physical Activity with Body Posture in Children. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1851670. [PMID: 27761467 PMCID: PMC5059512 DOI: 10.1155/2016/1851670] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/31/2016] [Accepted: 09/07/2016] [Indexed: 11/17/2022]
Abstract
Introduction. Excessive body mass in turn may contribute to the development of many health disorders including disorders of musculoskeletal system, which still develops intensively at that time. Aim. The aim of this study was to assess the relationship between children's body mass composition and body posture. The relationship between physical activity level of children and the parameters characterizing their posture was also evaluated. Material and Methods. 120 school age children between 11 and 13 years were enrolled in the study, including 61 girls and 59 boys. Each study participant had the posture evaluated with the photogrammetric method using the projection moiré phenomenon. Moreover, body mass composition and the level of physical activity were evaluated. Results. Children with the lowest content of muscle tissue showed the highest difference in the height of the inferior angles of the scapulas in the coronal plane. Children with excessive body fat had less slope of the thoracic-lumbar spine, greater difference in the depth of the inferior angles of the scapula, and greater angle of the shoulder line. The individuals with higher level of physical activity have a smaller angle of body inclination. Conclusion. The content of muscle tissue, adipose tissue, and physical activity level determines the variability of the parameter characterizing the body posture.
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Affiliation(s)
- Justyna Wyszyńska
- Medical Faculty, University of Rzeszów, 26 Warszawska Street, 35-205 Rzeszów, Poland
| | | | - Justyna Drzał-Grabiec
- Medical Faculty, University of Rzeszów, 26 Warszawska Street, 35-205 Rzeszów, Poland
| | - Maciej Rachwał
- Medical Faculty, University of Rzeszów, 26 Warszawska Street, 35-205 Rzeszów, Poland
| | - Joanna Baran
- Medical Faculty, University of Rzeszów, 26 Warszawska Street, 35-205 Rzeszów, Poland
| | | | - Justyna Leszczak
- Medical Faculty, University of Rzeszów, 26 Warszawska Street, 35-205 Rzeszów, Poland
| | - Artur Mazur
- Medical Faculty, University of Rzeszów, 26 Warszawska Street, 35-205 Rzeszów, Poland
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von Hippel PT, Bradbury WK. The effects of school physical education grants on obesity, fitness, and academic achievement. Prev Med 2015; 78:44-51. [PMID: 26163396 DOI: 10.1016/j.ypmed.2015.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 04/30/2015] [Accepted: 06/24/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Foundations and governments fund a number of programs that provide grants to improve school physical education or other forms of school-based physical activity. The effects of these grant programs are unknown. We evaluate the effects of Texas Fitness Now, a program in which the state of Texas granted $37 million to improve physical education in high-poverty middle schools over the 4 school years from 2007-08 to 2010-11. The stated goals of Texas Fitness Now were to reduce obesity, increase fitness, and raise academic achievement. METHOD We summarize how Texas Fitness Now funds were spent and estimate the impact of Texas Fitness Now using a fixed-effects longitudinal model that exploits changes in schools' eligibility over time. Changes in eligibility occurred when eligibility expanded to new schools after year 2 and when the program was terminated after year 4. RESULTS Most Texas Fitness Now funds were spent on sports and fitness equipment. Smaller amounts were spent on anti-obesity curricula. Texas Fitness Now improved strength and flexibility, especially among girls, but it did not improve BMI or academic achievement, and it had mixed effects on aerobic capacity. The fitness benefits were not lost in the year after the program ended, perhaps because schools kept the equipment that they had bought during their years of eligibility. CONCLUSION The results of Texas Fitness Now were typical for an intervention that relied almost exclusively on physical activity. Programs that improve BMI as well as fitness tend to have a more fully developed nutrition component.
