Obesity and walking

Source: Wikipedia, the free encyclopedia.

Obesity and walking describes how the locomotion of

thermic effect of food, non-exercise activity thermogenesis (NEAT), and exercise.[8] While many treatments for obesity are presented to the public, exercise in the form of walking is an easy, relatively safe activity. Walking may initially result in reduced weight, but adopting the habit over the long term may not result in additional weight loss.[9]

Biomechanics

Knee osteoarthritis and other joint pain are common complaints amongst obese individuals and are often a reason as to why exercise prescriptions such as walking are not continued after prescribed.[citation needed] To determine why an obese person might have more joint problems than a non-obese individual, the biomechanical parameters must be observed to see differences between obese and non-obese walking.[citation needed
]

Stride and cadence

Numerous studies have examined the differences in

velocities and find that they share a similar preferred walking speed with lean individuals.[11][16][17]

Joint angle differences

In a study by DeVita and Hortobágyi, obese people were found to be more erect throughout the stance phase with greater hip

plantarflexion during the course of stance than non-obese people.[12] They also found that obese individuals had less knee flexion in early stance and greater plantarflexion at toe off.[12] In a study looking at knee extension, Messier et al. found a significant positive correlation with maximum knee extension and BMI.[18] That same study looked at mean angular velocities at the hip and ankle and found no difference between obese and lean individuals.[18]

Ground reaction force

A

anteroposterior and mediolateral forces.[18] Because of the study population, this study did not compare obese adults with lean counterparts. Browning and Kram in 2006 observed two groups (one obese and one non-obese group) of young adult’s ground reaction forces across different speeds. They found that absolute ground reaction forces were significantly greater for the obese people than the non-obese group at slower walking speeds and at each walking speed the peak vertical force was approximately 60% greater.[11] Absolute peak in the anteroposterior and mediolateral directions were also greater for the obese group but the difference was erased when scaled to body weight.[11] Forces were also greatly reduced at slower walking speeds.[11]

Net muscle moments

Lower extremity joint loading is estimated through net muscle moments, joint reaction forces, and joint loading rates. Net muscle moments can increase up to 40% as walking speeds rise from 1.2 to 1.5 m/s.[19] One could then predict that as speed increases, loads felt by the lower-extremity joints would increase as the net muscle moments and ground reaction forces increase. Browning and Kram have also found that stance-phase sagittal-plane net muscle moments are greater in obese adults when compared to lean individuals.[11]

Energetics

Metabolic rate

It is well established that obese individuals expend a greater amount of

adipose distribution did not matter, overall body composition of percent body fat was related to net metabolic rate.[16]
Therefore, obese individuals are using more metabolic energy than their lean counterparts when walking at the same speed.

Normalization

Many measurements are normalized to body weight in order to account for differing body weights when doing comparisons (see VO2 max testing). Normalizing body weight when comparing obese and lean individuals' metabolic rates reduces the difference, indicating that body weight rather than body fat composition is the primary indicator for the metabolic cost of walking.[24] Caution must be taken when analyzing the scientific literature to understand if findings are normalized or not because they may be interpreted differently.

Possible strategies

One possible suggested strategy to maximize energy expenditure while reducing lower joint extremity is to have obese people walk at a slow speed with an incline. Researchers found that by walking at either 0.5 or 0.75 m/s and a 9° or 6° incline respectively would equate to the same net metabolic rate as an obese individual walking at 1.50 m/s with no incline.[25] These slower speeds with an incline also had significantly reduced loading rates and reduced lower-extremity net muscle moments.[25] Other strategies to consider are slow walking for extended periods of time and training underwater to reduce loads on joints and increase lean body mass.[26]

Limitations working with obese individuals as study participants

It is often very difficult to recruit obese people that do not have other

X-rays
have improved the placement of these biomechanical markers, but variability still remains and should be taken into account when analyzing scientific findings.