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Affiliation(s)
- Paul T von Hippel
- Center for Health and Social Policy, LBJ School of Public Affairs, University of Texas, Austin, TX, USA.
| | - W Kyle Bradbury
- Center for Health and Social Policy, LBJ School of Public Affairs, University of Texas, Austin, TX, USA
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Sparrey CJ, Bailey JF, Safaee M, Clark AJ, Lafage V, Schwab F, Smith JS, Ames CP. Etiology of lumbar lordosis and its pathophysiology: a review of the evolution of lumbar lordosis, and the mechanics and biology of lumbar degeneration. Neurosurg Focus 2015; 36:E1. [PMID: 24785474 DOI: 10.3171/2014.1.focus13551] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The goal of this review is to discuss the mechanisms of postural degeneration, particularly the loss of lumbar lordosis commonly observed in the elderly in the context of evolution, mechanical, and biological studies of the human spine and to synthesize recent research findings to clinical management of postural malalignment. Lumbar lordosis is unique to the human spine and is necessary to facilitate our upright posture. However, decreased lumbar lordosis and increased thoracic kyphosis are hallmarks of an aging human spinal column. The unique upright posture and lordotic lumbar curvature of the human spine suggest that an understanding of the evolution of the human spinal column, and the unique anatomical features that support lumbar lordosis may provide insight into spine health and degeneration. Considering evolution of the skeleton in isolation from other scientific studies provides a limited picture for clinicians. The evolution and development of human lumbar lordosis highlight the interdependence of pelvic structure and lumbar lordosis. Studies of fossils of human lineage demonstrate a convergence on the degree of lumbar lordosis and the number of lumbar vertebrae in modern Homo sapiens. Evolution and spine mechanics research show that lumbar lordosis is dictated by pelvic incidence, spinal musculature, vertebral wedging, and disc health. The evolution, mechanics, and biology research all point to the importance of spinal posture and flexibility in supporting optimal health. However, surgical management of postural deformity has focused on restoring posture at the expense of flexibility. It is possible that the need for complex and costly spinal fixation can be eliminated by developing tools for early identification of patients at risk for postural deformities through patient history (genetics, mechanics, and environmental exposure) and tracking postural changes over time.
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Affiliation(s)
- Carolyn J Sparrey
- Mechatronic Systems Engineering, Simon Fraser University, Surrey, British Columbia, Canada
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Pryce R, Kriellaars D. Body segment inertial parameters and low back load in individuals with central adiposity. J Biomech 2014; 47:3080-6. [DOI: 10.1016/j.jbiomech.2014.06.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 06/10/2014] [Accepted: 06/24/2014] [Indexed: 10/25/2022]
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Abstract
Evidence suggests that the growing prevalence of obesity in the workforce has resulted in an increase in the incidence and cost of musculoskeletal injuries. Obesity can modify job demands and affect worker capacity in terms of anthropometry and occupational biomechanics, which may place workers at greater risk of injury. This paper presents a review of studies quantifying the work-relevant impacts of obesity, specifically related to work task demands, capacities, and their potential imbalance. The increased body fat that accompanies obesity leads to larger anthropometric dimensions and inertial parameters, particularly in the trunk and thigh areas. Consequently, individuals who are obese adjust their work postures and motions as an accommodation. These changes may affect the biomechanical demands on the joints and increase the burden on the musculoskeletal system. Independent of job demands, obesity-related differences also occur with respect to strength, fatigue, and task performance. Directions for future research are provided, focusing on the need for workplace redesign to account for changing workforce demographics.
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Affiliation(s)
- Lora A Cavuoto
- Department of Industrial and Systems Engineering, University at Buffalo, 324 Bell Hall, Buffalo, NY, 14221, USA.
| | - Maury A Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
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Ponta ML, Gozza M, Giacinto J, Gradaschi R, Adami GF. Effects of Obesity on Posture and Walking: Study Prior to and Following Surgically Induced Weight Loss. Obes Surg 2014; 24:1915-20. [DOI: 10.1007/s11695-014-1254-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Atchison JW, Vincent HK. Obesity and low back pain: relationships and treatment. Pain Manag 2014; 2:79-86. [PMID: 24654621 DOI: 10.2217/pmt.11.64] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
SUMMARY Low back pain (LBP) and obesity (defined as BMI ≥30 kg/m(2)) are common problems in the general population. The treatment of LBP is not clearly defined and has variable success in different populations and time-frames. When a person presents with LBP who also meets the criteria for obesity, many questions are raised as to the value of weight-loss treatments and the success and/or safety of usual treatments of LBP, especially exercise. Based on the current medical literature for the treatment of LBP in patients who are obese: there should be attempts at weight loss (nonsurgical or surgical), especially if the person is in the morbidly obese (BMI >40 kg/m(2)) range; all usual forms of exercise and physical therapy treatments are possible and can be beneficial without increased concerns for injury; and, if necessary, invasive treatments such as spinal injections or surgery are potentially beneficial and have similar complication rates to the nonobese population. These options should be offered when medically necessary and appropriate.
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Affiliation(s)
- James W Atchison
- Department of Orthopedics & Rehabilitation, Interdisciplinary Center for Musculoskeletal Training & Research, University of Florida, Gainesville, FL 32611, USA
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Does reduction mammaplasty revert skeletal disturbances in the vertebral column of patients with macromastia? A preliminary study. Aesthetic Plast Surg 2014; 38:104-112. [PMID: 23949126 DOI: 10.1007/s00266-013-0194-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 07/11/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Enlarged breasts are associated with many physical and psychological symptoms. It is important to use objective criteria in documenting physical changes of a patient's body due to enlarged breasts and the benefits of surgery. This preliminary study aimed to determine whether the reduction mammaplasty procedure changes the angles of cervical lordosis, thoracic kyphosis, and lumbar lordosis. METHODS The study population consisted of 22 patients who underwent breast reduction surgery. All the patients had lateral cervicothoracolumbar radiographs taken preoperatively and at least 2 months postoperatively. Cervical lordosis, thoracic kyphosis, and lumbar lordosis angles, as well as sagittal balance, were examined. The body mass index (BMI), breast tissue volume, and excised tissue amount of each patient were recorded. RESULTS All the patients had increased cervical lordosis and thoracic kyphosis angles preoperatively, and the angles were significantly decreased postoperatively. Of the 22 patients, 7 had decreased and 8 had increased lumbar lordosis angles. All the lordosis angles showed significant improvement at the last examination. Seven patients had disturbed sagittal balance preoperatively, and all had normal sagittal balance postoperatively. Preoperative total breast tissue volume was positively correlated with the differences in cervical lordosis angles, BMI, preoperative cervical lordosis angles, and cervical lordosis angles. CONCLUSION Hypertrophic breasts are not only a cosmetic but also a functional problem complicated by pathologic conditions in the vertebral column such as increased cervical lordosis, thoracic kyphosis, and increased or decreased lumbar lordosis. Breast reduction may improve these pathologic angles. Reducing the nonphysiologic weight of enlarged breasts located anterior to the main axis of the body may correct pathologic angulation and disturbed sagittal balance of the vertebral column. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Pataky Z, Armand S, Müller-Pinget S, Golay A, Allet L. Effects of obesity on functional capacity. Obesity (Silver Spring) 2014; 22:56-62. [PMID: 23794214 DOI: 10.1002/oby.20514] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 05/05/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the relationships between BMI and walking speed, balance control, sit-to-stand performance (a measure of mass specific lower limb power), and endurance. DESIGN AND METHODS Thirty-six women with a BMI ≥ 30 kg/m(2) and 10 women with normal body weight (BMI between 18 kg/m(2) and 25 kg/m(2) ) were enrolled in this observational study. The obese group comprised 12 persons with a BMI ≥ 30 and <35 (obese), 14 subjects with a BMI ≥ 35 and <40 (severe obesity) and 10 people with a BMI ≥ 40 kg/m(2) (morbid obesity). All subjects underwent a clinical examination, a gait test, an endurance test (6 minutes walking test), a mass specific lower limb power test (five times sit-to-stand) and a balance test. RESULTS Obese women exhibited slower fast gait speeds (P < 0.05) with correspondingly shorter stride lengths, poorer sit-to-stand performance (P < 0.05), and endurance (P < 0.05). However, once the state of severe obesity was reached, additional weight gain (morbid obesity) does not seem to decrease these functional capacities any further. CONCLUSION This study underlines the importance of assessing obese patients' related physical problems in an early stage of obesity in order to focus exercise regimens and promote appropriate health behaviors.