See also

References

  1. ^ Flegal K, Carroll M, Ogden C, and Curtin L. Prevalence and trends in obesity among US adults, 1999–2008. JAMA 303(3): 235–241, 2010.
  2. ^ Wang Y and Beydoun M. The obesity epidemic in the United States-gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis. Epidemiol Rev 29(1): 6–28, 2007.
  3. ^ Vague J, Vague P, Tramoni M, Vialettes B, and Mercier P. Obesity and diabetes. Acta Diabetologica 17(2): 87–99, 1980.
  4. ^ Sowers, J. Obesity and cardiovascular disease. Clin Chem. 44:1821–1825, 1998.
  5. ^ Calle E and Thun M. Obesity and cancer. Oncogene 23: 6365–6378, 2004.
  6. ^ Wolk R, Shamsuzzaman A, and Somers V. Obesity, sleep apnea, and hypertension. Hypertension 42: 1067–1074, 2003.
  7. ^ Felson D, Anderson J, Naimark A, Walker A, and Meenan M. Obesity and knee osteoarthritis; The Framingham study. Ann Intern Med 109:18–24, 1988.
  8. ^ Levine J, Weg M, Hill J, and Klesges R. Non-exercise activity thermogenesis; The crouching tiger hidden dragon of societal weight gain. Arterioscler Thromb Vasc Biol 26:729–736, 2006.
  9. ^ Jakicic J, Winters C, Lang W, and Wing R. Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women. JAMA 282(16): 1554–1560, 1999.
  10. ^ a b c Spyropoulos, P., J. C. Pisciotta, K. N. Pavlou, M. A. Cairns, and S. R. Simon. Biomechanical gait analysis in obese men. Arch. Phys. Med. Rehabil. 72:1065–1070, 1991.
  11. ^ a b c d e f g h Browning RC and Kram R. Effects of obesity on the biomechanics of walking at different speeds. Med Scie Sports Exerc 39(9): 1632–1641, 2007.
  12. ^ a b c DeVita P and Hortobagyi T. Obesity is not associated with increased knee joint torque and power during level walking. J Biomech 36: 1355–1362, 2003.
  13. ^ a b Hills AP, Parker AW. Locomotor characteristics of obese children. Child Care Health Dev 1992;18:29–34.
  14. ^ Ledin T, Odkvist LM. Effects of increased inertial load in dynamic and randomized perturbed posturography. Acta Otolaryngol 1993;113:249–52.
  15. ^ a b McGraw, B., McClenaghan, B.A., Williams, H.G., Dickerson, J., Ward, D.S. Gait and postural stability in obese and nonobese prepubertal boys. Archives of Physical Medicine and Rehabilitation 81: 484–489, 2000.
  16. ^ a b c Browning, RC., EA. Baker, JA. Herron, and R. Kram. Effects of obesity and sex on the energetic cost and preferred speed of walking. J. Appl. Phys. 100:390–398, 2006.
  17. ^ a b Browning RC and Kram R. Energetic cost and preferred speed of walking in obese vs. normal weight women. Obes Res 13: 891–899, 2005.
  18. ^ a b c d e Messier, S. P., W. H. Ettinger, and T. E. Doyle. Obesity: effects on gait in an osteoarthritic population. J. Appl. Biomech. 12: 161–172, 1996.
  19. ^ Lelas JL, Merriman GJ, Riley PO, and Kerrigan DC. Predicting peak kinematic and kinetic parameters from gait speed. Gait & Posture 17: 106–112, 2003.
  20. ^ Bloom WL and Marshall FE. The comparison of energy expenditure in the obese and lean. Metabolism 16: 685–692, 1967.
  21. ^ Melanson EL, Bell ML, Knoll JR, Coelho LB, Donahoo WT, Peters JC, and Hill JO. Body mass index and sex influence the energy cost of walking at self-selected speeds (Abstract). Med Sci Sports Exerc 35: S183, 2003.
  22. PMID 27184275.{{cite journal}}: CS1 maint: multiple names: authors list (link
    )
  23. ^ Foster GD, Wadden TA, Kendrick ZV, Letizia KA, Lander DP, and Conill AM. The energy cost of walking before and after significant weight loss. Med Sci Sports Exerc 27: 888–894, 1995.
  24. ^ Ayub BV and Bar-Or O. Energy cost of walking in boys who differ in adiposity but are matched for body mass. Med Sci Sports Exerc 35: 669–674, 2003.
  25. ^ a b Ehlen K, Reiser R, and Browning RC. Energetics and biomechanics of inclined treadmill walking in obese adults. Med Scie Sports Exerc 43(7): 1251–1259, 2011.
  26. ^ Greene N, Lambert B, Greene E, Carbuhn A, Green J, and Crouse S. Comparative efficacy of water and land treadmill training for overweight or obese adults. Med Sci Sports Exerc 41(9):1808–1815, 2009.
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