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Affiliation(s)
- Zoltan Pataky
- Service of Therapeutic Education for Chronic Diseases, WHO Collaborating Centre, Department of Community Medicine, University Hospitals of Geneva, Geneva, Switzerland
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Silva AG, Sharples P, Johnson MI. Studies comparing surrogate measures for head posture in individuals with and without neck pain. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/174328810x12647087218631] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Godde K, Taylor RW. Distinguishing body mass and activity level from the lower limb: Can entheses diagnose obesity? Forensic Sci Int 2013; 226:303.e1-7. [DOI: 10.1016/j.forsciint.2013.01.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 07/27/2012] [Accepted: 01/22/2013] [Indexed: 11/29/2022]
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Abstract
During seated forward reaching tasks in obese individuals, excessive abdominal tissue can come into contact with the anterior thigh. This soft tissue apposition acts as a mechanical restriction, altering functional biomechanics at the hip, and causing difficulty in certain daily activities such as bending down, or picking up objects from the floor. The purpose of the study was to investigate the contact forces and associated moments exerted by the abdomen on the thigh during seated forward-reaching tasks in adult obese individuals. Ten healthy subjects (age 58.1 ± 4.4) with elevated BMI (39.04 ± 5.02) participated in the study. Contact pressures between the abdomen and thigh were measured using a Tekscan Conformat pressure-mapping sensor during forward-reaching tasks. Kinematic and force plate data were obtained using an infrared motion capture system. The mean abdomen-thigh contact force was 10.17 ± 5.18% of body weight, ranging from 57.8 N to 200 N. Net extensor moment at the hip decreased by mean 16.5 ± 6.44% after accounting for the moment generated by abdomen-thigh tissue contact. In obese individuals, abdomen-thigh contact decreases the net moment at the hip joint during seated forward-reaching activities. This phenomenon should be taken into consideration for accurate biomechanical modeling in these individuals.
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Romero-Vargas S, Zárate-Kalfópulos B, Otero-Cámara E, Rosales-Olivarez L, Alpízar-Aguirre A, Morales-Hernández E, Reyes-Sánchez A. The impact of body mass index and central obesity on the spino-pelvic parameters: a correlation study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2012; 22:878-82. [PMID: 23149493 DOI: 10.1007/s00586-012-2560-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Revised: 06/06/2012] [Accepted: 10/28/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Obesity is an increasing problem of epidemic proportion, and it is associated with various musculoskeletal disorders, including impairment of the spine. However, the relationship between obesity and spino-pelvic parameters remains to date unsupported by an objective measurement of the mechanical behavior of the spino-pelvic parameters depending on body mass index (BMI) and the presence of central obesity. Such analysis may provide a deeper understanding of this relationship. PURPOSE To assess whether BMI and central obesity are associated with modifications on spino-pelvic parameters and determine if exists any correlation between BMI and obesity with the type of lumbar lordosis (LL). METHODS A cross-sectional study with 200 participants was conducted. Parameters measured were LL, pelvic tilt, sacral slope, and pelvic incidence (PI), using lumbosacral radiographs in lateral view. Subjects were classified depending on BMI. In a secondary analysis, the subjects were categorized into two groups depending on the presence or not of elevated abdominal circumference. The categorical variables were compared using Chi-square test, and the mean values were compared using ANOVA and student t test. A Spearman correlation test was used to analyze the correlation between BMI categories and LL types. RESULTS From the total of participants, there were 51 (25.5 %) normal weight subjects, 93 (46.5 %) overweight, and 56 (28 %) obese individuals. The spino-pelvic parameters among these groups are practically equal. The correlation between the different BMI categories and LL types is poor 0.06 (P = 0.34). In a secondary analysis, grouping the participants in obese and non-obese, the results showed that obesity is modestly positively associated with increasing of spino-pelvic parameters values, in particular with PI (P = 0.078). The comparison made between the presence or not of central obesity, interestingly did not show significant differences. CONCLUSIONS Despite the results did not reach statistically significant differences, the results indicate that the obese spine is slightly different from the non-obese spine. Therefore, this relationship deserves future attention.
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Affiliation(s)
- S Romero-Vargas
- Spine Surgery Service, Instituto Nacional de Rehabilitación, Calzada México Xochimilco #289 Col. Arenal de Guadalupe, Zip Code 14389, Mexico City, Mexico
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